Perinatal deaths by PSANZ classification

Overview

Hospital maternity service levels are used to group hospitals with similar characteristics for comparative reporting and service planning purposes (see Glossary and explanatory notes). In NSW in 2021, 53.0% of perinatal deaths were among babies born in maternity service level 6 hospitals. The percentage of perinatal deaths attributed to congenital abnormalities was higher among babies born in maternity service level 6 hospitals (37.2%) compared to all other hospital maternity service levels, reflecting patterns of referral for diagnosis and treatment. Maternity service level 6 hospitals had lower rates of unexplained antepartum fetal deaths (6.6%) compared to other hospital maternity service levels, possibly due to better access to perinatal post-mortem services.

Perinatal deaths by PSANZ perinatal death classification and maternity service level, NSW 2021

By number of births

PSANZ-PDC Major category	Level 6	Level 5	Level 4	Level 3	Level 2	Public hospital¹	Private	Total NSW²
Congenital anomaly	174	50	17	6	0	247	18	265
Perinatal infection	19	16	n.p.	n.p.	0	n.p.	n.p.	44
Hypertension	16	5	7	0	0	28	0	28
Antepartum haemorrhage (APH)	22	15	7	n.p.	0	n.p.	n.p.	52
Maternal conditions	45	16	n.p.	n.p.	0	n.p.	n.p.	68
Complications of multiple pregnancy	34	n.p.	n.p.	0	0	45	6	51
Specific perinatal conditions	11	17	n.p.	n.p.	0	36	10	46
Hypoxic peripartum death	n.p.	6	n.p.	n.p.	0	n.p.	n.p.	21
Placental dysfunction or causative placental pathology	37	10	7	6	0	60	11	73
Spontaneous preterm labour or rupture of membranes (<37 weeks gestation)	69	22	13	6	0	110	8	118
Unexplained antepartum fetal death	31	22	25	n.p.	n.p.	93	17	110
Neonatal death without obstetric antecedent	n.p.	n.p.	n.p.	0	0	7	0	7
Total	468	190	96	n.p.	n.p.	798	82	883

By percentage of births

PSANZ-PDC Major category	Level 6	Level 5	Level 4	Level 3	Level 2	Public hospital¹	Private	Total NSW²
Congenital anomaly	37.2	26.3	17.7	14.0	0.0	31.0	22.0	30.0
Perinatal infection	4.1	8.4	n.p.	n.p.	0.0	n.p.	n.p.	5.0
Hypertension	3.4	2.6	7.3	0.0	0.0	3.5	0.0	3.2
Antepartum haemorrhage (APH)	4.7	7.9	7.3	n.p.	0.0	n.p.	n.p.	5.9
Maternal conditions	9.6	8.4	n.p.	n.p.	0.0	n.p.	n.p.	7.7
Complications of multiple pregnancy	7.3	n.p.	n.p.	0.0	0.0	5.6	7.3	5.8
Specific perinatal conditions	2.4	8.9	n.p.	n.p.	0.0	4.5	12.2	5.2
Hypoxic peripartum death	n.p.	3.2	n.p.	n.p.	0.0	n.p.	n.p.	2.4
Placental dysfunction or causative placental pathology	7.9	5.3	7.3	14.0	0.0	7.5	13.4	8.3
Spontaneous preterm labour or rupture of membranes (<37 weeks gestation)	14.7	11.6	13.5	14.0	0.0	13.8	9.8	13.4
Unexplained antepartum fetal death	6.6	11.6	26.0	n.p.	100.0	11.7	20.7	12.5
Neonatal death without obstetric antecedent	n.p.	n.p.	n.p.	0.0	0.0	0.9	0.0	0.8
Total	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0

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Notes

Source: Maternal and Child Health Register (SAPHaRI). Centre for Epidemiology and Evidence, NSW Ministry of Health.

Neonatal deaths comprise babies who were born and died in NSW, including babies who died after discharge or transfer from the hospital of birth. Maternity service levels are described in Explanatory notes.

Public total includes public hospitals with a maternity service level other than those specified in the table.
Total NSW includes births at home assisted by independent midwives and births at level 1 hospitals.
Cells with counts less than 5 are suppressed, and other cells may also be hidden to prevent back-calculation. These cells are marked with n.p.

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