MBRRACE-UK: Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK
THIS IS NOT THE MBRRACE-UK ONLINE REPORTING SYSTEM. IF YOU WISH TO REPORT A CASE PLEASE GO TO: www.mbrrace.ox.ac.uk
MBRRACE-UK release “Saving Lives, Improving Mothers’ Care”
The fifth annual MBRRACE-UK report of “Saving Lives, Improving Mothers’ Care” is published today (1st November 2018). The number of women dying as a consequence of complications during or after pregnancy remains low in the UK - fewer than 10 of every 100,000 pregnant women die in pregnancy or around childbirth. However, there are striking inequalities: black women are five times and Asian women two times more likely to die as a result of complications in pregnancy than white women and urgent research and action to understand these disparities is needed.
Heart disease remains the leading cause of women dying during pregnancy or up to six weeks after giving birth, followed by blood clots. Maternal suicide is the fifth most common cause of women’s deaths during pregnancy and its immediate aftermath, but is the leading cause of death over the first year after pregnancy. Although there is greater awareness of the importance of mental health during pregnancy and in the first year after birth, there is still a long way to go in recognising symptoms, supporting women with mental health problems and providing access to specialist perinatal mental health care.
The report highlights the risk of blood clots, particularly among women who are overweight or obese, and emphasises the importance of awareness of symptoms, such as leg or buttock pain and breathlessness even in early pregnancy.
Women who are aged 40 or over have three times the risk of dying during or after pregnancy compared to women in their early 20s and although cancer in pregnancy is uncommon, women and their doctors and midwives need to be aware that it can happen.
The report emphasises the importance of considering the benefits of starting or continuing medication to treat physical and mental health conditions during pregnancy, as well as the risks. Many medicines are safe in pregnancy, and so ensuring a woman is properly treated while pregnant may be the best way to care for both her and her baby.
To read more you can download the full report, lay summary and the infograpic here: https://www.npeu.ox.ac.uk/mbrrace-uk/reports
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MBRRACE-UK release “Perinatal Mortality Surveillance for Births in 2016
The Perinatal Mortality Surveillance Report for Births in 2016 is published today (15th June 2018). Whilst the overall perinatal mortality rate is essentially unchanged since last year, compared with 2013, when MBRRACE-UK started reporting, the rate has decreased overall. Importantly the stillbirth rate for twins has nearly halved since 2014 and although the decrease in neonatal deaths in twins is smaller at 30% both represent a statistically significant change which indicates these reductions are unlikely to be due to chance.
Variations in rates between Trusts and Health Boards remain, although the variation in the stillbirth rate between Trusts and Health Boards delivering similar levels of care is now less marked than in the past. Nevertheless, there is still room for improvement as our average rate of stillbirths and neonatal deaths is still higher than in many other similar European countries. This fact, together with the findings from recent MBRRACE-UK confidential enquiries, suggest that with further improvements to the organisation and systems of care provided to mothers and their babies, a continuing reduction mortality rates is indeed possible.
To read more you can download the full report, executive summary and the infograhpic on the reports page.
'MBRRACE-UK' is the collaboration appointed by the Healthcare Quality Improvement Partnership (HQIP) to run the national Maternal, Newborn and Infant clinical Outcome Review Programme (MNI-CORP) which continues the national programme of work conducting surveillance and investigating the causes of maternal deaths, stillbirths and infant deaths.
The aim of the MNI-CORP MBRRACE-UK programme is to provide robust national information to support the delivery of safe, equitable, high quality, patient-centred maternal, newborn and infant health services.
MBRRACE-UK achieves this by:
- Surveillance of all maternal deaths
- Confidential enquiries into maternal deaths during and up to one year after the end of the pregnancy
- Confidential enquiries into cases of serious maternal morbidity on a rolling basis
- Surveillance of perinatal deaths including late fetal losses (22-23 weeks gestation), stillbirths and neonatal deaths
- Confidential enquiries into stillbirths, infant deaths and cases of serious infant morbidity on a rolling basis
The scope MNI-CORP is a national programme which encompasses England, Wales, Scotland, Northern Ireland, Jersey, Guernsey and the Isle of Man
Duration of the programme: MBRRACE-UK were commissioned to run the programme from May 2012 to March 2017; following a further competitive re-commissioning round the programme has been extended to run until 30th September 2021.
Funding: The MNI-CORP programme is commissioned by HQIP on behalf of NHS England, NHS Wales, the Health and Social Care Division of the Scottish government, the Department of Health, Social Services and Public Safety, Northern Ireland (DHSSPS), the States of Jersey, Guernsey, and the Isle of Man.
Notifications of maternal deaths should be made by ringing the Oxford MBRRACE-UK office on 01865 289715.
Reporting of stillbirths, perinatal deaths and infant deaths is via the MBRRACE-UK online reporting system available here: www.mbrrace.ox.ac.uk. Guidelines for using the system can be downloaded here: MBRRACE online data entry guidebook (release April 2013 v101) .
Units are asked to review their access to the internet to ensure that the web browser they are using meets the specifications required to enter data via the MBRRACE-UK system; older versions of software are not suitable as they do not meet NHS data security requirements. Please view the IT specification page to check this for your Unit.
Please also view the MBRRACE-UK IT deployment page which outlines more information about the deployment of the MBRRACE-UK data collection system and may be helpful for IT staff in Units.
Information about why we are collecting non-anonymised information and details about the approvals we have to collect this information is provided on the 'Why we need identifiers' page.
The topics selected for future confidential enquiries are available on the Topics page.
Please also see our Frequently Asked Questions page.
Assessors for the Confidential Enquiries into Maternal and Infant Deaths
With the exception of a small number of specific specialties we have recruited most assessors for the Confidential Enquiries into Maternal Death and the current perinatal confidential enquiry. Any future positions will be advertised here.