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Overview

The final results for the babies born in 2018 who have been reported to Each Baby Counts are presented in Figure 1:

Figure 1: Final results for babies born in 2018 who were reported to the Each Baby Counts programme

651,587 term babies born in the UK in 2018

Arrow pointing downExclusions:
Ineligible babies (650 336) – babies who do not meet the Each Baby Counts criteria of stillbirth, early neonatal death and severe brain injury; also excluded are other potentially unreported babies (106)

1145 eligible babies reported

Arrow pointing downExclusions: Additional babies (n) were excluded for the following reasons: 
– Reports that were started but not completed by the lead reporter (52) 
– Centrally excluded (congenital or chromosomal abnormalities) (38) 

1055 completed reports following central exclusion for congenital or chromosomal abnormality 

Arrow pointing downCompleted reports not fully reviewed by Each Baby Counts reviewers before close of reporting period (281)

774 completed and fully reviewed reports

Arrow pointing downCompleted reports with insufficient information for reviewers to make an assessment of the care provided (87)

687 babies fully reported and the reviews appraised by at least 1 reviewer as containing sufficient information for assessment.

As part of the quality assurance process, the number of potentially unreported babies who still met the Each Baby Counts criteria in 2018 was estimated through cross-checks with other national datasets, specifically the MBRRACE-UK and the BadgerNet databases. The relevant units were then asked to provide information on babies meeting the Each Baby Counts case definition, but further information was not received for 106 potentially eligible babies identified through these sources. This proportion (9%) is higher than those in previous reports, no doubt owing to the programme pause to alleviate the undue burden on frontline clinicians who would need to be involved in the cross-checking process.

The information for these babies was not checked or completed by the trust or health board’s lead reporters before close of the reporting period. Historically, a large proportion of these notifications have been found to be duplicates, already reported, and babies with chromosomal congenital abnormalities, which would have subsequently gone on to be excluded. So the final impact on numbers tends to be minimal.

651 587 babies were born at term in the UK during 2018. 121 babies died during labour and a further 165 babies were born alive but died within the first week after birth (early neonatal deaths). A total of 859 babies met the Each Baby Counts criteria for babies born with severe brain injury diagnosed within the first 7 days of life:

  • diagnosed with grade III hypoxic-ischaemic encephalopathy (HIE), or
  • therapeutically cooled (active cooling only), or
  • had decreased central tone and was comatose and had seizures of any kind.

It should be noted that the Each Baby Counts definition of severe brain injury is based on the information that is available within the first 7 days after birth. At this point, the long-term implications are unknown. It is yet to be determined how many babies will go on to have long-term disability.

The proportion of babies born in 2018 who met the Each Baby Counts definition of stillbirth, early neonatal death or severe brain injury was 1 in every 569 term babies (1.76 per 1000 term births) (Table 1 and Figure 2).

Table 1: Babies reported to Each Baby Counts over time

 

2015

2016

2017

2018

Number of babies reported

1136

1123

1130

1145

Rate

1 in 637 (CI 600–675)

1 in 620 (CI 585–658)

1 in 599 (CI 565–636)

1 in 569 (CI 537–604)

Rate per 1000

1.57 (CI 1.48–1.66)

1.61 (CI 1.51–1.71)

1.67 (CI 1.57–1.77)

1.76 (CI 1.66–1.86)

95% confidence intervals presuming a normal distribution.

While the rates of babies reported year on year have increased slightly, there has been little change in the proportions of types of cases (Table 2).

How many babies?

Figure 2: Breakdown of babies reported to Each Baby Counts by eligibility (N = 1145)

Figure 2 for Each Baby Counts final progress report 2020

Note: These categories are mutually exclusive. Babies with a severe brain injury who died within the first 7 days of life are classified as early neonatal deaths.

The total number of babies that fulfilled the Each Baby Counts criteria in 2018 was 1145. Of these:

11% Intrapartum stillbirths
121 babies

14% Early neonatal deaths
165 babies

75% Severe brain injuries
859 babies

Table 2: Eligibility of cases reported to Each Baby Counts over time, with annual totals in brackets

 

2015
(1139)

2016
1123)

2017
(1130)

2018
(1145)

Stillbirth

126

124

130

121

Early neonatal deaths (0–6 days)

159

145

150

165

Severe brain injury

854

854

850

859