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Legislative Assembly for the ACT: 2005 Week 12 Hansard (Thursday, 20 October 2005) . . Page.. 4004 ..


Neonatal death, ACT & Australia. 1997 - 2003

ACT

Australia

Year

Live births

Neonatal Deaths

High 95% CI

Low 95% CI

ACT Rate

Live births

Neonatal Deaths

High 95% CI

Low 95% CI

Australian Rate

1997

4208

13

4.8

1.4

3.1

251745

805

3.4

3.0

3.2

1998

3982

21

7.5

3.0

5.3

249555

754

3.2

2.8

3.0

1999

4252

13

4.7

1.4

3.1

248839

849

3.6

3.2

3.4

2000

4064

14

5.2

1.6

3.4

249595

773

3.3

2.9

3.1

2001

3938

8

3.4

0.6

2.0

246332

802

3.5

3.0

3.3

2002

4112

11

4.3

1.1

2.7

250963

779

3.3

2.9

3.1

2003

4128

16

5.8

2.0

3.9 251126

732

3.1

2.7

2.9

Note: Rate per 1,000 livebirths.

Source: ABS ACT Deaths Data & ABS Causes of Death (3303.0)

There was no statistically significant difference between the ACT neonatal death rate and the Australian rate of 2.9 per 1,000 registered live births (95% Confidence Intervals: 2.7 – 3.1) in 2003.

In 2003, there were a number of neonatal deaths in the ACT resulting from extremely premature multiple births. These deaths alone account for the difference in rates between the ACT and Australia in 2003, and the difference in rates in the ACT over the last five years.

It should be noted that relatively small fluctuations in the number of deaths each year in the ACT impact markedly on annual rates. Thus, neonatal death rates for the ACT should not be reviewed on an annual basis, but examined over a minimum of five years (the ACT rate for the period 1997-2003 is 3.3/1000 and the rate for Australia for the same period is 3.2/1000). This issue also highlights the necessity to examine 95% confidence intervals when comparing ACT rates to national rates or rates for other states and territories.

In response to the question about Government actions to reduce the neonatal death rate, the ACT has a Fetal Medicine Unit that cares for high-risk pregnancies of women in the ACT and surrounding NSW and a tertiary level Centre for Newborn Care staffed by a dedicated group of Neonatologists and Neonatal Intensive Care Nurses. This combination provides a range of excellent services to the ACT and surrounding region.

The ACT Chief Health Officer closely monitors the infant, perinatal and neonatal death rates. The ACT Perinatal Death Database Committee provides an on-going collection of information about perinatal deaths within the ACT and information on perinatal deaths is reported bi-annually to the Clinical Audit Committee (an approved committee under the ACT Health Act 1993).

While neonatal death rates are a useful performance indicator for neonatal services in developing countries, in developed countries, the neonatal death rates have fallen to the point that their usefulness as an indicator of service performance has diminished. This is because a large proportion of the neonatal deaths that do occur are the result of serious birth defects or extreme prematurity, and as such may be unavoidable.

It is for these reasons that it is unlikely that we will see a considerable reduction in the ACT or Australian neonatal death rate and will continue to see fluctuations in rates in the ACT on an annual basis.



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