COVID infection in mothers and babies “does not appear to have played a role” in the spike in neonatal deaths in Scotland during September.
A preliminary investigation found that the overall number of births in September was normal, but that the number of infants born prematurely was high compared to previous months and that this may have contributed to the unusual increase in the neonatal mortality rate.
The latest figures show that the number of deaths among newborns in October had fallen back to within expected thresholds, with 14 deaths and a mortality rate of 3.3 per 1000 live births.
Neonatal mortality is defined as a death within 28 days of birth.
The figures are monitored on a monthly basis for any abnormal fluctuations which could signal a wider problem.
A joint investigation by Public Health Scotland, the Scottish Government, the Scottish National Neonatal Network, and the Maternity and Children Quality Improvement Collaborative was triggered when the deaths in September of 21 infants pushed the neonatal mortality rate to 4.8 per 1000 live births, well beyond an upper warning threshold known as the “control limit”.
It was the first time since current records began in July 2017 that this had been breached.
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The spike came soon after confirmed Covid cases in Scotland had surged to a record 6,400 per day in early September, leading to speculation of a link with the virus.
Covid infections during pregnancy are associated with an increased risk of premature births and stillbirth, and concerns have previously been raised over “substantially lower” vaccine uptake among pregnant women.
However, initial findings appear to discount a link.
READ MORE: Investigation launched into abnormal spike in neonatal deaths
In its summary, PHS states: “Initial findings suggest that, overall, the number of births in September 2021 was at the expected level.
"Preliminary information on prematurity suggests that the number of babies born at less than 32 weeks gestation in September 2021 was at the upper end of monthly numbers seen in 2021 to date.
“This may contribute to the neonatal mortality rate, as prematurity is associated with an increased risk of neonatal death...there is no information at this stage to suggest that any of the neonatal deaths in September 2021 were due to Covid-19 infection of the baby.
“Likewise, preliminary review does not indicate that maternal Covid-19 infection played a role in these events.”
The vaccination status of the mothers of the infants who died is unknown and will not be released due to “patient confidentiality”.
Last week, NHS Greater Glasgow and Clyde issued an urgent appeal to expectant mothers to attend vaccine drop-in centres over the weekend amid concerns over an increase in the number of pregnant women being admitted to intensive care with Covid, the “vast majority” of whom were unvaccinated.
Chief Midwife Evelyn Frame said: “Some women who have become seriously unwell have had to have their baby delivered early, which is far from ideal.”
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For Scotland as a whole, data up to the end of September indicates that 99 women had been admitted to critical care within 21 days of testing positive for Covid during pregnancy. Of these women, 98 were unvaccinated.
Uptake is believed to have been hampered by mixed messaging and changing advice during the pandemic, with reports still persisting of pregnant women being turned away from clinics or urged by midwives to delay despite official guidance to get vaccinated.
Of the 1,342 mothers who gave birth in Scotland during September, 34 per cent were vaccinated but only 24% had received both doses, compared to around 60-70% of all women aged 18 to 39.
PHS says that more than 200,000 women have so far received the vaccine during pregnancy across the UK and US “with no concerning safety signals”.
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