Understanding the causes of neonatal deaths

The death of a baby is a truly devastating experience for any family to go through. While medical developments and hospital environments have reduced the likelihood of neonatal deaths, perinatal deaths and stillbirths in recent years, sadly birth still carries this unfortunate risk.

Research shared by Sands, one of the leading charities offering help after a neonatal death, revealed approximately 14 babies die before, during or shortly after birth in the UK every day. While this is thankfully a small percentage of the thousands of babies born each day, it is still a sobering statistic to consider.

In this article, we provide clarification of what a neonatal death is, outline some of the leading causes of these incidents, including some which are preventable or occur as a result of negligence, and what legal and emotional support is available for parents affected by these difficult circumstances.

What is classified as a neonatal death?

If a baby dies within 28 days of birth, it is classified as a neonatal death. The majority of these will occur within the first week of the baby’s life, which is also referred to as early neonatal death or perinatal death. Death between 7 days and 28 days of life is referred to as a late neonatal death.

Some key neonatal death statistics:

• In 2018, 2,020 babies died within the four weeks of their lives, which was a ratio of one death per 360 births
• Close to half of all neonatal deaths in England and Wales are the result of immaturity-related conditions
• It is estimated that 1 in every 7 babies is admitted to a neonatal unit every year due to being born prematurely (prior to 37 weeks) or being born unwell or injured
• In 2017, 41% of neonatal deaths were as a result of complications that occurred during the neonatal period; 36% were due to congenital anomalies and 12% were due to babies being born extremely prematurely

What is the difference between a neonatal death and a stillbirth?

A stillbirth is when a baby dies before birth but after 24 weeks of pregnancy. This is the key distinction between stillbirth and neonatal death, although they can result from similar causes and, in rare instances, negligence during antenatal care.

Stillbirths account for a larger percentage of infant deaths than in the neonatal period, with an occurrence rate of approximately 1 in every 250 births.

Indeed, stillbirths account for over half the deaths each year for children under the age of 1 in the UK. They are often deeply traumatic experiences, particularly as the mother will still need to give birth often knowing that their child has already passed away.

Of course, the death of an infant at any age is a tragedy, particularly if the cause of this was entirely preventable or due to a negligent act. In the next section, we will explore some of the most prominent causes of neonatal deaths.

What are the leading causes of neonatal deaths?

If a parent loses their child before, during or shortly after birth, they will often want to know why this has happened.

Studies into neonatal deaths have unearthed some of the leading causes and risk factors for these ill-fated incidents. These include:

Premature birth

If the baby is born prior to 37 weeks, this can raise the risks of neonatal or perinatal death. This is due to the potential of them to develop complications like:

• Respiratory distress syndrome (RDS) – a breathing difficulty which occurs because babies do not have a protein that prevents their lungs from collapsing
• Intraventricular haemorrhage (IVH) – bleeding in the brain
• Necrotizing enterocolitis (NEC) – a problem with the baby’s intestines
• Infections – due to their compromised immune systems, premature babies are at greater risk of developing potentially deadly diseases like meningitis, sepsis and pneumonia

Low birth weight

Low birth weights for babies have been strongly linked as a cause of neonatal deaths and infant mortality, with 173 deaths per 1,000 live births for babies born weighing less than 1.5kg recorded in 2012, compared to 1.3 per 1,000 babies born at normal birth weights.

Genetic disorders or birth defects

If a baby is born with a defect of the heart, brain or lungs which means they have not developed properly, or a genetic disorder passed on from the parents, these can lead to their death at an extremely young age.

In many cases, these instances cannot be prevented or addressed despite the best care and attention of the medical team. However, the professionals who provide the mother’s antenatal care should regularly monitor the baby to identify any signs of birth defects that might affect the child’s development or chances of survival following birth, helping to ensure they are given proper opportunity for effective treatment.

Birth injuries or complications

Complications or injuries that occur during birth can lead to the death of a baby in its first four weeks of life, or leave them with conditions that will require lifelong care and treatment. Common birth injuries leading to death include:

• Brain injuries, often as a result of oxygen starvation or physical trauma to the head of the baby during birth
• Meconium aspiration syndrome, where the stress of birth causes the baby to breathe in meconium into their lungs
• Umbilical cord prolapse, which can become trapped against the baby’s body during delivery
• Placental abruption, where the placenta separates from the uterus earlier than intended

In most circumstances, these injuries are unavoidable despite the best efforts of the doctors, midwives and other professionals supporting birth. However, they can occasionally occur as a result of negligence, either due to failure to monitor and identify any potential problems during antenatal care, or inappropriate care taken during labour and delivery.

Infections

If a bacterial infection is not identified or treated in the mother, this can pass from the vagina into the womb and can infect the baby, which in turn can lead to neonatal deaths and stillbirths. The most common infections include:

• Strep B
• E. coli
• Klebsiella
• Enterococcus
• Haemophilus influenza
• Chlamydia
• Mycoplasma/ureaplasma

The health of the mother

Characteristics and factors which affect the mother’s health and wellbeing can also increase the likelihood of a neonatal death occurring. Such factors may include:

• The age of the mother (births by mothers under 20 and over 40 have higher neonatal death rates)
• Maternal obesity
• Chronic health conditions
• Smoking during pregnancy
• Substance abuse

Negligent antenatal or neonatal care

Finally, although it is rare, if the medical professionals looking after the mother and baby both during pregnancy and following birth are negligent, whether that is the failure to monitor and address any signs of risk to the baby or inappropriate treatment of any kind, this can directly influence the likelihood of neonatal deaths.

This may also include circumstances where a baby is born in a poor condition, despite the best efforts and responsible care of its medical professionals, but then receives poor neonatal care leading to its death rather than recovery.

Where can you find support after a neonatal death?

If you or a loved one has been affected by the loss of a baby, there are a number of charities that have been established to support bereaved parents following a neonatal death.

Sands

For the past 40 years, Sands has been working with organisations across the UK on techniques to reduce the number of neonatal deaths and stillbirths, as well as offering dedicated support for parents and loved ones affected by these incidents.

Bliss

Bliss is regarded as the leading charity supporting the needs and treatment of the 100,000+ children each year that require neonatal care in UK hospitals.

The Lullaby Trust

The Lullaby Trust was created to offer emotional support for bereaved families following the death of an infant, as well as to raise awareness of sudden infant death.

Alongside these, on the NHS website you can find links to a large number of mental health helplines who can offer advice, support and reassurance following the loss of a child.

Claiming after an avoidable birth injury leads to death

The subject of neonatal deaths is never an easy one to discuss or even think about, but we hope that this article has helped you develop a stronger understanding of what it is and the most prevalent causes behind it.

As noted, in a large number of cases, a neonatal death cannot be prevented in spite of the best care and efforts provided by medical professionals. But, in isolated incidents, the inaction, negligence or inappropriate treatment of an infant or mother before, during or shortly following birth can directly contribute to the death of a baby.

If you have reason to believe your child’s death was the result of a negligent birth injury, our specialists will investigate this on your behalf to establish if there was any breach in your medical professional’s duty of care, and if this caused the avoidable death of your infant.

We understand the emotions involved in these delicate cases and go to every effort to support and guide you every step of the way, helping you achieve the closure, compensation and justice you are entitled to.

For more information, get in touch with our experts today.

Disclaimer

All content contained within this article is meant for general information only – this should not be treated as a substitute for medical advice from your doctor or another healthcare provider. If you require legal advice specific to your situation, please contact our team directly.

Gadsby Wicks is not liable for any diagnosis made from the content of this article, nor does it endorse any service or external site linked to within the article.

Always consult your GP if you are concerned about your health and wellbeing, or speak to us if you require legal advice.