An investigation has been launched following an abnormal increase in deaths among newborn babies in Scotland.
21 babies died during September within 28 days of birth, according to official figures
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While infant death rates vary widely from month to month the increase was larger than expected from chance alone.
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Public Health Scotland (PHS) and other agencies are now looking into whether the Covid pandemic or other factors could be behind the increase.
Figures for the number of stillborn babies also increased in September.
Herald Scotland reports: Control and warning limits are designed to flag up to public health teams when neonatal, stillbirth or other infant deaths are occurring at unexpectedly high or low levels which may not be due to chance.
Concerns have previously been raised about the potential impact of Covid on maternity services and maternal wellbeing, but it is the first time since the pandemic began that neonatal deaths have been so abnormally above average.
Although the rate fluctuates month to month, the figure for September – at 4.9 per 1000 live births – is on a par with levels that were last typically seen in the late 1980s.
Public Health Scotland (PHS), which is one of the bodies currently investigating the spike, said the fact that the upper control limit has been exceeded “indicates there is a higher likelihood that there are factors beyond random variation that may have contributed to the number of deaths that occurred”.
PHS said it is working with the Scottish National Neonatal Network, the Maternity and Children Quality Improvement Collaborative and the Scottish Government “to understand any possible contributing factors to the most recent infant mortality patterns, and to incorporate findings into existing prevention and improvement work”.