This report reviews perinatal mortality over a variety of time periods (from 33 years to 15 years), depending on the dataset and describes some of the changes since data collection started. The data is collected across Scotland and therefore represents changes in the whole population. Source agency: ISD Scotland (part of NHS National Services Scotland) Designation: National Statistics Language: English Alternative title: Scottish Perinatal and Infant Mortality and Morbidity Report

In 2021, the birth rate per 1,000 population in Scotland was ***, compared with *** in the previous year. Between 1999 and 2002 the birth rate in Scotland fell from **** to ****, followed by a brief period of increasing birth rates between 2002 and 2008 before starting to decline afterward.

In later years, information on certain congenital anomalies occurring in live births, stillbirths, miscarriages and terminations had also been included. In 2011, a more detailed data collection form was used and a new system for classifying the cause of death was introduced. The quality and completeness of information improved and causes of death reflected modern practice and knowledge.

a For the >32 weeks category, figs for the Netherlands were too small to be reported for two of the gestational age groupings.b Only linkable infants included.Unadjusted mortality rates (%) within 30 days: by gestational age.

The child mortality rate in the United Kingdom, for children under the age of five, was 329 deaths per thousand births in 1800. This means that approximately one in every three children born in 1800 did not make it to their fifth birthday. Over the course of the next 220 years, this number has dropped drastically, particularly in the first half of the twentieth century, and the rate has dropped to its lowest point ever in 2020 where it is just four deaths per thousand births.

National Records of Scotland Guidance;What is ‘period’ life expectancyAll of the estimates presented in this report are ‘period’ life expectancy. They are calculated assuming that mortality rates for each age group in the time period (here 2021-2023) are constant throughout a person’s life. Period life expectancy is often described as how long a baby born now could expect to live if they experienced today’s mortality rates throughout their lifetime. It is very unlikely that this would be the case as it means that future changes in things such as medicine and legislation are not taken into consideration.Period life expectancy is not an accurate prediction of how long a person born today will actually live, but it is a useful measure of population health at a point in time and is most useful for comparing trends over time, between areas of a country and with other countries.How national life expectancy is calculatedThe latest life expectancy figures are calculated from the mid-year population estimates for Scotland and the number of deaths registered in Scotland during 2021, 2022, and 2023. Life expectancy for Scotland is calculated for each year of age and represents the average number of years that someone of that age could expect to live if death rates for each age group remained constant over their lifetime. Life expectancy in Scotland is calculated as a three-year average, produced by combining deaths and population data for the three-year period. Three years of data are needed to provide large enough numbers to make these figures accurate and lessen the effect of very ‘good’ or ‘bad’ years. Throughout this publication, the latest life expectancy figures refer to 2021-2023 period. How sub-national life expectancy is calculatedWe calculate life expectancy for areas within Scotland using a very similar method to the national figures but with a few key differences. Firstly, we use age groups rather than single year of age. This is to increase the population size of each age group to reduce fluctuations and ensure accurate calculation of mortality rates. Secondly, we use a maximum age group of 90+ whereas the national figures are calculated up to age 100. These are known as ‘abridged life tables.’ Because these methods produce slightly different figures, we also calculate a Scotland figure using the abridged method to allow for accurate comparisons between local areas for example. This Scotland figure is only for comparison and does not replace the headline national figure. You can read more information about the methods in this publication in our methodology guide on the NRS website. Uses of life expectancyLife expectancy at birth is a very useful indicator of mortality conditions across a population at a particular point in time. It also provides an objective means of comparing trends in mortality over time, between areas of a country and with other countries. This is used to monitor and investigate health inequalities and to set public health targets. Life expectancy is also used to inform pensions policy, research and teaching.

A confidence interval: 95%.a The first hospital episode (FHE) starts at the day of birth and includes all continuous hospital days, including transfers between different hospitals.Risk adjusted average number of hospital days during FHE.a

The Scottish Stillbirth and Infant Death Survey (SSBIDS) collects additional information on stillbirths, neonatal deaths and late fetal deaths.

Number of infant deaths (stillbirth, perinatal and those aged under 1 year old).

There were 12,129 births registered in Scotland between 1 January and 31 March 2022. This is 4.3 per cent lower than the quarter one average of 12,676. At 16,179 the number of deaths in 2022 quarter one is 0.9 per cent lower than the quarter one average of 16,329. The age-standardised mortality rate for the four-quarter period ending in 2022 quarter 1 was 2.3 per cent lower than the previous four-quarter period (ending 2021 quarter 4). This rate takes into account the growing and ageing population and is therefore the best indicator of the direction of the mortality trend.
There were 48 stillbirths (3.9 per 1000 live and still births), 10 per cent below the quarter one average. There were 43 infant deaths (3.5 per 1000 live births), 7% lower than the quarter one average. There were 3,666 marriages. This was 21% higher than the average number of first quarter marriages. There were 129 same-sex marriages, compared with a five-year average of 123. Since June 2021 mixed-sex couples have been able to form a civil partnership. Of the 118 civil partnerships registered in the first quarter of 2022, 96 involved mixed-sex couples. There were 22 same-sex civil partnerships, compared with a five-year average of 14.

aThe Netherlands: 2006–2007, Norway: 2008–2009bThe European Perinatal Health Report 2008 is based on data from 2004, incidence figs are per 100 live-born infantscThe linkage is between MBR and Cause of Death Registry. The linkage with the HDR for LoS analysis was 65%dThe linkage is between MBR and Cause of Death Registry. The linkage with the HDR for LoS analysis was 58%Number and proportion of VLBW and VLGA infants among live-born infants in EuroHOPE data.

There were 11,237 births registered in Scotland between 1 April and 30 June 2022. This is 11.5 per cent lower than the quarter two average of 12,702. At 14,982 the number of deaths in 2022 quarter two is 9.7 per cent higher than the quarter two average of 13,660 The age-standardised mortality rate for the four-quarter period ending in 2022 quarter 2 was 1.5 per cent higher than the previous four-quarter period (ending 2022 quarter 1). This rate takes into account the growing and ageing population and is therefore the best indicator of the direction of the mortality trend.
There were 36 stillbirths (3.2 per 1000 live and still births), 26.8 per cent below the quarter two average. There were 46 infant deaths (4.1 per 1000 live births), 12.2% higher than the quarter two average. There were 9,331 marriages. This was 25.9% higher than the recent average, and the highest number of second quarter marriages since 1993. There were 340 same-sex marriages, compared with a five-year average of 236. Since June 2021 mixed-sex couples have been able to form a civil partnership. Of the 157 civil partnerships registered in the second quarter of 2022, 135 involved mixed-sex couples. There were 22 same-sex civil partnerships, compared with a five-year average of 16.

In 2021 the live birth rate of the United Kingdom fell to 10.4 births per 1,000 population, the lowest it had been during this time period. The UK's birth rate has been declining steadily since 2010 when the birth rate was 12.9 births per 1,000 population. After 1938, the year with the highest birth rate in the UK was 1947, when the crude birth rate was 21.2 births per 1,000 population. Under two children per mother in 2021 The most recent crude live birth rate for this statistic is based on the 694,685 births, that occurred in 2021 as well as the mid-year population estimate of 67 million for the United Kingdom. It has a close relation to the fertility rate which estimates the average number of children women are expected to have in their lifetime, which was 1.53 in this reporting year. Among the constituent countries of the UK, Northern Ireland had the highest birth rate at 11.6, followed by England at 10.5, Wales at 9.3, and Scotland at 8.7. International comparisons The UK is not alone in seeing its birth and fertility rates decline dramatically in recent decades. Across the globe, fertility rates have fallen noticeably since the 1960s, with the fertility rate for Asia, Europe, and the Americas being below two in 2021. As of this year, the global fertility rate was 2.31, and was by far the highest in Africa, which had a fertility rate of 4.12, although this too has fallen from a high of 6.72 in the late 1960s. A reduction in infant mortality, as well as better access to contraception, are factors that have typically influenced declining fertility rates recently.

Annual data on death registrations by area of usual residence in the UK. Summary tables including age-standardised mortality rates.

In 2021/23, life expectancy at birth in Scotland was 80.8 years for women and 76.78 years for men. For people aged 65 in Scotland life expectancy was 19.7 years for women and 17.52 years for men.

There were 11,692 births registered in Scotland between 1 July and 30 September 2022. This is 12.6 per cent lower than the quarter three average of 13,375. At 14,925 the number of deaths in 2022 quarter three is 10.2 per cent higher than the quarter three average of 13,549. The age-standardised mortality rate for the four-quarter period ending in 2022 quarter 3 was 0.8 per cent lower than the previous four-quarter period (ending 2022 quarter 2). This rate takes into account the growing and ageing population and is therefore the best indicator of the direction of the mortality trend. There were 48 stillbirths (4.1 per 1000 live and still births), 8.4 per cent below the quarter three average. There were 34 infant deaths (2.9 per 1000 live births), 21.3% below the quarter three average. There were 10,658 marriages in quarter 3 of 2022. This was 1.8% higher than the recent average. There were 382 same-sex marriages, compared with a five-year average of 356. Since June 2021 mixed-sex couples have been able to form a civil partnership. Of the 185 civil partnerships registered in the third quarter of 2022, 156 involved mixed-sex couples. There were 29 same-sex civil partnerships, compared with a five-year average of 23.

According to reports from Kilmarnock, Scotland, in the eighteenth century, smallpox claimed the lives of 622* people between 1728 and 1763. The reports show us that almost 95 percent of these deaths were recorded among infants and children below the age of six years, and roughly two thirds of all smallpox deaths were recorded among those aged below three years. The disproportion between adult and child deaths due to smallpox was not unique to Kilmarnock at this time, as studies from Sweden and Switzerland show similar results; these studies and comparisons can be used to highlight the important role that vaccination has played in lowering the the infant and child mortality rates across Europe.

The objective of this paper was to compare health outcomes and hospital care use of very low birth weight (VLBW), and very preterm (VLGA) infants in seven European countries. Analysis was performed on linkable patient-level registry data from seven European countries between 2006 and 2008 (Finland, Hungary, Italy (the Province of Rome), the Netherlands, Norway, Scotland, and Sweden). Mortality and length of stay (LoS) were adjusted for differences in gestational age (GA), sex, intrauterine growth, Apgar score at five minutes, parity and multiple births. The analysis included 16,087 infants. Both the 30-day and one-year adjusted mortality rates were lowest in the Nordic countries (Finland, Sweden and Norway) and Scotland and highest in Hungary and the Netherlands. For survivors, the adjusted average LoS during the first year of life ranged from 56 days in the Netherlands and Scotland to 81 days in Hungary. There were large differences between European countries in mortality rates and LoS in VLBW and VLGA infants. Substantial data linkage problems were observed in most countries due to inadequate identification procedures at birth, which limit data validity and should be addressed by policy makers across Europe.

This file contains the infant death categorisations associated with the ICD10h (Historic cause of death coding and classification scheme for individual-level causes of death). ICD10h has been designed by the authors to aid the coding and classification of causes of death recorded on historic individual death records and associated files include a manual, the list of codes, descriptions and values of a general categorisation, and exemplar list of historic strings together with the ICD10h codes. The ICD10h system is based on the 10th revision of the International Classification of Diseases - 2016 version (ICD10 - 2016), and combines ICD10 codes (without modification) with new codes for archaic/historic terms.

The data was derived from the following projects/deposited data: Determining the Demography of Victorian Scotland Through Record Linkage, ESRC RES-000-23-0128 held at the Cambridge Group for the History of Population and Social Structure, University of Cambridge; P. Gunn and R. Kippen, ‘Household and Family Formation in Nineteenth-Century Tasmania, Dataset of 195 Thousand Births, 93 Thousand Deaths and 51 Thousand Marriages Registered in Tasmania, 1838-1899’, 2008.

The resource creation was supported by the following projects: Digitising Scotland/Scottish Health Informatics Project (funded by the ESRC); Studying Health in Port Cities (funded by The Netherlands Organisation for Scientific Research); The Great Leap (funded by COST-Action CA22116).

SHARING/ACCESS INFORMATION

This resource is available under a CC BY licence.

Recommended citation for this dataset: Alice Reid, Eilidh Garrett, Maria Hiltunen Maltesdotter, Angelique Janssens, 2024, ICD10h: Historic cause of death coding and classification scheme for individual-level causes of death – Infant Categorisations [https://doi.org/10.17863/CAM.109963]

Please see the associated resources: Historic cause of death coding and classification scheme for individual-level causes of death – manual [https://doi.org/10.17863/CAM.109960] Historic cause of death coding and classification scheme for individual-level causes of death – Codes [https://doi.org/10.17863/CAM.109961] Historic cause of death coding and classification scheme for individual-level causes of death – English language historic strings [https://doi.org/10.17863/CAM.109962]

ICD10h is a research tool created to facilitate the study of historical cause of death records and should not be used for any official purpose. It is based on the International Classification of Diseases, 10th Revision (ICD-10) version 2016 (Geneva: World Health Organization 2016) but is not a recognised version or extension of ICD-10 and is not authorised by WHO. However we have consulted with WHO: they recognise that ICD10h is a useful academic methodology and have not raised any objections to its creation. Data coded using ICD10h are not directly comparable with data coded in ICD-10, and the underlying or primary cause of death derived using the ICD10h methodology may be different from the underlying cause derived in ICD-10 according to the WHO rules. Please note that ICD-10 version 2016 is not the most recent version of ICD-10; and that WHO now recommend the use of ICD-11; a more advanced and detailed classification.

DATA & FILE OVERVIEW

ICD10h_InfantCat.xlsx Excel file consisting of 2 worksheets: 1) ReadMe sheet 2) InfantCat

Separate csv file for 2) containing the same information.

This file builds on a previous, unpublished version of ICD10h (dating from 2020). InfantCat2024 provides an updated version of the previous categorisation (InfantCat2020). Please see the Manual for detail of the changes.

METHODOLOGICAL INFORMATION

The data were hand-coded and subject to stringent algorithm-assisted tests.

DATA-SPECIFIC INFORMATION FOR: InfantCat

Number of variables: 4

Number of cases/rows: 14088

Variable List: IDMasterlist (unique ID number, same as Masterlist table) ICD10h (ICD10h code ) Infantcat2024 (Infantcat2024 category) Infantcat2020 (Infantcat2020 category)

BackgroundThere is limited evidence to support the use of customised centile charts to identify those at risk of stillbirth and infant death at term. We sought to determine birth weight thresholds at which mortality and morbidity increased and the predictive ability of noncustomised (accounting for gestational age and sex) and partially customised centiles (additionally accounting for maternal height and parity) to identify fetuses at risk.MethodsThis is a population-based linkage study of 979,912 term singleton pregnancies in Scotland, United Kingdom, between 1992 and 2010. The main exposures were noncustomised and partially customised birth weight centiles. The primary outcomes were infant death, stillbirth, overall mortality (infant and stillbirth), Apgar score