Quality Declaration- Perinatal data, summary


Definition

Perinatal deaths statistics refer to all fetal (stillbirth) deaths of at least 20 weeks' gestation or at least 400 grams birth weight, and neonatal deaths (all live born babies who die within 28 days of birth, regardless of gestation or weight).

Institutional environment

Statistics on perinatal deaths presented in this publication are sourced from death registrations administered by the various state and territory Registry of Births, Deaths and Marriages. It is a legal requirement of each state and territory that all neonatal deaths and those fetal deaths of at least 20 weeks' gestation or 400 grams birth weight are registered. As part of the registration process, information on the cause of death is either supplied by the medical practitioner certifying the death on a Medical Certificate of Cause of Perinatal Death, or supplied as a result of a coronial investigation.

Death records are provided electronically and/or in paper form to the Australian Bureau of Statistics (ABS) by individual Registrars on a monthly basis. Each death record contains both demographic data and medical information from the Medical Certificate of Cause of Perinatal Death, where available. Information from coronial investigations are provided to the ABS through the National Coroners Information System (NCIS).

For further information on the institutional environment of the ABS, including the legislative obligations of the ABS, financing and governance arrangements, and mechanisms for scrutiny of ABS operations, please see ABS Institutional Environment.

Relevance

Perinatal statistics provide valuable information for the analysis of fetal, neonatal and perinatal deaths in Australia. This publication presents data at the national and state level on registered perinatal deaths by sex, state of usual residence, main condition in fetus/infant, main condition in mother and Aboriginal and Torres Strait Islander status. Fetal, neonatal and perinatal death rates are also provided.

The ABS Causes of Death collection includes all perinatal deaths that occurred and were registered in Australia, including deaths of persons whose usual residence is overseas. Deaths of Australian residents that occurred outside Australia may be registered by individual Registrars, but are not included in ABS deaths or perinatal deaths statistics.

This publication only includes information on registered fetal and neonatal deaths. This scope differs from other Australian data sources on perinatal deaths including the National Perinatal Mortality Collection, which sources data via state and territory perinatal committees directly through hospital and health centres.

Since the 2006 reference year, the scope of the perinatal death statistics has included all fetal deaths of at least 20 weeks' gestation or at least 400 grams birth weight, and all neonatal deaths (all live born babies who die within 28 days of birth, regardless of gestation or weight) which are:

• registered in Australia for the reference year and are received by the ABS by the end of the March quarter of the subsequent year; and
• registered prior to the reference year but not previously received from the Registrar nor included in any statistics reported for an earlier period.

Timeliness

Causes of Death, Australia dataset is released annually, approximately nine months after the end of the reference period and in conjunction with Deaths, Australia 2017 (cat. no. 3302.0). Perinatal deaths data are included in the Causes of Death, Australia 2017 (cat. no. 3303.0) published outputs.

Prior to the release of the 2015 dataset, Causes of Death data had been released approximately 15 months after the end of the reference period, however changes to process allowed for more timely access to Australian mortality data. For more information see A more timely annual collection: changes to ABS processes (Technical Note) in Causes of Death, Australia, 2015 (cat. no. 3303.0).

Causes of death statistics are released with a view to ensuring that they are fit for purpose when released. To meet user requirements for timely data it is often necessary to obtain information from the administrative source before all information for the reference period is available (e.g. finalisation of coronial proceedings). A balance needs to be maintained between accuracy (completeness) of data and timeliness, taking account of the different needs of users. As coroner-certified deaths can have ill-defined causes of death until a case is closed within the coronial system, a revisions process was introduced to enhance the cause of death output for open coroner cases. This process enables the use of additional information for coding relating to coroner certified deaths at approximately 12 and/or 24 months after initial processing. See Explanatory Notes 57-60 and the Causes of Death Revisions, 2014 Final Data Technical Note in Causes of Death, Australia, 2016, for further information on the revision process.

Causes of Death, Australia, 2017, includes preliminary data for 2017 and 2016, revised data for 2015 and final data for 2014 and prior years. Revised output for the 2015 and 2016 data will be released in early 2019.

Accuracy

Non-sampling errors may influence accuracy in datasets for collections which are a complete census of the population rather than a sample. Non-sampling error arises from inaccuracies in collecting, recording and processing the data. Every effort is made to minimise non-sampling error by working closely with data providers, undertaking quality checks throughout the data processing cycle, training of processing staff, and efficient data processing.

The main sources of non-sampling error for perinatal deaths data are:

• completeness of an individual record at a given point in time (e.g. incomplete causes of death information due to non-finalisation of coronial proceedings);
• completeness of the dataset e.g. impact of registration lags, processing lags and duplicate records;
• extent of coverage of the population (whilst all deaths are legally required to be registered some cases may not be registered for an extended time, if at all);
• particular data items which would be useful for statistical purposes may not be collected by jurisdictions where that item is not essential for administration purposes;
• question and ‘interviewer’ biases given that information for death registrations are supplied about the person by someone else. For example, Aboriginal and Torres Strait Islander identification as reported by a third party can be different from self reported responses on a form; and
• level of specificity and completeness in coronial reports or doctor's findings on the Medical Certificate of Cause of Perinatal Death will impact on the accuracy of coding.

The ABS has implemented a revisions process that applies to all coroner-certified deaths registered after 1 January 2006. This is a change from preceding years where all ABS processing of causes of death data for a particular reference period was finalised approximately 13 months after the end of the reference period. The revisions process enables the use of additional information relating to coroner-certified deaths as it becomes available over time, resulting in increased specificity of the assigned ICD-10 codes. See Explanatory Notes 57-60 and the Causes of Death Revisions, 2014 Final Data Technical Note in Causes of Death, Australia, 2016, for further information on the revision process.

Coherence

Use of the supporting documentation released with the statistics is important for assessing coherence within the dataset and when comparing the statistics with data from other sources. Changing business rules over time and/or across data sources can affect consistency and hence interpretability of statistical output. The Explanatory Notes in each issue contains information pertinent to the particular release which may impact on comparison over time.

Perinatal data presented in the Causes of Death publication include demographic items, as well as causes of death information, which is coded according to the International Classification of Diseases (ICD). The ICD is the international standard classification for epidemiological purposes and is designed to promote international comparability in the collection, processing, classification, and presentation of cause of death statistics. The classification is used to classify diseases, conditions, injuries and external events as recorded on many types of medical records as well as death records. It is used for both morbidity and mortality purposes, with the morbidity version incorporating clinical modifications. The ICD is revised periodically to incorporate changes in the medical field. The 10th revision of ICD (ICD-10) is used for the 2017 data.

Interpretability

Information on some aspects of statistical quality may be hard to obtain as information on the source data has not been kept over time. This is related to the issue of the administrative rather than statistical purpose of the collection of the source data.

In 2014, the ABS implemented Iris, a new automated coding software product for assisting in the processing of cause of death data, and improved a number of coding practices to realign with international best practice. As part of this, the ABS began a review of its method of coding perinatal deaths which, for the 2013-2017 data published in this issue, has meant a change to the method used for assigning an underlying cause of death to neonatal deaths. It is advised that data users refer to the Changes to Perinatal Death Coding Technical Note in Causes of Death, Australia, 2014, for further information on changes to the perinatal dataset.

The Causes of Death, Australia (cat. no. 3303.0) publication contains detailed Explanatory Notes, Appendices and a Glossary in each issue that provide information on the data sources, terminology, classifications and other technical aspects associated with these statistics.

Accessibility

In addition to the information provided in the commentary, a series of data cubes are also available providing detailed breakdowns by cause of death. The ABS observes strict confidentiality protocols as required by the Census and Statistics Act (1905). This may restrict access to data at a very detailed level which is sought by some users.

If the information you require is not available from the commentary or the data cubes, then the ABS may also have other relevant data available on request. Inquiries should be made to the National Information and Referral Service on 1300 135 070 or by sending an email to client.services@abs.gov.au.

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