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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”.
Expert in maternal and fetal health at University of Edinburgh, Dr Sarah Stock said it was rare for newborn babies to become infected or seriously-ill with Covid but she said the virus could be having an impact in other ways.
“We know, for instance, that when pregnant women have Covid they can become seriously unwell, and in order to protect the mother and baby that can lead to pre-term deliveries,” she said. “Pre-term delivery is the biggest driver of neonatal mortality.
“We also know that the pandemic has put a lot of pressure on health services and that could be having an impact.”
PHS is now working with the Scottish National Neonatal Network , the Maternity and Children Quality Improvement Collaborative and the Scottish government to understand possible contributing factors.
Figures for the number of stillborn babies also increased in September but not beyond the upper warning or control limit.
Deaths of newborn babies have fallen steadily in recent decades with the mortality rate per 1,000 births dropping from double figures in the 1970s to 2.1 in 2020.
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