Births

Statistical Publication Notice

30 September 2008

Births in Scottish Hospitals

INTRODUCTION

The data presented here are obtained from the Scottish Morbidity Record (SMR02) which is submitted by maternity hospitals to ISD using routinely collected information. A wide range of information is collected on the SMR02 - some of which are detailed below:

mother - age, height, smoking history, previous obstetric history.
birth - induction, analgesia, method of delivery, outcome.
baby - apgar score, sex, gestation, weight.

Although there is no legal requirement to submit these data to ISD, the level of submission falls slightly short of the known total number of births occurring each year when compared to the number of statutory birth registrations. However, the deficit is only around 2%. As a result, Scotland has some of the best information on pregnancy and births available anywhere in the world.

KEY POINTS

The number of births in Scotland is increasing with 53,024 births in year ending March 2006 and 55,363 births for year ending March 2007.

Births to mothers aged 30-34 have risen steadily and this is now the most common age to have a baby, accounting for 28% of all maternities in 2007 compared to 13% in 1976.

In singleton births, a low birth weight baby (less than 2500g) is 3 times more likely to be born to a mother living in an area of high deprivation than to a mother living in an area of low deprivation.

In singleton births, the emergency caesarean section rate increased from 3.9% in 1976 to a peak of 15.4% in 2006, followed by a slight drop in 2007 to 15.0%. The rate of elective* or planned caesarean sections also rose from 4.7% in 1976 to 9.1% in 2006 and 9.7% in 2007. Together this resulted in an overall increase in caesarean section rates from 8.6% in 1976 to 24.5% in 2006 and 24.7% in 2007.

[*An elective caesarean section refers to a caesarean section, which has been planned in advance and in most cases will have been recommended for clinical reasons such as breech or multiple births or previous caesarean section. It may also be the case that the woman will have chosen this method of delivery for non-clinical reasons.]

INTERPRETATION

These analyses were last released in July 2006. The delay in updating these statistics was due to problems in data submission from one of the NHS boards which has now been resolved. However, there may still be a very small shortfall in data (in one or two NHS Boards) and therefore this release should be considered as provisional.

ISD has collected SMR02 data since the late 1960’s but the data are not considered to be complete, or of good enough quality for publication until 1975.

The population data used for calculating age specific rates are provided by the General Register Office for Scotland (GROS).

DETAILED FINDINGS

Babies born in Scotland: There were 53,024 live births recorded in Scottish hospitals in the year ending March 2006 and 55,363 in the year ending March 2007.
‘Mothers are getting older’: A steady increase has been observed in the proportion of births to mothers aged 30-34, from 13% in 1976 to a peak of 30% in 2005. Although this has fallen slightly to 29% in 2006 and 28% in 2007, it is now the most common age to have a baby. There has also been a steady rise in the proportion of births to women aged 35 and over, from 6% in 1976 to 20% in each of the last 3 years, and the number of births in this age group now exceeds that in those aged 20-24.
Smoking in pregnancy: The overall percentage of women who report smoking at the time of their first antenatal booking has decreased consistently from 29.0% in 1995 to 21.7% in 2006 and a low of 20.9% in 2007. However, it should be noted that the percentage of ‘unknowns’ has risen from 5% in 1995 to 9.4% in 2006 and 11.9% in 2007 and that this may include a proportion of smokers.
Caesarean section: In singleton births, the emergency caesarean section rate increased from 3.9% in 1976 to a peak of 15.4% in 2006 with a slight drop to 15.0% in 2007. The rate of elective* or planned caesareans also rose from 4.7% in 1976 to 9.1% in 2006 and 9.7% in 2007. Together this resulted in an overall increase in caesarean section rates from 8.6% in 1976 to 24.5% in 2006 and 24.7% in 2007. [*An elective caesarean section refers to a caesarean section, which has been planned in advance and in most cases will have been recommended for clinical reasons such as breech or multiple births or previous caesarean section. It may also be the case that the woman will have chosen this method of delivery for non-clinical reasons.]
Forceps deliveries: have fallen from 13.4% in 1976 to 7.6% in 2006 with a slight rise to 8.4% in 2007.
Premature babies: the percentage of pre-term (premature) singleton babies has risen from 5.2% in 1976 to 6.6% in 2006 and 6.2% in 2007.
Deprivation: the most common age for starting a family in areas of low deprivation is 32, which is 13 years later than the most common age in areas of high deprivation.
Low birth-weight: In singleton births a low birth-weight baby (less than 2500g) is 3 times more likely to be born to a mother living in an area of high deprivation than to a mother living in an area of low deprivation.
Miscarriage: There is a general downward trend in the number of miscarriages, falling from 7508 in 1998 to 5960 in 2007. However, it is likely that some, particularly early, miscarriages are either managed solely by General Practitioners or may not be recognised by the women and so are never referred to hospital.

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MAIN CONTACTS:

Etta Shanks
Maternity & Neonatal Team Leader
0131 275 6761
etta.shanks@isd.csa.scot.nhs.uk

Dr Jim Chalmers (Consultant in Public Health Medicine)
Head Of Programme
Women & Children's Health Information Programme
0131 275 6136
jim.chalmers@isd.csa.scot.nhs.uk

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