Use of refined perinatal mortality rate trends to evaluate the effect of a confidential inquiry.

Standardised perinatal mortality rates and cause-specific rates were used to evaluate the effect of a confidential inquiry into perinatal deaths in West Glamorgan obstetric units. Cause of death was classified by means of 5 pathological subgroups, and the denominator data were obtained from the computerised standard child-health system. The standardised perinatal mortality rate fell from 103 in 1981 to 85 in 1983, and the perinatal mortality rate fell from 15.9 to 9.4 per 1000 births in that period; 3 of the cause-specific rates declined considerably. The trend indicates an improvement in antenatal care, obstetric management, resuscitation, and care in special-care baby units. An audit in the form of a confidential inquiry contributes to an improvement in health services and a consequent reduction in perinatal mortality.