{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T08:00:10Z","timestamp":1778400010919,"version":"3.51.4"},"reference-count":55,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T00:00:00Z","timestamp":1740009600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>This study aimed to identify hospital trusts in England most consistently reporting higher-than-average rates of extended perinatal mortality (EPM), including stillbirths and neonatal deaths.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a retrospective study of MBRRACE-UK Perinatal Mortality Surveillance Reports (2015\u201321) comparing EPM rates for births occurring in 124 hospital trusts in England between 2013 and 2019. Utilizing MBRRACE-UK definitions and designations, including coloured bands (red and amber indicate higher death rates), we devised a scoring method to determine which trusts most consistently reported higher-than-average rates of EPM throughout seven years.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We identified 23 (18.5% of 124) \u2018red flag\u2019 trusts most consistently falling into MBRRACE-UK red and amber bands. They included Shrewsbury and Telford Hospitals NHS Trust (SaTH) and East Kent Hospitals University Trust, both under investigation during the parliamentary Health and Social Care Committee\u2019s inquiry into the safety of maternity services in England. Seven trusts, including SaTH, reported higher-than-average deaths in all seven years. Indications of regional patterns were evident.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>By examining maternity services mortality data over an extended period, patterns of clinical significance may emerge. We found evidence of a minority of trusts in England consistently reporting higher-than-average rates of EPM. These red flags may warrant further attention.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/pubmed\/fdaf019","type":"journal-article","created":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T00:05:46Z","timestamp":1740009946000},"page":"511-520","source":"Crossref","is-referenced-by-count":5,"title":["Recurring red flags: a retrospective study of MBRRACE-UK Perinatal Mortality Surveillance (2015\u201321) to identify maternity services most consistently reporting higher-than-average deaths"],"prefix":"10.1093","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2954-6811","authenticated-orcid":false,"given":"P","family":"McDonagh Hull","sequence":"first","affiliation":[{"name":"Department of Community Health Sciences, Cumming School of Medicine, University of Calgary , Calgary, Alberta T2N 4Z6 ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T","family":"Boulton","sequence":"additional","affiliation":[{"name":"Community Rehabilitation and Disability Studies, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary , Calgary, Alberta T2N 4Z6 ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B","family":"Lashewicz","sequence":"additional","affiliation":[{"name":"Community Rehabilitation and Disability Studies, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary , Calgary, Alberta T2N 4Z6 ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,2,20]]},"reference":[{"key":"2025082909340151100_ref1","doi-asserted-by":"publisher","first-page":"o899","DOI":"10.1136\/bmj.o899","article-title":"Ignoring women\u2019s experience led to the NHS\u2019s biggest maternity scandal","volume":"377","author":"Dobson","year":"2022","journal-title":"BMJ"},{"key":"2025082909340151100_ref2","volume-title":"Ockenden Report \u2013 Final","author":"Department of Health and Social Care"},{"key":"2025082909340151100_ref3","volume-title":"The Safety of Maternity Services in England. 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