Children’s Health in Northern Ireland Summary

Births – Summary Highest live birth rate in United Kingdom, 2016 Infant mortality rate Fertility rate Lowest: Still birth rate % breast fed at discharge Across the UK/RoI, 2016: % births by HSCT, 2016/17 2016/17: 13.3% 2010/11: 15.5% Women who smoke 2010/11: 1.8% Women with diabetes 2016/17: 7.6% 46.9% of infants breastfed (partial/total), 2016/17 Overweight/obese, 2016/17: 18% of P1 girls 25% of P1 boys Graphics downloaded from: thenounproject.com

Trend in births – Northern Ireland 2016: 24,158 registered births to NI residents. Birth rate of 12.9 per 1,000 population. Live birth rate (12.9) is the highest across the four UK countries, but lower than Republic of Ireland (13.7). 82 registered still births. 17.4% of live births to mothers whose country of birth was not NI. Report – Tables 1.1 and 1.2 Source: NISRA https://www.nisra.gov.uk/statistics/births-deaths-and-marriages/births

Births by Hospital

Projected Births – Health Trust In the next 20 years (2016-2036), the number of births is projected to increase in Southern Trust area, but decrease in all other Trust areas. Report – Table 1.3 Source: NISRA https://www.nisra.gov.uk/statistics/births-deaths-and-marriages/births

United Kingdom/Republic of Ireland - Comparisons When compared to other UK nations/Republic of Ireland, and based on most recent data available, Northern Ireland had: Lowest Still birth rate Percentage infants breastfed at discharge Highest Infant mortality rate Fertility rate Report – Comparative data – page 7

Births – Health Trusts 2016: Largest number of registered births recorded to NHSCT residents (5,764), with the lowest number in the WHSCT (3,955). Percentage share of births: BHSCT = 19.3% NHSCT = 23.9% SEHSCT = 17.6% SHSCT = 22.9% WHSCT = 16.4% % change in total births in the last ten years: 4.0% increase in Belfast Trust, 6.4% decrease in South Eastern Trust (NI = -1.6%). Report – Table 1.2 Source: NISRA https://www.nisra.gov.uk/statistics/births-deaths-and-marriages/births

Age of mother 2016/17 Teenage mothers: Following reductions, there have been small increases in numbers in the last two years. 3.2% of all births were to teenage mothers. 5.7% in the most deprived areas, 1.4% in the least deprived (NIMDM 2017). Older mothers (aged 40+): % births increased year on year between 2010/11 and 2015/16. Decreased in 2016/17 (3.8% of all births). 2.5% in the most deprived areas, 5.6% in the least deprived areas (NIMDM 2017). Report – Table 3.1 Source: Child Health System Source: NISRA, NI Multiple Deprivation Measure 2017 https://www.nisra.gov.uk/statistics/deprivation/northern-ireland-multiple-deprivation-measure-2017-nimdm2017

Maternal risk factors 2016/17 : 13.3% of mothers smoked (2010/11 = 15.5%) 7.6% of mothers had diabetes (2010/11 = 1.8%) Note: increase may be due in part to improved recording of diabetes on NIMATS/CHS 4.3% had pregnancy induced hypertension (2010/11 = 4.5%) Report – Table 6.1 Source: Child Health System

Maternal risk factors - Smoking 2016/17: % mothers who smoked at booking decreased with age - 29.7% of those aged <20 years, 7.9% of those aged 40+. A smaller proportion of first time mothers smoked (11.9%), compared to those who have been pregnant previously (14.4%). Over 18% of mothers in BHSCT area smoked, compared to 10% in SHSCT (NI=13%). In the most deprived areas (NIMDM 2017), 25.0% of mothers smoked, compared to 5.5% in the least deprived areas. Report – Table 6.2 Source: Child Health System Source: NISRA, NI Multiple Deprivation Measure 2017 https://www.nisra.gov.uk/statistics/deprivation/northern-ireland-multiple-deprivation-measure-2017-nimdm2017

Maternal risk factors - Diabetes 2016/17 : % mothers with diabetes increased with age - 3.7% of those aged less than 20 years, compared to 11.7% of those aged 40+. Higher proportion of mothers from “non-white” ethnic groups had diabetes (15.1%), compared to those from a “white” ethnic group (7.5%). All mothers = 7.7%. Little variation by deprivation quintile (NIMDM 2017). Report – Table 6.2 Source: Child Health System Source: NISRA, NI Multiple Deprivation Measure 2017 https://www.nisra.gov.uk/statistics/deprivation/northern-ireland-multiple-deprivation-measure-2017-nimdm2017

Maternal Body Mass Index (BMI) 2016/17: 22% of mothers measured as obese at time of booking appointment. Proportion has increased year on year since 2011/12. 52% of all mothers considered pre-obese or obese.   Levels of obesity, in general, increased with age. 26.1% of mothers from most deprived areas (NIMDM 2017) were classified as obese, compared to 17.3% from the least deprived areas. Report – Table 7.2 Source: NIMATS Source: NISRA, NI Multiple Deprivation Measure 2017 https://www.nisra.gov.uk/statistics/deprivation/northern-ireland-multiple-deprivation-measure-2017-nimdm2017

Method of Delivery 2016/17: 30.5% of infants born by Caesarean Section (CS), 56% had a normal delivery, 13% had another type of delivery e.g. breech, forceps. Proportion of infants born by CS increased with age. Antrim Area Hospital had the highest % CS (34.3%). Report – Table 8.2 Source: Child Health System Source: NISRA, NI Multiple Deprivation Measure 2017 https://www.nisra.gov.uk/statistics/deprivation/northern-ireland-multiple-deprivation-measure-2017-nimdm2017

Infant Birth Weight 2016/17: 6.2% of all births were of a low birth weight (6.0% live, 55.2% still). % low birth weight higher in those mothers aged over 40 (9.6%). (Note that this age group has a higher proportion of multiple births) 13.6% of live infants were born with a higher birth weight (4,000g+) and of these, 2.0% with a birth weight of 4,500g+. Mothers from a ‘white’ ethnic group were more likely to have a baby born with a high birth weight (13.7%). ‘Non-white’ = 6.6%. Report – Table 9.2 Source: Child Health System

Breastfeeding (total/partial) – at discharge 2016/17: 46.9% of live infants breastfed at discharge.   Increases with age of mother: aged <20 = 21.2%, 40+ = 56.3%. Much higher rates in infants born to mothers whose ethnic origin was not ‘white’.   By Council area, % breastfed ranges from 34.5% in Derry and Strabane to 57.2% in Lisburn and Castlereagh. Markedly lower in more deprived areas (31.5%). Least deprived = 64.1%. Report – Table 10.2 Source: Child Health System Source: NISRA, NI Multiple Deprivation Measure 2017 https://www.nisra.gov.uk/statistics/deprivation/northern-ireland-multiple-deprivation-measure-2017-nimdm2017  

Childhood Obesity – Primary 1 2016/17: Higher proportion of girls were overweight / obese (24.5%) compared to boys (17.9%).   All genders = 21.1%. Causeway Coast and Glens LGD had highest proportion of children overweight / obese = 23.2%. 23.8% of children living in the most deprived areas were overweight / obese, compared to 16.8% of children from the least deprived areas. Report – Table 11.2 Source: Child Health System Source: NISRA, NI Multiple Deprivation Measure 2017 https://www.nisra.gov.uk/statistics/deprivation/northern-ireland-multiple-deprivation-measure-2017-nimdm2017

Childhood Obesity – Year 8 2016/17: 28.5% of children measured as overweight / obese. This increased from 21.1% of Primary 1 children. Little difference in the proportion overweight / obese between the two genders (28.2% male, 28.8% female). Larger proportion of children from more deprived areas were measured as overweight / obese, compared to those living in the least deprived areas. Report – Table 11.5 Source: Child Health System Source: NISRA, NI Multiple Deprivation Measure 2017 https://www.nisra.gov.uk/statistics/deprivation/northern-ireland-multiple-deprivation-measure-2017-nimdm2017