A spike in the number of deaths of newborn babies in Scotland is to be investigated.
At least 21 babies under four weeks old died in September, a rate of 4.9 per 1,000 births.
Infant death rates vary widely from month to month, but the increase is larger than expected from chance alone.
Public Health Scotland (PHS) and other agencies will now look into whether the Covid pandemic or other factors could be behind the increase.
The average mortality rate among newborns is just over two per 1,000 births.
While all child deaths are investigated, the Herald newspaper reported that this wider inquiry was triggered when the mortality rate passed a “control” threshold, designed to pick up abnormal trends in infant deaths.
In a commentary on the figures, PHS says: “Exceeding the upper control limit indicates there is a higher likelihood that there are factors beyond random variation that may have contributed to the number of deaths.”
PHS said there was “currently no indication of links between these deaths and Covid-19 infection” although the data will be examined further.
Dr Sarah Stock, an expert in maternal and fetal health at University of Edinburgh, 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.
Source: BBC News