National Paediatric Mortality Register annual report 2025: data from 1st January 2019 to 31st December 2023

This is the second report of the National Office of Clinical Audit’s (NOCA’s) National Paediatric Mortality Register (NPMR) under the governance of NOCA, and it builds on the information and recommendations of the inaugural NPMR report to support the establishment of a national database for the collection and reporting of data on mortality in children and young people (CYP) in Ireland. Current and detailed mortality data are essential for informing healthcare policy, for monitoring population health outcomes and for driving improvements in the quality of care for both children and their families, including end-of-life care.

This report outlines the results of a retrospective review of available population mortality data (i.e. death certificate details) provided by Ireland’s central death registration unit, the Central Statistics Office (CSO). It provides national estimates of CYP mortality in Ireland for the period 2019–2023 and outlines the main causes of death at various stages of childhood development. A review of annual trends based on revised year of occurrence data is also provided. The data show that despite a decline in many causes of CYP mortality, overall mortality in infants and older children has either plateaued or increased during the years covered by this report. The greatest number of deaths occur in infants and older adolescents, many of which are potentially preventable, such as those resulting from sudden infant death syndrome or trauma. Important areas of CYP mortality that warrant further review are highlighted along with opportunities for shared learnings.

This report highlights the limitations of the existing mortality datasets; due to delays in the registration of many CYP deaths, data for 2022 and 2023 are provisional, making it difficult to identify emerging public health issues, while the lack of information on the characteristics of these deaths (including any contributory risk factors), means that the identification of high risk groups or families and recommendations for prevention are not possible. Injury remains the leading cause of death among older adolescents aged 15–18 years, accounting for just over one-half of all deaths registered for this age group during 2019–2023. Unfortunately, due to the limitations of the data, it was not possible to provide a more informative description of these deaths. Additional data must be collected on CYP mortality in order to accurately establish the burden of both intentional and unintentional injury, and of sudden unexpected and unexplained deaths in the Irish CYP population, as well as to aid in the identification of contributory and modifiable risk factors.

Implementation of a standardised and timely reporting system for infant and CYP deaths nationally across the Irish healthcare system will enable a more accurate understanding of the causes of child death and provide the basis for quality improvements in the delivery of care and better outcomes for CYP. As recommended in the first NPMR report, statutory notification of all deaths to a national database would be required. The recommendations in this report are aimed at improving the accessibility and quality of CYP mortality data by progressing the development and national implementation of the NPMR child death notification process.