The 1997 twinning rate of 13.4 per 1,000 births was similar to that of 1996 and the risk of death from any cause remained higher in multiple births than in singletons. Both the stillbirth rate of 17.5 per 1,000 total multiple births and the neonatal death rate of 16.6 per 1,000 live multiple births fell in comparison with the 1996 figures of 19.5 and 24.1 per 1,000 respectively. Any variation in stillbirth, neonatal and post-neonatal death rates between health boards is probably no greater than might be expected through chance. In decreasing order of frequency these are asthma, seizure, bronchiolitis, gastroenteritis, upper respiratory tract infection, croup, poisoning, pneumonia, cystic fibrosis and diabetes mellitus. As in other areas of the Health Service, the mean hospital stay for inpatients has been falling, figures for the mean duration of medical and surgical paediatric admissions being 3.9 and 3.2 days per episode respectively.
Accidents remain a major source of childhood mortality, morbidity and hospital admission.
While the number of accidental deaths in children aged less than 15 years declined from 161 in 1980 to a low of 40 in 1996, there were 67 accidental deaths in this age group in 1998. The causes of accidental death in childhood are shown in Table 3.6. There were 3,539 child casualties in road accidents in Scotland in 1998, children being persons under the age of 16 for the purposes of the Transport Series of Scottish Office Statistical Bulletins. There were 32 fatalities following such accidents, six more deaths than in 1997. There can be no complacency with regard to these accident statistics or to the fact that 35 of the 67 accidental deaths in children in 1998 resulted from causes other than road traffic accidents, many of them accidents in the home.