Landmark study shows inequalities when it comes to adverse birth outcomes in England

on 02 November 2021

A study of birth records in England show thousands of babies are being born prematurely, small or stillborn due to socioeconomic and racial inequalities across the country.

A team from the National Maternity and Perinatal Audit analysed 1,155,981 birth records in England between April 2015 and March 2017 in NHS hospitals.

The analysis estimates that 24% of stillbirths, 19% of preterm births and 31% of Fetal Growth Restriction (FGR) cases were caused by socioeconomic inequalities.

1 in 10 stillbirths, a fifth of preterm births, and a third of FGR cases were due to racial inequalities.

Pregnancy complications also disproportionately affected Black and minority ethnic women, contributing to 12% of stillbirths, 1% preterm births and 17% of FGR cases.

The NHS has a target of halving stillbirth and neonatal death rates and reducing levels of preterm birth by 25% by 2025.

Co-lead Author of the study, Professor Jan van der Meulen from the School of Hygiene & Tropical Medicine, said: “National targets to make pregnancy safer will only be achieved if there is a concerted effort by midwives, obstetricians, public health professionals and politicians to tackle the broader socioeconomic and ethnic inequalities.

“There are many possible reasons for these disparities. Women from deprived neighbourhoods and Black and minority ethnic groups may be at a disadvantage because of their environment, for example, because of pollution, poor housing, social isolation, limited access to maternity and health care, insecure employment, poor working conditions, and stressful life events.”

The study also found that stillbirths and FGR cases could have been potentially avoided. For example, 53.5% of stillbirths and 71.7% of FGR cases could have been avoided among south Asian women living in the most deprived fifth of neighbourhoods in England if they had the same risks as white women in the fifth most wealthiest areas of the country.

Nearly two-thirds of stillbirths among the most deprived Black women were also potentially avoidable if risks were the same as the wealthiest 20% of white women.

The study ‘Adverse pregnancy outcomes attributable to socioeconomic and ethnic inequalities in England: a national cohort study’ can be found on The Lancet website here.

Source: The Guardian