ArticleBMJ (Clinical research ed.)2011
Socioeconomic inequalities in outcome of pregnancy and neonatal mortality associated with congenital anomalies: population based study.
Article in BMJ (Clinical research ed.), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
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Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 67 citations in OpenAlex.
- Long-term survival of children born with congenital anomalies: A systematic review and meta-analysis of population-based studies.PLoS medicine · 2020Pooled it
- Pooled it
- Social Inequalities in Infant Mortality Related to Congenital Anomalies: A Population-Based Register Study.Paediatric and perinatal epidemiology · 2026Article
- Local diagnostic reference levels for pediatric fluoroscopy in a Brazilian tertiary referral center: A weight‑based analysis.Journal of applied clinical medical physics · 2026Article
- Neighborhood Socioeconomic & Geographic Determinants of Prenatal Congenital Heart Disease Diagnosis.Pediatric cardiology · 2026Article
- Evaluation of area based socioeconomic inequalities and neonatal mortality rates in France: national population based study.BMJ medicine · 2025Article
- Association between insurance type, clinical characteristics, and healthcare use in adults with congenital heart disease.International journal of cardiology. Congenital heart disease · 2024Article
- A Retrospective Observational Study Using Administrative Databases to Assess the Risk of Spontaneous Abortions Related to Environmental and Socioeconomic Conditions.Life (Basel, Switzerland) · 2023Article
- Cohort study of intervened functionally univentricular heart in England and Wales (2000-2018).Heart (British Cardiac Society) · 2022Article
- Understanding ethnic inequalities in stillbirth rates: a UK population-based cohort study.BMJ open · 2022Article
- Neonatal Morbidity and Mortality in Advanced Aged Mothers-Maternal Age Is Not an Independent Risk Factor for Infants Born Very Preterm.Frontiers in pediatrics · 2021Article
- Educational Inequalities in Hospital Use Among Older Adults in England, 2004-2015.The Milbank quarterly · 2020Article
- Time trends, geographical, socio-economic, and gender disparities in neonatal mortality in Burundi: evidence from the demographic and health surveys, 2010-2016.Archives of public health = Archives belges de sante publique · 2020Article
- Ethnic and socioeconomic variation in cause-specific preterm infant mortality by gestational age at birth: national cohort study.Archives of disease in childhood. Fetal and neonatal edition · 2020Article
- Child mortality in England compared with Sweden: a birth cohort study.Lancet (London, England) · 2018Article
- Do Mothers with Lower Socioeconomic Status Contribute to the Rate of All-Cause Child Mortality in Kazakhstan?BioMed research international · 2018Article
- Clinicians' perspectives of parental decision-making following diagnosis of a severe congenital anomaly: a qualitative study.BMJ open · 2017Article
- Assessing sociodemographic differences (or lack thereof) in prenatal diagnosis of congenital heart defects: a population-based study.BMJ open · 2016Observational
- Differences in obstetric care among nulliparous First Nations and non-First Nations women in British Columbia, Canada.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2016Article
- Socioeconomic inequalities in stillbirth rates in Europe: measuring the gap using routine data from the Euro-Peristat Project.BMC pregnancy and childbirth · 2016Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
objectivesTo investigate socioeconomic inequalities in outcome of pregnancy and neonatal mortality associated with congenital anomalies.
designRetrospective population based registry study.
settingEast Midlands and South Yorkshire regions of England (representing about 10% of births in England and Wales).
participantsAll registered cases of nine selected congenital anomalies with poor prognostic outcome audited as part of the United Kingdom's fetal anomaly screening programme with an end of pregnancy date between 1 January 1998 and 31 December 2007.
main outcome measuresSocioeconomic variation in the risk of selected congenital anomalies; outcome of pregnancy; incidence of live birth and neonatal mortality over time. Deprivation measured with the index of multiple deprivation 2004 at super output area level.
resultsThere were 1579 fetuses registered with one of the nine selected congenital anomalies. There was no evidence of variation in the overall risk of these anomalies with deprivation (rate ratio for the most deprived 10th with the least deprived 10th: 1.05, 95% confidence interval 0.89 to 1.23). The rate ratio varied with type of anomaly and maternal age (deprivation rate ratio adjusted for maternal age: 1.43 (1.17 to 1.74) for non-chromosomal anomalies; 0.85 (0.63 to 1.15) for chromosomal anomalies). Of the nine anomalies, 86% were detected in the antenatal period, and there was no evidence that this varied with deprivation (rate ratio 0.99, 0.84 to 1.17). The rate of termination after antenatal diagnosis of a congenital anomaly was lower in the most deprived areas compared with the least deprived areas (63% v 79%; rate ratio 0.80, 0.65 to 0.97). Consequently there were significant socioeconomic inequalities in the rate of live birth and neonatal mortality associated with the presence of any of these nine anomalies. Compared with the least deprived areas, the most deprived areas had a 61% higher rate of live births (1.61, 1.21 to 2.15) and a 98% higher neonatal mortality rate (1.98, 1.20 to 3.27) associated with a congenital anomaly.
conclusionsAntenatal screening for congenital anomalies has reduced neonatal mortality through termination of pregnancy. Socioeconomic variation in decisions regarding termination of pregnancy after antenatal detection, however, has resulted in wide socioeconomic inequalities in liveborn infants with a congenital anomaly and subsequent neonatal mortality.
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