ArticlePloS one2018
The contribution of gestational age, area deprivation and mother's country of birth to ethnic variations in infant mortality in England and Wales: A national cohort study using routinely collected data.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed.
- Wider determinants of adverse birth outcomes in Birmingham and Solihull.Frontiers in public health · 2025Article
- Addressing uncertainty in identifying pregnancies in the English CPRD GOLD Pregnancy Register: a methodological study using a worked example.International journal of population data science · 2025Article
- Participation in club sport in childhood is associated with mental health in preterm and term born adolescents.European child & adolescent psychiatry · 2024Article
- Race and Ethnicity, Deprivation, and Infant Mortality in England, 2019-2022.JAMA network open · 2024Article
- Inter-Generational Differences in Perinatal Health Behaviours: A Secondary Analysis of the Born in Bradford Cohort, Disentangling Ethnicity and Migration.Maternal and child health journal · 2023Article
- Signs of a turning tide in social norms and attitudes toward abortion in Ethiopia: Findings from a qualitative study in four regions.Reproductive health · 2022Article
- Evidence of disparities in the provision of the maternal postpartum 6-week check in primary care in England, 2015-2018: an observational study using the Clinical Practice Research Datalink (CPRD).Journal of epidemiology and community health · 2022Observational
- Racial variations of adverse perinatal outcomes: A population-based retrospective cohort study in Ontario, Canada.PloS one · 2022Article
- Article
- Gestational age and hospital admissions during childhood: population based, record linkage study in England (TIGAR study).BMJ (Clinical research ed.) · 2020Article
- Dysregulation of bile acids increases the risk for preterm birth in pregnant women.Nature communications · 2020Article
- Variations in neonatal mortality, infant mortality, preterm birth and birth weight in England and Wales according to ethnicity and maternal country or region of birth: an analysis of linked national data from 2006 to 2012.Journal of epidemiology and community health · 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
- Ethnic differences in singleton preterm birth in England and Wales, 2006-12: Analysis of national routinely collected data.Paediatric and perinatal epidemiology · 2019Article
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8 authors.
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Abstract
objectivesWe aimed to describe ethnic variations in infant mortality and explore the contribution of area deprivation, mother's country of birth, and prematurity to these variations.
methodsWe analyzed routine birth and death data on singleton live births (gestational age≥22 weeks) in England and Wales, 2006-2012. Infant mortality by ethnic group was analyzed using logistic regression with adjustment for sociodemographic characteristics and gestational age.
resultsIn the 4,634,932 births analyzed, crude infant mortality rates were higher in Pakistani, Black Caribbean, Black African, and Bangladeshi infants (6.92, 6.00, 5.17 and 4.40 per 1,000 live births, respectively vs. 2.87 in White British infants). Adjustment for maternal sociodemographic characteristics changed the results little. Further adjustment for gestational age strongly attenuated the risk in Black Caribbean (OR 1.02, 95% CI 0.89-1.17) and Black African infants (1.17, 1.06-1.29) but not in Pakistani (2.32, 2.15-2.50), Bangladeshi (1.47, 1.28-1.69), and Indian infants (1.24, 1.11-1.38). Ethnic variations in infant mortality differed significantly between term and preterm infants. At term, South Asian groups had higher risks which cannot be explained by sociodemographic characteristics. In preterm infants, adjustment for degree of prematurity (<28, 28-31, 32-33, 34-36 weeks) fully explained increased risks in Black but not Pakistani and Bangladeshi infants. Sensitivity analyses with further adjustment for small for gestational age, or excluding deaths due to congenital anomalies did not fully explain the excess risk in South Asian groups.
conclusionsHigher infant mortality in South Asian and Black infants does not appear to be explained by sociodemographic characteristics. Higher proportions of very premature infants appear to explain increased risks in Black infants but not in South Asian groups. Strategies targeting the prevention and management of preterm birth in Black groups and suboptimal birthweight and modifiable risk factors for congenital anomalies in South Asian groups might help reduce ethnic inequalities in infant mortality.
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