Assessing the impact of social determinants of health on rising preterm birth trends in England. A longitudinal ecological study, 2012-17.

Amy Wilcock, Davara Bennett, David Taylor-Robinson, Philip McHale

Abstract read

In one paragraph

Article in Journal of public health (Oxford, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Amy WilcockDivision of Population Health, Health Services Research & Primary Care, School of Health Sciences, University of Manchester, Oxford Road, Manchester M13 9PT, UK.

Davara BennettDepartment of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Brownlow Street, Liverpool L69 3GF, UK.

David Taylor-RobinsonDepartment of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Brownlow Street, Liverpool L69 3GF, UK.

Philip McHaleDepartment of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Brownlow Street, Liverpool L69 3GF, UK.

Funding

MRC Clinical Research Training Fellowship MR/T00794X/1National Institute for Health and Care Research (NIHR) School for Public Health Research NIHR 204000NIHR Research Professorship NIHR302438

6 · The paper itself

Abstract

backgroundPreterm birth (PTB) is the UK's leading cause of neonatal morbidity and mortality. There is international evidence of socioeconomic inequalities in PTB. Between 2012 and 2017, the proportion of live births occurring prematurely increased in England. This study explores how changes to major social determinants of health (SDH) may have contributed to recent trends.

methodsWe analysed PTB trends and their correlation with contemporaneous trends in major SDH predictors (socioeconomic status, income, and unemployment) for English Local Authorities. We used both fixed-effects and mixed-effects modelling to estimate the association between SDH and PTB rates between 2012 and 2017.

resultsThe gap in PTB inequalities widened over the study period, with the absolute difference in PTB rates between most and least disadvantaged communities rising by 35%. Mixed-effects analysis demonstrated an association between the proportion of children living in low-income households and PTB; for each percentage point increase in child poverty, an estimated additional 0.24 per 1000 births was preterm.

conclusionWe provide evidence of rising PTB rates in England prior to the pandemic, which disproportionately affected the poorest areas of the country. Policies targeting areas with higher child poverty rates are likely to reduce inequalities in PTB in England.

Indexed as

Premature BirthSocial Determinants of HealthEnglandFemaleHumansInfant, NewbornLongitudinal StudiesLow Socioeconomic StatusPregnancySocioeconomic Disparities in HealthSocioeconomic Factorspreterm birthSocial determinants of healthsocioeconomic inequalities

Identifiers

PMID42302169

DOI10.1093/pubmed/fdag045

PMCPMC13531721

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