Stillbirth rate twice as high among least well off in England

Posted by pt91 at Jun 25, 2012 11:31 AM |
Inequality evident for all causes and has not budged in eight years

Issued by University of Leicester Press Office on 25 June 2012

The rate of stillbirths in England is twice as high among the least well off as it is among the most affluent, shows research led by the University of Leicester and published in the online journal BMJ Open.

What is more, this inequality gap is evident across all causes of stillbirth, and has not changed in eight years, the findings show. The research was funded by the National Institute for Health Research (NIHR).

The authors from the Department of Health Sciences at the University of Leicester  assessed the number of singleton stillbirths occurring in England between 2000 to 2007, inclusive. They looked in particular at the specific causes of stillbirth per 10,000 births, in light of deprivation levels and year of birth.

Deprivation was measured at area level, using the UK index of multiple deprivation, and the most deprived 10ths were compared with the least deprived, to assess the extent of any inequality gap.

For every 10,000 births during the eight year period, 44 were stillborn babies, a rate that remained constant throughout.

Rates were twice as high among the most deprived 10th of England as they were among the least deprived - a disparity that remained constant throughout the study period.

This inequality gap was evident for all specific causes other than mechanical events, such as breech presentation, with the widest gap of all seen for bleeding before birth (antepartum haemorrhage).

Women living in the most deprived 10th of England were three times as likely to give birth to a stillborn baby following a bleed before their due date (antepartum haemorrhage), as those living in the least deprived 10th.

Risk factors for this condition include previous pregnancies, several pregnancies close together, smoking, and being at the extreme ends of the reproductive age spectrum, say the authors.

Similarly, stillbirths attributable to congenital abnormalities were nearly three times more likely among women from the areas of greatest deprivation.

Over half of stillbirths (59%) were deaths in the womb of unknown cause, and these accounted for around half of the gap in stillbirth rates between the least and most deprived areas, the findings showed.

Despite improvements in healthcare in developed nations, stillbirth remains relatively common, and the UK has one of the highest rates, say the authors, who add that their findings confirm previous trends.

“If the stillbirth rates seen in the least deprived areas were seen throughout the population, there would be a third fewer stillbirths in England, nearly 900 fewer every year,” they conclude.

The evidence from other high income countries, where the rate has fallen, suggests that there are modifiable factors, which can be addressed, they add.

Ends

[Socioeconomc inequalities in the rate of stillbirths by cause: a population based study doi 10.1136/bmjopen-2012-001100]

Contact:

Dr Lucy Smith (tel: 0116 2525418 or 07913062989 email: lks1@le.ac.uk)

or Prof David Field (tel: 0116 2525437 email: df64@le.ac.uk)

Department of Health Sciences, University of Leicester, Leicester, UK.

Notes:

The authors based at the University of Leicester together with the National Perinatal Epidemiology Unit in Oxford and other colleagues are part of the MBRRACE-UK team recently appointed by the Healthcare Quality Improvement Partnership (HQIP) to reinstate the collection of national data on stillbirth and neonatal mortality. The team hope these data will improve understanding of how the deaths of many babies could be prevented leading to safer and better care for women and babies in the future.

The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government’s strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website (www.nihr.ac.uk).

The research presents findings funded under an NIHR Programme Grant for Applied Research. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.

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