Researchers found significant disparities between various ethnic groups in perinatal care in the United Kingdom (U.K.), according to a recently published study in BJOJ.
These disparities could raise the risk of fetal and neonatal alloimmune thrombocytopenia (FNAIT) and other pregnancy-related diseases in minorities.
The study showed that after adjusting for socioeconomic deprivation and clinical risks, Asian and Black women had elevated risks of emergency caesarean section, while Black infants faced markedly higher risks of preterm birth, low birthweight, low Apgar scores and stillbirth/neonatal death.
Current evidence shows Black and Asian groups experience higher rates of adverse maternal and infant outcomes. This is linked to intersecting factors including systemic racism, language barriers, unequal healthcare access and migration-related stressors.
The study evaluates maternity safety concerns in the U.K., rising stillbirth and maternal mortality rates, conflicting evidence on the “healthy migrant effect,” and the need for advanced analyses beyond socioeconomic adjustment.
While not caused by a single disease, these inequalities stem from social determinants; recommended approaches include culturally safe continuity of midwifery care, improved interpreter services, community support integration and policy reforms addressing structural drivers.
“This study demonstrates persistent ethnic and migration-related disparities in maternal and infant outcomes within an ethnically diverse urban UK population, despite universal healthcare access,” the authors wrote.
The authors aimed to address evidence gaps by comparing risks of adverse perinatal outcomes (emergency caesarean, haemorrhage, preterm birth, low birthweight,, stillbirth/neonatal death) across ethnic groups in a multi-ethnic South London cohort, adjusting for deprivation and clinical factors, while exploring independent and intersecting contributions of migration-related variables, maternal nativity, need for interpretation, and country-of-origin income level, to better understand mechanisms driving inequalities and inform targeted interventions.
Using a retrospective cohort of almost 45000 singleton births from 2018 to 2023 from linked electronic health records in two South London maternity services, the authors estimated adjusted risk ratios, controlling for age, parity, obesity, smoking, previous caesarean, deprivation quintile and medical risk.
Key outcomes included higher emergency caesarean risks for Asian/Black women, elevated preterm/low birthweight/stillbirth risks for Black infants and mixed migration effects.
“Disparities in perinatal outcomes persist across ethnic and migrant groups in the U.K., with higher risks observed among Black, Asian, ‘Any Other’ ethnic groups, and women born outside the U.K.,” the authors wrote. “Addressing these inequalities requires a multi-level approach that combines clinical action with broader policy reforms aimed at the social and structural drivers of risk.”
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