Peer-reviewed article
Wider determinants of adverse birth outcomes in Birmingham and Solihull.
Ellis D, Au-Yeung CH, Dallaway A, Basra R, Owusu-Nepaul S et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined risk factors for adverse birth outcomes including low birth weight, premature birth, stillbirth, and neonatal death in Birmingham and Solihull, UK, analysing over 41,000 births between 2020 and 2023. The research found that ethnicity, socioeconomic deprivation, smoking, and multiple pregnancies were significantly associated with worse outcomes. If all women had the same birth outcome rates as White women in the least deprived areas, an estimated 191 premature births and 211 low birth weight cases could be prevented annually. The study highlights substantial health inequalities in birth outcomes across ethnic and socioeconomic groups.
Key points
- Asian and Black women had 1.4-2.7 times higher odds of low birth weight compared to White women
- Black women had 1.75 times increased odds of stillbirth; Asian women had 1.90 times increased odds of neonatal death
- Women smoking at delivery had 2.3 times higher odds of low birth weight, 1.5 times higher odds of premature birth, and 1.6 times higher odds of stillbirth
- Twins had significantly increased odds of low birth weight (3.3), premature birth (27.2), and neonatal death (5.6)
- Deprivation and housing or financial issues significantly increased odds of adverse birth outcomes
Limitations
This study is observational and cannot establish causation, only associations. The findings are specific to Birmingham and Solihull and may not be generalisable to other regions.
Abstract
Introduction Birmingham and Solihull face significant challenges related to adverse birth outcomes. This study aimed to identify demographic, socioeconomic, and lifestyle factors associated with an increased risk of low birth weight, premature birth, stillbirth, and neonatal death in Birmingham and Solihull. Methods Births (n = 41, 231) between October 2020 and April 2023 were analysed. The attributable fraction of premature births and low birth weight (LBW) attributable to socioeconomic and ethnic inequality was calculated. Multiple logistic regression analyses identified groups that had increased odds of premature birth (n = 3, 312), LBW (n = 1, 197), stillbirth (n = 173), and neonatal death (n = 208). Results Attributable fraction analysis estimated that 191 premature births and 211 LBWs each year would not have occurred if all women had the same rates as White women living in the least deprived areas. Ethnicity, socioeconomic deprivation, medical care, lifestyle, and vulnerability status were found to be significant risk factors for adverse birth outcomes. Asian and Black women had 1.4-2.7 times the odds of LBW compared to White women (p < 0.01). Black women had increased odds of stillbirth (OR : 1.75, p = 0.017) and Asian women had increased odds of neonatal death (OR : 1.90, p < 0.001). The odds of LBW (OR : 3.3), premature birth (OR : 27.2), and neonatal death (OR : 5.6) were significantly increased for twins (p < 0.001). For women smoking at delivery, the odds of LBW (OR : 2.3), premature birth (OR : 1.5), and stillbirth (OR : 1.6) were significantly increased (p < 0.05). Deprivation, and/or financial and housing issues also increased the odds of adverse birth outcomes (p < 0.05). Discussion These findings underscore the importance of targeted interventions and support for at-risk populations to reduce adverse birth outcomes in vulnerable communities.