Peer-reviewed article
The Impact of Community-Based Midwife Continuity of Care Models for Women Living in Areas of Social Disadvantage and Ethnic Diversity in the United Kingdom: A Prospective Cohort Study.
Fernandez Turienzo C, Burton S, Khan Z, Rayment-Jones H, Newburn M et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined whether a community-based midwife continuity of care model reduced preterm births in socially disadvantaged and ethnically diverse areas of South London. Pregnant women who received this model of care had significantly lower rates of preterm birth compared to those receiving standard care. The benefits were particularly pronounced for ethnic minority women and those living in deprived areas.
Key points
- Preterm birth risk was lower in the CBMCOC group (4.6%) compared to standard care (8.4%) after propensity score matching, with a risk ratio of 0.54
- Before matching, the unmatched analysis showed even greater difference: 4.6% vs 10.3% preterm birth rates
- Subgroup analyses confirmed reduced preterm birth rates among ethnic minority women and those in highly deprived areas when exposed to CBMCOC
- Study included 1,338 women in the CBMCOC group and 5,352 in the matched standard care comparison group
- The intervention addresses UK public health priorities around reducing maternal and newborn health inequalities
Limitations
The study is observational and relies on propensity score matching to control for confounding rather than randomised allocation. The study does not provide detailed information on the specific components of the CBMCOC model or long-term outcomes beyond preterm birth.
Abstract
Objective Addressing inequalities in maternal and newborn health is a UK public health priority. Evidence on effective multi-interventional strategies is urgently needed. This study evaluated the impact of community-based midwife continuity of care (CBMCOC) models for women and babies in ethnically diverse and socially disadvantaged areas of South London. Design We conducted a prospective cohort study using the eLIXIR, Born in South London, maternity-child data linkage. Setting United Kingdom. Population Pregnant women exposed to CBMCOC and standard care between 2018 and 2020. Methods Propensity score matching (1:4) was used to account for differences between CBMCOC and standard care cohorts and control for confounding bias. Conditional logistic regression estimated risk ratios. Subgroup analysis included women of Black, Asian and other ethnic minority groups, and those living in highly deprived areas. Outcomes The primary outcome was preterm birth (< 37 weeks' gestation). Secondary outcomes included other relevant maternal, perinatal, process and clinical variables. Results Before matching, 12 386 women were exposed to standard care and 1338 to CBMCOC; after matching, 5352 and 1338 were included, respectively. The risk of preterm birth was lower among women exposed to CBMCOC (unmatched: 4.6% vs. 10.3%, RR = 0.50, 95% CI: 0.38-0.64; matched: 4.6% vs. 8.4%, RR = 0.54, 95% CI: 0.40-0.70). Subgroup analyses showed reduced preterm birth rates among ethnic minority women and those in deprived areas when exposed to CBMCOC. Conclusions In this diverse population with a range of risk factors, locality-based interventions integrating community-based care and midwife continuity may reduce maternal and newborn health inequalities. Further trials of such models should be conducted.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Community-based midwife continuity of care (CBMCOC) model
- Population
- Pregnant women living in ethnically diverse and socially disadvantaged areas of South London between 2018 and 2020, including subgroups of ethnic minority women and those in highly deprived areas
Key finding
Preterm birth risk was 46% lower in CBMCOC group (RR=0.54, 95% CI: 0.40-0.70) after matching
C et al. · Europe PMC · 20 Jan 2026