Babies born to black mothers in richer countries are more likely to be stillborn or die in the first four weeks of life than those born to white women, NIHR-funded research finds.
New research published in the Lancet journal shows worse survival and health impacts for babies born to women from ethnic minority groups in high and upper-middle income countries. This includes the UK, US, and Canada.
The meta-analysis is the largest study of perinatal outcomes of its kind. Researchers from University of Birmingham, Birmingham Children’s Hospital, Ramon y Cajal Hospital Madrid, and St George’s University London led the analysis. It draws from 2.2 million pregnancies across 20 countries. They included Germany, Spain, Italy, Brazil, Australia and New Zealand.
They found Black women were twice as likely to experience neonatal mortality, where their baby dies in the first 28 days after birth. Stillborn pregnancies were twice as likely, compared to white women. Black mothers experienced worse outcomes too. This included preterm birth and babies who were small for their gestation age. This led to increased risk of health complications, the analysis found.
Hispanic mothers experienced worse neonatal mortality, with three times as many babies dying in the first four weeks after birth compared to white women. Mothers from South and East Asia had higher rates of preterm birth and smaller gestation age babies too, researchers found.
Study lead author, Professor Shakila Thangaratinam from the University of Birmingham, said: “Our analysis shows that babies of mothers from under-served and underrepresented racial and ethnic groups being more likely to die or face serious complications is a global phenomenon. Simply put, it’s not good enough that women who aren’t white are more likely to either lose their baby either during pregnancy or in the first weeks of life, or experience complications that can have a significant impact on their quality of life.
“Race and ethnic disparities in perinatal care is not located to one specific country or region, which means that there is a systemic issue across richer countries that needs to be addressed as an international community. Taken together with strong evidence that ethnic minority mothers themselves are at increased risk of death or major health complications during pregnancy, this paper further supports the need to urgently understand how healthcare systems are struggling to provide the right care for underserved families.”
The analysis of 51 papers demonstrates the scale of disparities between women from under-served groups and white women.
Dr John Allotey, Lecturer in Epidemiology and Women’s Health at the University of Birmingham said: “We urgently need to answer the question about why these systematic disparities exist around the world. We do already know that there are barriers that disproportionately affect women from racial and ethnic minority backgrounds, and part of addressing this tragic perinatal outcome gap is having better data on underserved populations.
“More data will enable clinicians to plan better interventions to serve minority mothers, and also provide better accountability to close the gap.”
NIHR’s Health Technology Assessment (HTA) Programme funded the research. It consists of two studies: One on preeclampsia and the other on predicting complications in pregnancy.