Ethnic differences in singleton preterm birth in England and Wales, 2006‐12: Analysis of national routinely collected data

Abstract

BackgroundData recorded at birth and death registration in England and Wales have been routinely linked with data recorded at birth notification since 2006. These provide scope for detailed analyses on ethnic differences in preterm birth (PTB).ObjectivesWe aimed to investigate ethnic differences in PTB and degree of prematurity in England and Wales, taking into account maternal sociodemographic characteristics and to further explore the contribution of mother's country of birth to these ethnic differences in PTB.MethodsWe analysed PTB and degree of prematurity by ethnic group, using routinely collected and linked data for all singleton live births in England and Wales, 2006‐2012. Logistic regression was used to adjust for mother's age, marital status/registration type, area deprivation and mother's country of birth.ResultsIn the 4 634 932 births analysed, all minority ethnic groups except ‘Other White’ had significantly higher odds of PTB compared with White British babies (ORs between 1.04‐1.25); highest odds were in Black Caribbean, Indian, Bangladeshi and Pakistani groups. Ethnic differences in PTB tended to be greater at earlier gestational ages. In all ethnic groups, odds of PTB were lower for babies whose mothers were born outside the UK.ConclusionsIn England and Wales, Black Caribbean, Indian, Bangladeshi, Pakistani and Black African babies all have significantly increased odds of being born preterm compared with White British babies. Bangladeshis apart, these groups are particularly at risk of extremely PTB. In all ethnic groups, the odds of PTB are lower for babies whose mothers were born outside the UK. These ethnic differences do not appear to be wholly explained by area deprivation or other sociodemographic characteristics.

Cervicovaginal microbiota and metabolome predict preterm birth risk in an ethnically diverse cohort

“…Taking into account that racial and ethnic differences could also reflect differences in environmental and social exposures, our study is in agreement with reports that Black ethnicity is a risk factor for sPTB ( 31 – 33 ), and it complements and adds knowledge to findings from previous studies ( 9 , 10 , 12 , 16 , 17 , 19 , 25 , 26 , 34 , 35 ) by demonstrating differences between the cervicovaginal environments based on women self-reporting White and Black racial backgrounds and providing data on the whole cervicovaginal environment ( 9 , 10 , 12 , 16 , 17 , 19 , 25 , 26 ). A healthy vaginal environment in pregnancy is considered to be one with low microbial diversity ( 14 , 25 ).…”

The impact of COVID-19 on pregnancy outcomes in a diverse cohort in England

“…National data from the UK 16 have shown an increase in iatrogenic preterm birth in symptomatic COVID-19, with largely good outcomes and a high proportion of affected women from Black, Asian and “other” minority ethnic groups. Most studies to date have lacked a control group, or compared outcomes to an unmatched historical cohort, and thus may overestimate the effect of COVID-19 due to the overlap between risk factors for COVID-19 16 and pregnancy complications, including obesity 17 and minority ethnicity 18 , 19 .…”

Validation of ethnicity in administrative hospital data in women giving birth in England: cohort study

“…1 19 In women giving birth, as across many areas of healthcare, it is well recognised that those from non-white ethnic groups experience poorer outcomes in the UK and across the world. [20][21][22][23][24][25] Reducing these inequalities requires a multifaceted approach, including access to good-quality data for monitoring care and outcomes stratified by ethnic group. 2 Electronic health records offer the potential to understand the associations between ethnicity and healthcare and outcomes in more detail, using statistical methods to understand to what extent associations are mediated through other factors such as socioeconomic deprivation and comorbidities.…”