Trends in infant mortality and stillbirth rates in Scotland by socio-economic position, 2000–2018: a longitudinal ecological study

Abstract

Background As Scotland strives to become a country where children flourish in their early years, it is faced with the challenge of socio-economic health inequalities, which are at risk of widening amidst austerity policies. The aim of this study was to explore trends in infant mortality rates (IMR) and stillbirth rates by socio-economic position (SEP) in Scotland, between 2000 and 2018, inclusive. Methods Data for live births, infant deaths, and stillbirths between 2000 and 2018 were obtained from National Records of Scotland. Annual IMR and stillbirth rates were calculated and visualised for all of Scotland and when stratified by SEP. Negative binomial regression models were used to estimate the association between SEP and infant mortality and stillbirth events, and to assess for break points in trends over time. The slope (SII) and relative (RII) index of inequality compared absolute and relative socio-economic inequalities in IMR and stillbirth rates before and after 2010. Results IMR fell from 5.7 to 3.2 deaths per 1000 live births between 2000 and 2018, with no change in trend identified. Stillbirth rates were relatively static between 2000 and 2008 but experienced accelerated reduction from 2009 onwards. When stratified by SEP, inequalities in IMR and stillbirth rates persisted throughout the study and were greatest amongst the sub-group of post-neonates. Although comparison of the SII and RII in IMR and stillbirths before and after 2010 suggested that inequalities remained stable, descriptive trends in mortality rates displayed a 3-year rise in the most deprived quintiles from 2016 onwards. Conclusion Whilst Scotland has experienced downward trends in IMR and stillbirth rates between 2000 and 2018, the persistence of socio-economic inequalities and suggestion that mortality rates amongst the most deprived groups may be worsening warrants further action to improve maternal health and strengthen support for families with young children.

Epidemiology of sudden infant death syndrome in Mexico, 2005–2020

“…This analysis also shows that in Mexico, for the studied period, 76.2% of deaths due SIDS occurred at home and up to 87% occurred in families without social security services or where their social security status was not known (Figure 7). This fact is directly related to the socioeconomic status of families and formal jobs, and probably most of these deaths occurred among poor families (22,49). The loss of an apparently healthy baby is a catastrophic event for any family, disconcerting for a doctor and a challenge for the forensic expert or pathologist in charge of proving the cause of death (50), as well as for the person responsible for the categorization.…”

“…This analysis also shows that in Mexico, for the studied period, 76.2% of deaths due SIDS occurred at home and up to 87% occurred in families without social security services or where their social security status was not known ( Figure 7 ). This fact is directly related to the socioeconomic status of families and formal jobs, and probably most of these deaths occurred among poor families ( 22 , 49 ).…”

Mortalidade infantil associada às iniquidades sociais: revisão de escopo

“…Trends in infant mortality and stillbirth rates in Scotland by socioeconomic position, 2000-2018: a longitudinal ecological study (61) 2021/ Escócia Estudo ecológico/ n=1.049.567…”

“…• Baixo nível socioeconômico foi associado a mortalidade infantil (1,10,11,15,44,47,61,(63)(64)(65) e a mortalidade neonatal (36) , a taxa de mortalidade infantil aumenta por fatores sociodemográfico (17) , pois está associada principalmente às populações socioeconomicamente desfavorecidas (49) , entretanto em condições socioeconômicas acima da média nacional não associaram mortalidade infantil as iniquidades sociais (34) .…”

Perinatal mortality in Ireland: inequalities by socio-economic group and country of birth

“…Smith et al, 6 for example, examining neonatal mortality in England found that the relative neonatal mortality gap between the most deprived tenth of the population of births and the least deprived tenth increased from 2.08 in 1997–99 to 2.68 in 2003–05 before falling to 2.35 in 2006–07. In Scotland, Harpur et al 7 found that while socio-economic inequalities in stillbirth and infant mortality were relatively consistent though time, there was some evidence to suggest that mortality rates in the most deprived groups deteriorated over time.…”