Racial, Social Factors Raise Pregnancy Risks, U.K. Study Shows

(Bloomberg) -- Race and socioeconomic factors play a key role in many adverse pregnancy outcomes such as stillbirth, according to a U.K. study of more than one million women.

Socioeconomic inequalities account for a quarter of stillbirths, a fifth of preterm births, and a third of births with fetal growth restriction, the research, published Monday in The Lancet medical journal, found. South Asian and Black women living in the most deprived areas in England experienced the largest inequity in pregnancy outcomes, the authors said.

The risk of stillbirth rose from 0.3% in White women to 0.7% in Black women, the data showed. South Asian women and Black women were also more likely to experience preterm birth -- before 37 weeks’ gestation -- with a risk of 6.5% and 6.6% respectively, compared with 6% for White women.

Racial and social inequality have been recognized as factors in birth outcomes in developed countries like the U.K. and U.S. for some time, though the extent to which they play a role isn’t always known. The National Health Service in England set a target to reduce overall rates of stillbirth and neonatal mortality by 50% and preterm birth by 25% between 2019 and 2025, yet efforts to improve results are affected by a lack of information on how social circumstances translate to birth.

The report, led by researchers from the U.K.’s Royal College of Obstetricians and Gynaecologists and the London School of Hygiene & Tropical Medicine, drew on data from the birth records of women who delivered one child between 2015 and 2017 in England. The authors concluded that 24% of stillbirths would not have occurred if pregnant women had the same risk of adverse outcomes.

“Efforts to close the gap in birth outcomes focusing primarily on improving maternity care and targeting individual behaviors have not been successful,” said co-lead author Jennifer Jardine from the Royal College. What’s needed is for “public health professionals and politicians to strengthen efforts to address the lifelong, cumulative impact of racism and social and economic inequalities on the health of women, families and communities.”

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