Preterm Births Higher Among Poor Mothers, Despite Equal Care

Despite improvements in obstetric care services, women from deprived areas are still more likely to give birth to a very preterm baby compared with mothers from more affluent areas, finds a study published on the British Medical Journal website.

Yet survival rates and provision of care was similar for infants from all areas, suggesting that neonatal care provision is equitable. A finding in contrast to many other areas of health care where socioeconomic inequalities in survival and access to care are common.

These findings highlight an urgent need to better understand the link between deprivation and risk of preterm birth, say the authors.

Researchers at the University of Leicester tracked 7,449 very preterm infants born 1998-2007 in the former Trent region of England from the onset of labor until discharge from neonatal care. A deprivation score was calculated for each infant using postcode data.

The authors point out that the data came only from one English region, which has about 54,000 births a year, representing one in 12 UK births, so the findings can't necessarily be extrapolated to different places. However, Trent does have a particularly good prospective dataset about births.

Their results show that mothers from the most deprived areas were nearly twice as likely to have a very preterm infant compared to those from the least deprived areas and consequently there were nearly twice as many deaths due to very preterm birth in the most deprived areas.

However, among very preterm infants, survival rates and neonatal care provision showed little variation across all deprivation measures. This suggests that, although socioeconomic inequalities in preterm birth rates persist, deprivation does not seem to be a barrier to accessing and receiving neonatal care.

This study did not look at individual factors such as smoking, ethnicity, and history of previous preterm birth. They believe that future studies should focus on the interplay between very preterm birth and the wider determinants of socioeconomic inequalities in health.

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