Babies born to Black mothers in rich countries twice as likely to die in first weeks of life

Largest analysis of perinatal outcomes finds disparities in outcomes based on race and ethnicity in high and upper-middle income countries

Black expectant mother wearing white dress with her hands and the hands of black father behind her on her pregnancy bump

Not enough is known about the causes and barriers that are leading to worse maternal outcomes for babies born to minority ethnic mothers.

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, new research has found.

A new meta-analysis published in the Lancet today (Thursday 8 December) funded by the National Institute for Health and Care Research, the research partner of the NHS, and the health charity Wellbeing of Women, shows significantly worse survival and health impacts for babies born to women from Black and ethnic minority groups across high and upper-middle income countries including the UK, US, and Canada.

Drawing on 2.2 million pregnancies across 20 countries, the team of researchers from the University of Birmingham, Birmingham Children’s Hospital, Ramon y Cajal Hospital Madrid, and St George’s University London found that Black women were twice as likely to experience neonatal mortality, where their baby dies in the first 28 days after being born, as well as having a stillborn baby, compared to white women. Black mothers also experienced worse outcomes including preterm birth and small-for-gestation-age babies leading to increased risk of health complications.

The study found that Hispanic mothers experienced worse neonatal mortality with three times as many babies dying in the first four weeks after birth compared to white women across the countries considered for the study. The analysis also found that mothers from South Asia and East Asia had significantly higher rates of preterm birth and small-for-gestation-age babies.

Professor Shakila Thangaratinam from the University of Birmingham and lead author of the study said:

“Our analysis shows that babies of mothers from underserved 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.

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.

Professor Shakila Thangaratinam

“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.”

 Global need to address disparities

The disparities in pregnancy outcomes highlighted between groups of underserved and under-represented mothers and white mothers highlight the need for global action.

Although the analysis of 51 papers demonstrates the scale of disparities between groups, the research group point out that a lack of data to identify the scale of the risks faced by women from racial and ethnic minority backgrounds.

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.”

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Notes for editors

For media enquiries please contact Tim Mayo, Press Office, University of Birmingham, tel: +44 (0)7920 405040: email: t.mayo@bham.ac.uk

The University of Birmingham is ranked amongst the world’s top 100 institutions. Its work brings people from across the world to Birmingham, including researchers, teachers and more than 6,500 international students from over 150 countries.

The University of Birmingham is a founding member of Birmingham Health Partners (BHP), a strategic alliance which transcends organisational boundaries to rapidly translate healthcare research findings into new diagnostics, drugs and devices for patients. Birmingham Health Partners is a strategic alliance between seven organisations who collaborate to bring healthcare innovations through to clinical application:

  • University of Birmingham
  • University Hospitals Birmingham NHS Foundation Trust
  • Birmingham Women's and Children's Hospitals NHS Foundation Trust
  • Aston University
  • The Royal Orthopaedic Hospital NHS Foundation Trust
  • Sandwell and West Birmingham Hospitals NHS Trust
  • West Midlands Academic Health Science Network

About the National Institute for Health and Care Research

The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. We do this by:

  • Funding high-quality, timely research that benefits the NHS, public health and social care;
  • Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services;
  • Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research;
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  • Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system;
  • Funding applied global health research and training to meet the needs of the poorest people in low and middle income countries.

NIHR is funded by the Department of Health and Social Care. Its work in low and middle income countries is principally funded through UK Aid from the UK government.

About Wellbeing of Women

Wellbeing of Women is the health charity saving and changing the lives of women, girls and babies. Led by women's voices, we improve health and wellbeing through research, education and advocacy. We imagine a world in which women's lives are not limited by their gynaecological and reproductive health. Help us make this a reality.