Joint contribution of socioeconomic circumstances and ethnic group to variations in preterm birth, neonatal mortality and infant mortality in England and Wales: a population-based retrospective cohort study using routine data from 2006 to 2012.
Adult
Bangladesh
/ ethnology
Black People
/ ethnology
Caribbean Region
/ ethnology
England
/ epidemiology
Female
Humans
India
/ ethnology
Infant
Infant Mortality
/ ethnology
Infant, Newborn
Male
Maternal Age
Minority Groups
/ statistics & numerical data
Pakistan
/ ethnology
Premature Birth
/ ethnology
Retrospective Studies
Socioeconomic Factors
Wales
/ epidemiology
White People
/ statistics & numerical data
IMD
NS-SEC
area deprivation
ethnicity
infant mortality
mediation
neonatal mortality
preterm birth
socioeconomic circumstances
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
31 07 2019
31 07 2019
Historique:
entrez:
3
8
2019
pubmed:
3
8
2019
medline:
10
6
2020
Statut:
epublish
Résumé
This study aimed to describe the variation in risks of adverse birth outcomes across ethnic groups and socioeconomic circumstances, and to explore the evidence of mediation by socioeconomic circumstances of the effect of ethnicity on birth outcomes. England and Wales. The data came from the 4.6 million singleton live births between 2006 and 2012. The main exposure was ethnic group. Socioeconomic circumstances, the hypothesised mediator, were measured using the Index of Multiple Deprivation (IMD), an area-level measure of deprivation, based on the mother's place of residence. The primary outcomes were birth outcomes, namely: neonatal death, infant death and preterm birth. We estimated the slope and relative indices of inequality to describe differences in birth outcomes across IMD, and the proportion of the variance in birth outcomes across ethnic groups attributable to IMD. We investigated mediation by IMD on birth outcomes across ethnic groups using structural equation modelling. Neonatal mortality, infant mortality and preterm birth risks were 2.1 per 1000, 3.2 per 1000 and 5.6%, respectively. Babies in the most deprived areas had 47%-129% greater risk of adverse birth outcomes than those in the least deprived areas. Minority ethnic babies had 48%-138% greater risk of adverse birth outcomes compared with white British babies. Up to a third of the variance in birth outcomes across ethnic groups was attributable to differences in IMD, and there was strong statistical evidence of an indirect effect through IMD in the effect of ethnicity on birth outcomes. There is evidence that socioeconomic circumstances could be contributing to the differences in birth outcomes across ethnic groups.
Identifiants
pubmed: 31371291
pii: bmjopen-2018-028227
doi: 10.1136/bmjopen-2018-028227
pmc: PMC6677942
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e028227Informations de copyright
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
Psychol Bull. 1990 Mar;107(2):238-46
pubmed: 2320703
Semin Perinatol. 2011 Aug;35(4):240-4
pubmed: 21798404
Health Stat Q. 2008 Winter;(40):18-29
pubmed: 19093637
BJOG. 2013 Oct;120(11):1356-65
pubmed: 23700966
Soc Sci Med. 1997 Mar;44(6):901-10
pubmed: 9080570
Am J Public Health. 2003 Feb;93(2):277-84
pubmed: 12554585
Health Stat Q. 2008 Autumn;(39):22-31, 34-55
pubmed: 18810886
BJOG. 2008 Jan;115(1):38-43
pubmed: 18053102
Stat Med. 1996 Oct 15;15(19):1987-97
pubmed: 8896134
BMJ Open. 2016 Apr 05;6(4):e009511
pubmed: 27048631
Lancet. 2012 Jun 9;379(9832):2151-61
pubmed: 22579125
Lancet. 2010 Jun 5;375(9730):1969-87
pubmed: 20466419
Health Stat Q. 2008 Spring;(37):15-23
pubmed: 18351024
Popul Stud (Camb). 1985 Mar;39(1):17-31
pubmed: 11611750
BJOG. 2011 Sep;118(10):1196-204
pubmed: 21668771
Br J Math Stat Psychol. 2014 Nov;67(3):451-70
pubmed: 24188158
J Pers Soc Psychol. 1986 Dec;51(6):1173-82
pubmed: 3806354
Popul Stud (Camb). 2010 Mar;64(1):19-41
pubmed: 20087815
BMC Public Health. 2008 Sep 15;8:316
pubmed: 18793437
Am J Public Health. 2002 Apr;92(4):624-31
pubmed: 11919063
Annu Rev Sociol. 2008 Jan 1;34:181-209
pubmed: 20689680
J Epidemiol Community Health. 2009 Sep;63(9):681-2
pubmed: 19679713
PLoS One. 2018 Apr 12;13(4):e0195146
pubmed: 29649290
BMC Pregnancy Childbirth. 2013 Apr 25;13:97
pubmed: 23617598
J Epidemiol Community Health. 2004 Nov;58(11):900-3
pubmed: 15483304
Health Stat Q. 2007 Spring;(33):25-33
pubmed: 17373380
Soc Sci Med. 2013 Apr;83:42-9
pubmed: 23465203
Am J Public Health. 2019 Jan;109(S1):S28-S33
pubmed: 30699015