Kayode Ggenga, Thilaganathan Baskaran, Burden Christy, Howell Amy, Cheng Vincent, Sandall Jane, Viner Maria, Brigante Lia, Anumba Dilly, Winter Cathy, Harlev-Lam Birte, Draycott Timothy, Judge Andrew, Lenguerrand Erik
Translational Health Science, Bristol Medical School, Southmead Hospital, University of Bristol, Bristol, UK.
Royal College of Obstetricians and Gynaecologists, London, UK.
BJOG. 2025 Jul;132(8):1130-1138. doi: 10.1111/1471-0528.18147. Epub 2025 May 16.
To examine the variation in stillbirth rates between different ethnic and socioeconomic groups within each organisational hospital group (health trust).
National registry study.
All health trusts (HT) in National Health Service England.
All mothers and babies born between April 2015 and March 2017.
This observational study examined ethnic and socioeconomic disparities in stillbirth rates for 1 268 367 births in 133 HTs compared to the national average.
Stillbirth at or after 24 gestational weeks.
The average stillbirth rates ranged from 3.4/1000 births for White women up to 7.1/1000 births for Black women. The rates ranged from 2.9/1000 births for women living in the least deprived areas to 4.7/1000 births for those in the most deprived. The proportions of HTs with stillbirth rates well above the national average (more than 2 standard deviations) for White, Asian and Black women were 0.8%, 21.8% and 38.6%, respectively. When HTs were ranked by stillbirth rate, there were notable variations, with some trusts demonstrating lower than average stillbirth rates for White women while concurrently having higher than average stillbirth rates for Asian and/or Black women. There were no units exhibiting lower than national average stillbirth rates for Asian/Black women while concurrently having higher than average stillbirth rates for White women.
These findings suggest that access to and delivery of maternity care vary depending on the mother's ethnicity and level of socioeconomic deprivation. Social factors are likely determinants of inequality in stillbirth rather than maternity care alone.
研究各组织医院组（医疗信托机构）内不同种族和社会经济群体之间死产率的差异。
全国登记研究。
英格兰国民医疗服务体系中的所有医疗信托机构。
2015年4月至2017年3月期间出生的所有母婴。
这项观察性研究将133个医疗信托机构中1268367例分娩的种族和社会经济差异与全国平均水平进行了比较，以分析死产率。
孕24周及以后的死产情况。
白人女性的平均死产率为每1000例分娩中有3.4例，黑人女性为每1000例分娩中有7.1例。生活在最不贫困地区的女性死产率为每1000例分娩中有2.9例，而生活在最贫困地区的女性为每1000例分娩中有4.7例。白人、亚洲和黑人女性死产率远高于全国平均水平（超过2个标准差）的医疗信托机构比例分别为0.8%、21.8%和38.6%。按死产率对医疗信托机构进行排名时，存在显著差异，一些信托机构白人女性的死产率低于平均水平，而亚洲和/或黑人女性的死产率高于平均水平。没有单位出现亚洲/黑人女性死产率低于全国平均水平，而白人女性死产率高于平均水平的情况。
这些发现表明，获得孕产妇护理的机会和孕产妇护理的提供情况因母亲的种族和社会经济贫困程度而异。社会因素可能是死产不平等的决定因素，而不仅仅是孕产妇护理。
