A national population-based cohort study to investigate inequalities in maternal mortality in the UK 2009-17: Running title: Inequalities in UK maternal mortality

Research output: Contribution to journalArticle

Authors

  • Marian Knight
  • Kathryn Bunch
  • Sara Kenyon
  • Derek Tuffnell
  • Jennifer Kurinczuk

Colleges, School and Institutes

External organisations

  • University of Oxford
  • University of Bradford

Abstract

Background
Disparities have been documented in maternal mortality rates between women from different ethnic, age and socioeconomic groups in the UK. It is unclear whether there are differential changes in these rates amongst women from different groups over time.
Objectives
To describe maternal mortality rates in different age, ethnic and socioeconomic groups between 2009-17 in the UK, and to identify whether there are any changes in the observed inequalities, or different trends amongst population subgroups.
Methods
Maternal mortality rates with 95% confidence intervals (CI) in specific age, deprivation and ethnic groups were calculated using numbers of maternal deaths as numerator and total maternities as denominator. Risk ratios (RR) with 95% CI were calculated and compared using ratios of relative risk (RRR). Change over time was investigated using non-parametric tests for trend across ordered
groups.
Results
Women from black and Asian groups had a higher mortality rate than white women in most time periods, as did women aged 35 and over and women from the most deprived quintile areas of residence. There was evidence of an increasing trend in maternal mortality amongst black women (p=0.029) and a decrease in mortality amongst women from the least deprived areas (Quintile I
p=0.054, II p=0.029), but no statistically significant trends over time in any of the other ethnic, age or IMD groups. There was a widening of the disparity between black and white women (RR 2.59 in 2009-11 compared to 5.27 in 2015-17, ratio of the relative risks (RRR) 2.03, 95% CI 1.11, 3.72).
Conclusions
The clear differences in the patterns of maternal mortality amongst different ethnic, age and socioeconomic groups emphasise the importance of research and policies focussed specifically on women from black and minority ethnic groups, together with other disadvantaged groups, to begin to reduce maternal mortality in the UK.

Details

Original languageEnglish
JournalPaediatric and Perinatal Epidemiology
Publication statusAccepted/In press - 4 Dec 2019

Keywords

  • Maternal mortality, ethnic groups, socioeconomic factors, maternal age, cohort analysis