Wider determinants of adverse birth outcomes in Birmingham and Solihull

IntroductionBirmingham and Solihull face significant challenges related to adverse birth outcomes. This study aimed to identify demographic, socioeconomic, and lifestyle factors associated with an increased risk of low birth weight, premature birth, stillbirth, and neonatal death in Birmingham and S...

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Main Authors: David Ellis, Chung Him Au-Yeung, Alexander Dallaway, Ranjana Basra, Sylvia Owusu-Nepaul, Jenny Riley, Rebecca Howell-Jones, Justin Varney, Marion Gibbon
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1544903/full
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author David Ellis
Chung Him Au-Yeung
Alexander Dallaway
Alexander Dallaway
Ranjana Basra
Sylvia Owusu-Nepaul
Jenny Riley
Rebecca Howell-Jones
Justin Varney
Marion Gibbon
author_facet David Ellis
Chung Him Au-Yeung
Alexander Dallaway
Alexander Dallaway
Ranjana Basra
Sylvia Owusu-Nepaul
Jenny Riley
Rebecca Howell-Jones
Justin Varney
Marion Gibbon
author_sort David Ellis
collection DOAJ
description IntroductionBirmingham and Solihull face significant challenges related to adverse birth outcomes. This study aimed to identify demographic, socioeconomic, and lifestyle factors associated with an increased risk of low birth weight, premature birth, stillbirth, and neonatal death in Birmingham and Solihull.MethodsBirths (n = 41, 231) between October 2020 and April 2023 were analysed. The attributable fraction of premature births and low birth weight (LBW) attributable to socioeconomic and ethnic inequality was calculated. Multiple logistic regression analyses identified groups that had increased odds of premature birth (n = 3, 312), LBW (n = 1, 197), stillbirth (n = 173), and neonatal death (n = 208).ResultsAttributable fraction analysis estimated that 191 premature births and 211 LBWs each year would not have occurred if all women had the same rates as White women living in the least deprived areas. Ethnicity, socioeconomic deprivation, medical care, lifestyle, and vulnerability status were found to be significant risk factors for adverse birth outcomes. Asian and Black women had 1.4–2.7 times the odds of LBW compared to White women (p < 0.01). Black women had increased odds of stillbirth (OR : 1.75, p = 0.017) and Asian women had increased odds of neonatal death (OR : 1.90, p < 0.001). The odds of LBW (OR : 3.3), premature birth (OR : 27.2), and neonatal death (OR : 5.6) were significantly increased for twins (p < 0.001). For women smoking at delivery, the odds of LBW (OR : 2.3), premature birth (OR : 1.5), and stillbirth (OR : 1.6) were significantly increased (p < 0.05). Deprivation, and/or financial and housing issues also increased the odds of adverse birth outcomes (p < 0.05).DiscussionThese findings underscore the importance of targeted interventions and support for at-risk populations to reduce adverse birth outcomes in vulnerable communities.
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spelling doaj-art-c1304cb8ae43407e8ecde8b31af715db2025-08-20T03:08:29ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-04-011310.3389/fpubh.2025.15449031544903Wider determinants of adverse birth outcomes in Birmingham and SolihullDavid Ellis0Chung Him Au-Yeung1Alexander Dallaway2Alexander Dallaway3Ranjana Basra4Sylvia Owusu-Nepaul5Jenny Riley6Rebecca Howell-Jones7Justin Varney8Marion Gibbon9Public Health, Birmingham City Council, Birmingham, United KingdomPublic Health, Birmingham City Council, Birmingham, United KingdomFaculty of Education, Health and Wellbeing, School of Health and Society, University of Wolverhampton, Wolverhampton, United KingdomWarwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United KingdomBirmingham Women's and Children's Hospital Foundation Trust, Birmingham, United KingdomBirmingham Women's and Children's Hospital Foundation Trust, Birmingham, United KingdomPublic Health, Birmingham City Council, Birmingham, United KingdomPublic Health, Birmingham City Council, Birmingham, United KingdomPublic Health, Birmingham City Council, Birmingham, United KingdomPublic Health, Birmingham City Council, Birmingham, United KingdomIntroductionBirmingham and Solihull face significant challenges related to adverse birth outcomes. This study aimed to identify demographic, socioeconomic, and lifestyle factors associated with an increased risk of low birth weight, premature birth, stillbirth, and neonatal death in Birmingham and Solihull.MethodsBirths (n = 41, 231) between October 2020 and April 2023 were analysed. The attributable fraction of premature births and low birth weight (LBW) attributable to socioeconomic and ethnic inequality was calculated. Multiple logistic regression analyses identified groups that had increased odds of premature birth (n = 3, 312), LBW (n = 1, 197), stillbirth (n = 173), and neonatal death (n = 208).ResultsAttributable fraction analysis estimated that 191 premature births and 211 LBWs each year would not have occurred if all women had the same rates as White women living in the least deprived areas. Ethnicity, socioeconomic deprivation, medical care, lifestyle, and vulnerability status were found to be significant risk factors for adverse birth outcomes. Asian and Black women had 1.4–2.7 times the odds of LBW compared to White women (p < 0.01). Black women had increased odds of stillbirth (OR : 1.75, p = 0.017) and Asian women had increased odds of neonatal death (OR : 1.90, p < 0.001). The odds of LBW (OR : 3.3), premature birth (OR : 27.2), and neonatal death (OR : 5.6) were significantly increased for twins (p < 0.001). For women smoking at delivery, the odds of LBW (OR : 2.3), premature birth (OR : 1.5), and stillbirth (OR : 1.6) were significantly increased (p < 0.05). Deprivation, and/or financial and housing issues also increased the odds of adverse birth outcomes (p < 0.05).DiscussionThese findings underscore the importance of targeted interventions and support for at-risk populations to reduce adverse birth outcomes in vulnerable communities.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1544903/fullpregnancy outcomepregnancy complicationshealth inequitiessocial determinants of healthsocioeconomic factorsethnicity
spellingShingle David Ellis
Chung Him Au-Yeung
Alexander Dallaway
Alexander Dallaway
Ranjana Basra
Sylvia Owusu-Nepaul
Jenny Riley
Rebecca Howell-Jones
Justin Varney
Marion Gibbon
Wider determinants of adverse birth outcomes in Birmingham and Solihull
Frontiers in Public Health
pregnancy outcome
pregnancy complications
health inequities
social determinants of health
socioeconomic factors
ethnicity
title Wider determinants of adverse birth outcomes in Birmingham and Solihull
title_full Wider determinants of adverse birth outcomes in Birmingham and Solihull
title_fullStr Wider determinants of adverse birth outcomes in Birmingham and Solihull
title_full_unstemmed Wider determinants of adverse birth outcomes in Birmingham and Solihull
title_short Wider determinants of adverse birth outcomes in Birmingham and Solihull
title_sort wider determinants of adverse birth outcomes in birmingham and solihull
topic pregnancy outcome
pregnancy complications
health inequities
social determinants of health
socioeconomic factors
ethnicity
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1544903/full
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