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Deprivation, Ethnicity Major Predictors of Perinatal Death

Spending on maternal services doesn't explain differences in infant, perinatal deaths

WEDNESDAY, Aug. 5 (HealthDay News) -- Infant and perinatal mortality are high in parts of England, and social deprivation, ethnicity and maternal age explain many of the differences in these mortality rates between primary care trusts, according to a study published Aug. 4 in BMJ.

Nick Freemantle, Ph.D., of the University of Birmingham in the United Kingdom, and colleagues obtained data on infant and perinatal mortality, ethnicity, deprivation, maternal age, spending on maternal services and "Spearhead" status (signifying the worst mortality rates) for the 303 primary care trusts in England. They used predictive models to explain differences in infant and perinatal mortality between trusts and to identify trusts with worse-than-expected outcomes.

The researchers found that infant mortality rates varied by trust from 1.4 to 10.83 deaths per 1,000 live births, and that perinatal mortality varied from 3.93 to 16.66 per 1,000 births. A combination of maternal age, ethnicity and social deprivation accounted for 80.5 percent of the differences in perinatal mortality between trusts. The authors further note that spending on maternal services did not account for any of the differences.

"Most primary care trusts can be confident on the basis of these findings that the social conditions and ethnicity of the communities they serve are more important determinants of these particular health outcomes than current variation in levels of expenditure on maternity services," the authors write. "Nevertheless, the absolute rates of infant and perinatal mortality remain high in parts of England, and the burden of avoidable deaths remains largely with deprived communities and ethnic minorities."

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