Infant mortality rates in deprived areas of England are more than double that of the least deprived areas, analysis has shown.
Researchers from the University of Glasgow identified four key factors which significantly influence infant mortality rates, including pre-term birth, smoking during pregnancy, teenage pregnancy and maternal depression.
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Together, these factors account for more than one-third of the inequalities observed between the most and least deprived areas of England.
The findings, published in The Lancet Regional Health Europe, highlight the ‘alarming’ differences in infant mortality rates across the country and the need for increased Government investment in deprived areas.
Infant mortality measures a country’s health and wellbeing, reflecting the effectiveness of the health systems and the impact of economic and social conditions on the health of mothers and newborns. Overall, infant mortality in the UK has improved from the 1980s to the early 2010s, but since 2014, rates of improvement have plateaued. In areas of high deprivation, infant mortality has increased from 5.3 deaths per 1,000 births in 2018 to 5.5 deaths per 1,000 births in 2021. In contrast, in the least deprived areas, infant mortality dropped from 2.7 deaths per 1,000 births in 2018 to 2.5 deaths per 1,000 births in 2021.
The researchers analysed data from primary care records from the Clinical Practice Research Datalink (CPRD), which is linked to the Index of Multiple Deprivation (IMD), and infant mortality from the Office for National Statistics death data. Almost 400,000 linked mother and child health records across England between 2004 and 2019 were examined. Potential influencing factors, including maternal age, prior maternal health conditions, pregnancy lifestyle factors and complications, use of medications during pregnancy, and characteristics of birth, were considered, and statistical analysis was used to determine the associations between each factor and infant mortality.
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Four key factors were identified as contributing most to infant mortality rates. These include pre-term birth, smoking during pregnancy, teenage pregnancy and maternal depression, which were all highlighted as notable risk factors.
If the issue of pre-term birth is addressed, the researchers estimate that it could reduce the inequality in infant mortality by 15.23 per cent. Similarly, addressing the problems associated with smoking during pregnancy, maternal age of less than 20 years at childbirth, and maternal depression could reduce the inequality in infant mortality by 13.6 per cent, 10.52 per cent and 9.1 per cent, respectively. Collectively, these factors account for more than one-third of the socioeconomic inequality in mortality rates amongst infants.
Targeting these factors through a series of interventions could mitigate a proportion of the inequality in infant mortality rates, but the researchers suggest that the underlying socioeconomic issues must also be addressed.
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Dr Frederick Ho, lead author of the study from the University of Glasgow’s School of Health and Wellbeing, said: ‘The inequality in infant mortality is at an alarming level. This study shows that while inequality could be potentially reduced by changing healthcare and lifestyle, policy changes, such as increased investment in deprived areas, would be required for substantial improvement.’
