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Observational Study
. 2025 Jul;132(8):1130-1138.
doi: 10.1111/1471-0528.18147. Epub 2025 May 16.

Disparities in Stillbirths in England: Analysis of A Population-Based Study of 1.3 Million Births

Ggenga Kayode  1 , Baskaran Thilaganathan  2   3 , Christy Burden  1 , Amy Howell  1 , Vincent Cheng  1 , Jane Sandall  4 , Maria Viner  5 , Lia Brigante  6 , Dilly Anumba  7 , Cathy Winter  8 , Birte Harlev-Lam  6 , Timothy Draycott  1   2   8 , Andrew Judge  1 , Erik Lenguerrand  1 ; Tommy's National Centre for Maternity Improvement
Affiliations
Observational Study

Disparities in Stillbirths in England: Analysis of A Population-Based Study of 1.3 Million Births

Ggenga Kayode et al. BJOG. 2025 Jul.

Abstract

Objective: To examine the variation in stillbirth rates between different ethnic and socioeconomic groups within each organisational hospital group (health trust).

Design: National registry study.

Setting: All health trusts (HT) in National Health Service England.

Population: All mothers and babies born between April 2015 and March 2017.

Methods: This observational study examined ethnic and socioeconomic disparities in stillbirth rates for 1 268 367 births in 133 HTs compared to the national average.

Outcome: Stillbirth at or after 24 gestational weeks.

Results: 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.

Conclusions: 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.

Keywords: ethnicity; maternity care provision; social inequality; stillbirth.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Variation in stillbirth rate across health trusts in NHS England compared to the national rate (3.4 stillbirths/1000 births).
FIGURE 2
FIGURE 2
Variation in stillbirth rate across health trusts in NHS England by ethnicity compared to the national rate (3.4 stillbirths/1000 births).
FIGURE 3
FIGURE 3
Variation in stillbirth rate across health trusts in NHS England by Index of Multiple Deprivation (IMD) compared to the national rate (3.4 stillbirths/1000 births).
See this image and copyright information in PMC

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