The Impact of Community-Based Midwife Continuity of Care Models for Women Living in Areas of Social Disadvantage and Ethnic Diversity in the United Kingdom: A Prospective Cohort Study

Fernandez Turienzo, C, Burton, S ORCID: 0000-0003-3823-3275, Khan, Z, Rayment-Jones, H, Newburn, M, Seed, P, Vowles, Z, Sandall, J, Easter, A and the eLIXIR-BiSL Partnership (2026) The Impact of Community-Based Midwife Continuity of Care Models for Women Living in Areas of Social Disadvantage and Ethnic Diversity in the United Kingdom: A Prospective Cohort Study. BJOG: An International Journal of Obstetrics & Gynaecology. ISSN 1470-0328

Preview

Text BJOG - 2026 - Fernandez Turienzo - The Impact of Community‐Based Midwife Continuity of Care Models for Women Living in.pdf - Published Version Available under License Creative Commons Attribution. Download (331kB) | Preview

Abstract

Objective
Addressing inequalities in maternal and newborn health is a UK public health priority. Evidence on effective multi-interventional strategies is urgently needed. This study evaluated the impact of community-based midwife continuity of care (CBMCOC) models for women and babies in ethnically diverse and socially disadvantaged areas of South London.

Design
We conducted a prospective cohort study using the eLIXIR, Born in South London, maternity–child data linkage.

Setting
United Kingdom.

Population
Pregnant women exposed to CBMCOC and standard care between 2018 and 2020.

Methods
Propensity score matching (1:4) was used to account for differences between CBMCOC and standard care cohorts and control for confounding bias. Conditional logistic regression estimated risk ratios. Subgroup analysis included women of Black, Asian and other ethnic minority groups, and those living in highly deprived areas.

Outcomes
The primary outcome was preterm birth (< 37 weeks' gestation). Secondary outcomes included other relevant maternal, perinatal, process and clinical variables.

Results
Before matching, 12 386 women were exposed to standard care and 1338 to CBMCOC; after matching, 5352 and 1338 were included, respectively. The risk of preterm birth was lower among women exposed to CBMCOC (unmatched: 4.6% vs. 10.3%, RR = 0.50, 95% CI: 0.38–0.64; matched: 4.6% vs. 8.4%, RR = 0.54, 95% CI: 0.40–0.70). Subgroup analyses showed reduced preterm birth rates among ethnic minority women and those in deprived areas when exposed to CBMCOC.

Conclusions
In this diverse population with a range of risk factors, locality-based interventions integrating community-based care and midwife continuity may reduce maternal and newborn health inequalities. Further trials of such models should be conducted.

Item Type:	Article
Uncontrolled Keywords:	11 Medical and Health Sciences; Obstetrics & Reproductive Medicine; 3215 Reproductive medicine
Subjects:	B Philosophy. Psychology. Religion > BF Psychology H Social Sciences > HQ The family. Marriage. Woman H Social Sciences > HT Communities. Classes. Races R Medicine > RG Gynecology and obstetrics
Divisions:	Psychology (from Sep 2019)
Publisher:	Wiley
Date of acceptance:	13 November 2025
Date of first compliant Open Access:	22 January 2026
Date Deposited:	22 Jan 2026 12:04
Last Modified:	22 Jan 2026 12:04
DOI or ID number:	10.1111/1471-0528.70101
URI:	https://researchonline.ljmu.ac.uk/id/eprint/27957

View Item