The Role of Ethnicity and Migration in Perinatal Inequalities: A Retrospective Cohort Study

Rayment-Jones, H, Burton, S ORCID: 0000-0003-3823-3275, Bridle, L, Mohamud, Y, Easter, A, Seed, P, The eLIXIR Born in South London Partnership and Sandall, J (2026) The Role of Ethnicity and Migration in Perinatal Inequalities: A Retrospective Cohort Study. BJOG: An International Journal of Obstetrics and Gynaecology. ISSN 1470-0328

Preview

Text BJOG - 2026 - Rayment‐Jones - The Role of Ethnicity and Migration in Perinatal Inequalities A Retrospective Cohort Study.pdf - Published Version Available under License Creative Commons Attribution. Download (308kB) | Preview

Abstract

Objective
To examine ethnic disparities in perinatal outcomes and the role of migration factors.

Design
Retrospective cohort.

Setting
Two maternity services in South London, UK.

Population or Sample
Women birthing singleton infants between 24 and 43 weeks' gestation (2018–2023).

Methods
Linked electronic health records were analysed using generalised linear mixed models (GLMMs) with Poisson distribution to estimate adjusted risk ratios (aRR) and 95% confidence intervals (CI) by ethnicity, migration, interpreter need, and country-of-origin income, adjusting for socioeconomic deprivation and medical risk.

Main Outcome Measures
Emergency caesarean, haemorrhage, preterm birth, low birthweight, low Apgar score, stillbirth or neonatal death.

Results
Among 44 634 births, compared with White women, emergency caesarean risk was higher for Asian (aRR 1.22, 95% CI 1.14–1.30, p < 0.001) and Black women (1.16, 1.10–1.23, p < 0.001). Haemorrhage was higher for Asian women (1.12, 1.02–1.23, p = 0.021), those needing interpretation (1.16, 1.06–1.27, p < 0.001), and lower for Mixed ethnicity women (0.86, 0.74–0.99, p = 0.038). Infants of Black women had elevated risks of preterm birth (1.23, 1.13–1.34, p < 0.001), low birthweight (1.74, 1.60–1.89, p < 0.001), low Apgar (2.06, 1.71–2.48, p < 0.001), and stillbirth/neonatal death (1.57, 1.21–2.05, p < 0.001). Asian infants had increased risks of preterm birth (1.19, 1.07–1.33, p = 0.002) and low birthweight (1.69, 1.52–1.87, p < 0.001). Foreign-born women had lower risks of low birthweight (0.71, 0.62–0.81, p < 0.001) but higher risks of low Apgar (1.24, 1.06–1.46, p = 0.009) and stillbirth/neonatal death (1.33, 1.07–1.65, p = 0.011). Risks were highest for ethnic minority, foreign-born women, though effect sizes were modest.

Conclusions
Ethnic minority and foreign-born women, particularly from LMICs or needing interpreters, face elevated risks with modest clinical impact.

Item Type:	Article
Uncontrolled Keywords:	11 Medical and Health Sciences; Obstetrics & Reproductive Medicine; 3215 Reproductive medicine
Subjects:	B Philosophy. Psychology. Religion > BF Psychology R Medicine > RG Gynecology and obstetrics
Divisions:	Psychology (from Sep 2019)
Publisher:	Wiley
Date of acceptance:	16 January 2026
Date of first compliant Open Access:	30 January 2026
Date Deposited:	30 Jan 2026 10:31
Last Modified:	30 Jan 2026 10:31
DOI or ID number:	10.1111/1471-0528.70169
URI:	https://researchonline.ljmu.ac.uk/id/eprint/28016

View Item