An Easy Step to Preventing BAME Baby Deaths

An easy step to preventing BAME baby deaths

As mentioned in my previous article, Health Inequality1, we know that pregnancy outcomes tend to be worse for women of Black and minority ethnic origin. Unfortunately, the higher death rates are not only seen for the mothers (Black women in the UK being four times more likely to die in pregnancy and childbirth than White women)2, but also the infants.

A study of 15 million pregnancies in the UK showed that babies of Black women are about twice as likely to die before or during delivery than those born to White women3. (This is known as a stillbirth). Even babies that are born alive are still more likely to die in the first 4 weeks of life (termed a ‘neonatal death’) if they are Black than if they are White4.

The good news: according to a study published in the British Journal of Obstetrics and Gynaecology in December, there is a very simple questionnaire that newly pregnant women can take that appears to virtually wipe out this excess risk5. The questionnaire was made by the Fetal Medicine Foundation (FMF) and, unlike the standard questions from the National Institute of Health and Clinical Excellence (NICE) that are usually used, it takes note of ethnicity, and gives a numerical risk score of developing placenta problems. (Placenta problems are responsible for a lot of these deaths.) The four-year study at St George’s University Hospitals NHS Foundation Trust compared the standard NICE checklist with the new FMF questions. For women who were found to be at higher risk, different treatments such as aspirin, extra scans, and an offer of a Due Date delivery were given.

The results were impressive, indeed: Not only is the new FMF questionnaire safer for all babies (shown by reducing the baby death rate by 60%), it brings the death rate down for non-White babies (death rate of 3.22 in 1,000 births) to almost the same level as White babies (2.55 per 1,000). This is even more significant when the same study showed that, with the old NICE questionnaire, non-White babies were 3 times more likely to die (7.95 in 1,000) than White babies (2.63 in 1,000)5.

The bad news: this questionnaire isn’t yet being used nation-wide. According to an online article by the Royal College of Midwives, it is currently being used and evaluated in Sheffield, Chertsey and Bolton, in addition to St George’s6.

If you are a pregnant woman of colour, ask your midwife or Obstetrician about the FMF screening tool, or read more about it in one of the links below. If you have questions about any issue raised by this article that you’d like to discuss, please feel free to book an appointment with one of our private GPs on the CheckUp Health app. We are currently offering free appointments for a limited time – use code WELCOME when booking an appointment for a £60 discount.

References

  1. https://checkuphealth.co.uk/blogs/health-inequality/
  2. https://www.npeu.ox.ac.uk/assets/downloads/mbrrace-uk/reports/maternal-report-2020/MBRRACE-UK_Maternal_Report_2020_-_Lay_Summary_v10.pdf
  3. Muglu J, Rather H, Arroyo-Manzano D, Bhattacharya S, Balchin I, Khalil A, et al. Risks of stillbirth and neonatal death with advanc-ing gestation at term: a systematic review and meta-analysis of cohort studies of 15 million pregnancies. PLoS Med. 2019;16(7):1–16. https://doi.org/10.1371/journal.pmed.1002838
  4. https://www.npeu.ox.ac.uk/assets/downloads/mbrrace-uk/reports/perinatal-surveillance-report-2019/MBRRACE-UK_Perinatal_Surveillance_Report_2019_-_Tables_and_Figures_V1.pdf
  5. Liu, B., Nadeem, U., Frick, A., Alakaloko, M., Bhide, A., & Thilaganathan, B. (2022). Reducing health inequality in Black, Asian and other minority ethnic pregnant women: impact of first trimester combined screening for placental dysfunction on perinatal mortality. BJOG : an international journal of obstetrics and gynaecology, https://doi.org/10.1111/1471-0528.17109
  6. https://www.rcm.org.uk/media-releases/2022/february/pregnancy-screening-algorithm-can-reduce-racial-disparities-in-baby-deaths-research-shows/

Leave a Reply

Your email address will not be published. Required fields are marked *