Intended for healthcare professionals


Socioeconomic inequalities in survival in neonates

BMJ 2009; 339 doi: (Published 02 December 2009) Cite this as: BMJ 2009;339:b5041
  1. Ron Gray, senior clinical research fellow1,
  2. Marie C McCormick, Sumner and Esther Feldberg professor of maternal and child health2
  1. 1National Perinatal Epidemiology Unit, University of Oxford, Headington, Oxford OX3 7LF
  2. 2Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA 02115, USA
  1. ron.gray{at}

    Access to good intensive care blunts the effects of deprivation

    In the linked prospective cohort study (doi:10.1136/bmj.b4702), Smith and colleagues assessed socioeconomic inequalities in survival and neonatal care provision among very preterm infants.1 A cohort of 7449 infants born during a 10 year period (1998-2007) at between 22+0 and 32+6 weeks’ gestation were followed up until discharge from neonatal care. What do the findings suggest about equity of neonatal care provision?

    Preterm birth is a leading cause of infant mortality worldwide and a substantial cause of childhood disability in survivors. The risks of death are highest in babies born before 33 weeks’ gestation—the very preterm group. Furthermore, both preterm birth and infant mortality are associated with socioeconomic position, with the risks being highest in those from the most deprived socioeconomic groups.2 3 As might be expected, the most striking socioeconomic inequalities in neonatal survival are seen from a global perspective, with 98% of neonatal deaths occurring in less developed countries.4 However, even in high income …

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