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Covid-19: Admit ethnic minority pregnant women to hospital earlier, says NHS England

BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m2628 (Published 30 June 2020) Cite this as: BMJ 2020;369:m2628

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  1. Gareth Iacobucci
  1. The BMJ

Pregnant women from ethnic minority backgrounds who display covid-19 symptoms should have a lower threshold for admission to hospital, NHS England has said.

The advice comes after research1 recently published in The BMJ showed that more than half of pregnant women admitted to hospital with covid-19 are from an ethnic minority background, even though they only make up a quarter of the births in England and Wales.

Because of the increased risk, local NHS bodies should ensure that clinicians have a lower threshold to review, admit, and consider multidisciplinary escalation in women from ethnic minority backgrounds, NHS England said.

Maternity units should also discuss vitamins, supplements, and nutrition in pregnancy with all women, and reach out and reassure pregnant ethnic minority women with tailored communications, NHS England recommends.

It also advised that in NHS trust maternity information systems, ethnicity should be recorded alongside other risk factors such as living in a deprived area, comorbidities, body mass index, and being aged 35 years or over, to identify those most at risk of poor outcomes.

The advice has been communicated to trusts by England’s chief midwifery officer Jacqueline Dunkley-Bent.

“While Public Health England is continuing to assess and advise on the impact of the covid-19 outbreak on ethnic groups, I want to make sure that the NHS is doing everything we can to reach out, reassure, and support those pregnant women and new mums most at risk,” she said.

“Understandably, the pandemic has caused pregnant women increased anxiety, but I want to make sure that every pregnant woman in England knows that the NHS is here for them. If you have any doubt whatsoever that something isn’t right with you or your baby, contact your midwife immediately.”

Gill Walton, chief executive officer of the Royal College of Midwives (RCM), said the college supported the measures.

“Even before this pandemic, women from black, Asian, or minority ethnic (BAME) backgrounds had poorer pregnancy outcomes and covid-19 has sharpened this inequality.

“The RCM supports the steps the chief midwifery officer has asked maternity units to undertake and we are calling for these actions to be implemented swiftly. During the pandemic, the RCM launched a campaign aimed at pregnant women from BAME backgrounds to ensure they were not missing important antenatal appointments or scans and I know midwives have been extra vigilant following up with women who have missed appointments, but despite these efforts BAME women remain at unacceptable risk.”

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