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Thousands of adverse birth outcomes in England down to ‘alarming’ inequality

inequality

Thousands of adverse birth outcomes in England down to ‘alarming’ inequality

Thousands of babies in England are being born prematurely, smaller than expected or stillborn because of “alarming” and “devastating” socioeconomic and racial inequality across the country, a landmark study has suggested.

Both are known risk factors for poor pregnancy outcomes. However, until now, little has been known about the scale of their “heartbreaking” impact on women and babies.

Now research involving more than 1m births suggests socioeconomic inequalities account for a quarter of all stillbirths, a fifth of preterm births, and a third of cases of foetal growth restriction (FGR), a condition in which babies are smaller than expected for their gestational age.

At the same time, one in 10 stillbirths and almost one in five FGR cases are due to racial inequalities, the study suggests. The findings, which have prompted calls for urgent action, were published in the medical journal the Lancet.

Dr Jennifer Jardine of the Royal College of Obstetrics and Gynaecologists (RCOG), one of the study’s co-lead authors, said: “I think that people will be shocked. The stark reality is that across England, women’s socioeconomic and ethnic background are still strongly related to their likelihood of experiencing serious adverse outcomes for their baby.”

The review, which was conducted by a team from the National Maternity and Perinatal Audit, analysed 1,155,981 birth records between April 2015 and March 2017 in NHS hospitals in England.

The analysis estimates that 24% of stillbirths, 19% of preterm births, and 31% of FGR cases were attributed to socioeconomic inequality and would not have occurred if all women had the same risk of adverse pregnancy outcomes as women in the least-deprived group.

Adjusting for ethnicity, maternal smoking and body mass index (BMI) substantially reduced these inequalities. That suggests that these characteristics can explain a considerable part of the socioeconomic inequalities in pregnancy outcomes.

Pregnancy complications disproportionately affected Black and minority-ethnic women: 12% of all stillbirths, 1% of preterm births, and 17% of FGR cases were attributed to ethnic inequality.

Prof Jan van der Meulen of the London School of Hygiene & Tropical Medicine, another co-lead author, told the Guardian the disparities were unacceptable but said there were no quick fixes that could immediately solve the problem.

The NHS has set a target of halving stillbirth and neonatal death rates and reducing levels of preterm birth by 25% by 2025.

However, the study findings suggest that current national programmes to make pregnancy safer, which focus on an individual woman’s risk and behaviour and their antenatal care, will not be enough to improve outcomes for babies born in England.

To reduce disparities in birth outcomes at a national level, Van der Meulen said, politicians, public health professionals and healthcare providers must work together to tackle racism and discrimination and improve women’s social circumstances, social support and health throughout their lives.

“National targets to make pregnancy safer will only be achieved if there is a concerted effort by midwives, obstetricians, public health professionals and politicians to tackle the broader socioeconomic and ethnic inequalities,” he said.

The largest increases in excess risk of complications among the most socioeconomically disadvantaged Black and south Asian and women.

Half of stillbirths (53.5%) and seven in 10 FGR cases (71.7%) among south Asian women living in the most deprived fifth of neighbourhoods in England could be avoidable if they had the same risks as white women in the most affluent fifth, the study suggests.

This was similarly the case for nearly two-thirds of stillbirths (63.7%) and half of FGR cases (55%) among Black women from the most deprived neighbourhoods.

“There are many possible reasons for these disparities,” said Van der Meulen. “Women from deprived neighbourhoods and Black and minority ethnic groups may be at a disadvantage because of their environment, for example, because of pollution, poor housing, social isolation, limited access to maternity and health care, insecure employment, poor working conditions, and stressful life events.”

Dr Edward Morris, the president of the RCOG, said the findings of the study were alarming, adding: “They provide more evidence that poverty, racism and discrimination can affect women throughout their lives and ultimately lead to devastating incidences of pregnancy complications and baby loss.”

Dr Christine Ekechi, a consultant obstetrician and gynaecologist and co-chair of RCOG’s race equality taskforce, said the disparities were heartbreaking.

“These women are being let down by a healthcare system that is supposed to protect them. Reducing the occurrence of potentially avoidable adverse pregnancy outcomes needs to be a national priority,” she said.

Health

Group hails IG as mother accused Hospital of stealing Placenta

The Inspector General of Police, (IG) Kayode Egbetokun has received praises for the prompt arrest of suspects accused of stealing the placenta of a new born baby in privated hospital located in Kwara State. The suspects were taken from Ilofa to Ilorin, the Kwara State capital on Thursday.
In a statement signed by NHRC’s official, Mr Taiwo Adeleye said the arrest of the suspects was an important step towards securing justice for the families of Mr Rotimi Williams whose wife accused health officials at a private hospital of stealing the placenta of her new born baby.
The Nigerian Human Rights Community, (NHRC),a coalition of 130 civil society groups spread across Nigeria on Thursday expressed delight at the arrest of the suspects by the police.
The group said it was aware of plots by some powerful individuals to clog the wheel of justice but was delighted that the IG has brought hope to the despairing family. It called for full investigation that would lead to the arrest and prosecution of all culprits.
Few days ago, Mrs Williams accused the management of Cottage hospital, Ilofa, Kwara State of failing to account for the placenta of her new born baby. In complaints lodged with the NHRC, Mrs Williams said a nurse, Mrs Alabi took the delivery, one nurse Adeloye cleaned up the baby while one Mrs Toyin, a ward attendant claimed she mistakenly threw away the placenta.
“In Nigerian agelong tradition, the placenta is linked to the spiritual and physical wellbeing of a new born baby. There is a customary and agelong way of burying placenta of which every medical staff is aware.The disappearance of a baby’s placenta is a source of eternal trauma for the parents and a prelude to impugn the future of the child based on timeless tradition and beliefs,” the NHRC said.
The Coalition said the placenta could be stolen for rituals, adding that stealing a placenta is like killing the child or using the child for ritual by other means The group said it would follow-up the case “day and night” to ensure justice is done. The NHRC said Mrs Toyin brought out the mother’s bags from the labour room but failed to take the placenta along.
The rights group said one Mrs Ayoni Awolusi in the course of the delivery, claimed she was to be on duty but was absent. The medical personnel expected to be on dury was Dr. Ajibola. NHRC said Mrs Williams put to bed around 7pm on Sunday May 12 but discovered the missing placenta very early on Monday 13th, May.
The group called on the IG to intensify the probe and ensure every one connected with the gory episode is brought to justice

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Health

AstraZeneca withdraws COVID-19 vaccines from market as demand reduces

Anglo-Swedish drugmaker AstraZeneca on Wednesday said it was withdrawing Covid vaccine Vaxzevria, one of the first produced in the deadly pandemic, citing “commercial reasons” following a slump in demand.

“As multiple, variant Covid-19 vaccines have since been developed there is a surplus of available updated vaccines. This has led to a decline in demand for Vaxzevria, which is no longer being manufactured or supplied,” an AstraZeneca spokesperson added in a statement.

“We will now work with regulators and our partners to align on a clear path forward to conclude this chapter and significant contribution to the Covid-19 pandemic.”

AstraZeneca rapidly developed the successful Covid-19 jab during the coronavirus pandemic which erupted in the first half of 2020.

Vaxzevria, developed alongside Oxford University, was at first offered at cost but Astra decided in late 2021 to sell it for profit.

But the world pivoted towards mRNA vaccines, particularly the one produced by US drugs giant Pfizer and German peer BioNTech, after rare blood-clot problems with Astra’s jab increased public hesitancy about taking it.

Sales collapsed further as global Covid restrictions were fully lifted worldwide and the world emerged from the global health crisis.

The AstraZeneca spokesperson said the group had begun the process from taking it off the market in the Europe, Middle East and Africa (EMA) region.

The company will work with other regulators globally to start market authorisation withdrawals for the Vaxzevria “where no future commercial demand for the vaccine is expected”.

The spokesperson said that, according to independent estimates, “over 6.5 million lives were saved in the first year of use alone” and more than three billion doses were supplied globally.

“We are incredibly proud of the role Vaxzevria played in ending the global pandemic,” the spokesperson said.

“Our efforts have been recognised by governments around the world and are widely regarded as being a critical component of ending the global pandemic. ”

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Health

NMA lauds Police for arresting fake doctor in Lagos

The Nigerian Medical Association, NMA, has commended the Nigerian Police Force for arresting an alleged fake medical doctor.

In an interview with the News Agency of Nigeria on Tuesday in Lagos, Dr Benjamin Olowojebutu, Chairman, NMA Lagos, said the arrest will strengthen the association’s fight against quackery in the medical profession.

Olowojebutu explained that medical quackery was a dangerous practice that posed a threat to the well-being of citizens and the delivery of quality healthcare in the state, and country.

“The arrest is a welcome development for the health sector; we would expose these quacks and ensure that Lagos does not suffer further morbidity and mortality from their nefarious activities.

“We are glad that our work on anti-quackery has started yielding progress as we are determined to weed out quacks from the medical profession,” he said.

The chairman pledged that NMA Lagos, with the support of the Ministry of Health, Health Monitoring and Accreditation Agency, HEFAMAA, and police, would eradicate quacks from the state.

According to him, the association would hold an anti-quackery summit soon, after which it would present a white paper to the Lagos State Government on anti-quackery.

Olowojebutu warned hospitals to refrain from employing staff whose certificates and licences had not been verified by the MDCN to safeguard the health of the populace.

The 37-year-old medical practitioner with suspected forged certificates was arrested by police at Skylink Medical Centre, Elepe-Ikorodu.

The police said they arrested the suspect, who claimed to be the managing director of the health facility, based on intelligence gathered by the command through members of the Elepe community concerning the activities of the suspect.

The police recovered two suspected forged certificates of the Obafemi Awolowo University, Ile-Ife, Osun State and the Medical and Dental Council of Nigeria, MDCN, after searching for the facility.

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