Health

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

NCDC records 832 Lassa fever, Mpox cases, 135 deaths

The Nigeria Centre for Disease Control and Prevention (NCDC) has confirmed the country has recorded 832 confirmed cases of Lassa fever and Mpox.

Speaking during a press briefing on Friday in Abuja, the agency’s Director General, Dr. Jide Idris, revealed that 132 fatalities were recorded from Lassa fever and three from Mpox.

While acknowledging a recent decline in Lassa fever infections during epidemiological week 16 (ending April 20, 2025), he warned that the overall risk remains high, particularly in endemic regions.

“Cumulatively, as of week 16, Nigeria has reported 4,253 suspected cases of Lassa fever, 696 confirmed cases, and 132 deaths, resulting in a case fatality rate of 19.0 percent,” he stated.

Dr. Idris attributed recent improvements to intensified surveillance, treatment efforts, and enhanced community engagement. He emphasized, however, the continued need for vigilance and collaboration to sustain progress.

Regarding Mpox, the NCDC boss disclosed that three deaths have been recorded in 2025—two in Abia and Ebonyi States in week 10, and one recently in Rivers State involving a patient co-infected with HIV and tuberculosis. As of week 16, 723 suspected cases and 136 laboratory-confirmed cases of Mpox have been reported across 35 states and the Federal Capital Territory (FCT). The national case fatality rate currently stands at 2.2 per cent.

“The epidemic curve reveals multiple peaks in Mpox cases, indicating ongoing transmission. While most states have reported suspected cases, confirmed infections are heavily concentrated in Nigeria’s southern and central regions,” Dr. Idris noted.

To address these outbreaks, the NCDC has activated its Emergency Operations Centre (EOC), deployed National Rapid Response Teams to affected states, and prepositioned essential medical supplies, including personal protective equipment and laboratory consumables. Five additional Mpox diagnostic laboratories have also been optimized in Bauchi, Kano, Cross River, Rivers, and Enugu States.

“Healthcare workers are undergoing specialized training in infection prevention, case management, and cerebrospinal meningitis (CSM) care. Community outreach is being reinforced through public awareness campaigns, media engagement, and targeted health communication strategies,” he added.

On cerebrospinal meningitis, Dr. Idris reported a consistent decline in new cases and fatalities over the last three weeks.

He attributed the improvement to effective vaccination, early treatment, and adaptive surveillance strategies tailored to real-time data.

“Although the situation remains serious, strong national and state-level coordination is showing positive results. The response will continue until full containment is achieved and states take full ownership of the CSM Incident Action Plan,” he said.

Dr. Idris also expressed concern about the rising Mpox trend since its reemergence in 2017, with significant spikes recorded between 2022 and 2024, positioning Nigeria among the most affected countries globally. He warned that underreporting and delayed data entry remain challenges that need urgent resolution to ensure accurate and timely outbreak response.

A national mortality review for the recent Mpox deaths is being planned to further assess response effectiveness and identify areas for improvement.

The NCDC reaffirmed its commitment to safeguarding public health through timely surveillance, transparent reporting, and coordinated national response mechanisms aimed at reducing disease burden and preventing future outbreaks.

Health

Only 89 doctors left in Kwara Govt hospitals amid ‘Japa’ crisis – Health Board

The Executive Secretary of the Kwara State Hospital Management Board, Abdulrahman Malik, disclosed that there is an acute shortage of medical doctors in the state-owned hospitals.

Speaking at the state interministerial press briefing for the first quarter of 2025 on Tuesday, April 29, Malik said that due to the ‘Japa’ syndrome, doctors do not want to take up appointments with the state government, even when the government is ready to recruit them.

He lamented that while between 180 and 200 doctors are required in the government service, only 89 of them are available in the service.

He said the number of available doctors only recently became 89 from 86 when three who had left the service returned after the government introduced a new and improved salary for the doctors’ services.

The hospital board’s boss said the government had been trying to attract doctors to the state service with improved salaries and facilities that could encourage them to stay, especially in the rural areas where many of them do not want to go.

He also disclosed that the government has introduced an intern nurses programme for the training of nurses who would replace many nurses who had left the service for abroad.

“The mass exodus of health professionals is severely affecting our capacity to provide adequate care,” the official said.

“Gov. AbdulRahman AbdulRazaq has approved an upgrade in the salaries of our doctors to match federal pay in a bid to retain the few we have left.

“The revised salary structure has led to the return of three doctors who had previously resigned, bringing the total number on the state’s payroll to 89.

“However, the figure still falls short of the estimated 180 to 200 physicians needed to serve the state’s population effectively.

“Nigeria’s doctor-to-patient ratio is currently estimated at one doctor to over 5,000 patients, far below the World Health Organisation’s (WHO) recommended one doctor to 600 patients.”

Health

Wike approves recruitment of 34 resident doctors for FCT hospitals

The Minister of the Federal Capital Territory (FCT), Mr Nyesom Wike, has approved the recruitment of 34 resident doctors for a seven-year residency training to enhance health-care delivery in FCT.

Mr Lere Olayinka, Senior Special Assistant to the minister on Public Communications and Social Media, made this known in a statement in Abuja on Wednesday.

Olayinka explained that the 34 doctors would be the first batch of 60 medical doctors approved for residency training in eight specialities in FCT Administration hospitals.

He said that five out of the 34 doctors would work in the psychiatric department, four in internal medicine and one in general surgery.

Others, he said would comprise one in anesthesiology, eight in family medicine, six in ophthalmology and nine in obstetrics and gynaecology.

“This is the first time this is being done outside employees of the Health Management Board, thereby, giving doctors more opportunity and bringing more competent hands into healthcare delivery in the FCT,” he said.

The spokesman added that the remaining 26 doctors would be recruited in due course by the FCTA Civil Service Commission.

He said that the 26 doctors would comprise one for psychiatry department, four for internal medicine, eight for general surgery, five in anesthesiology, and eight paediatrics.