Perinatal mortality in Ireland: Inequalities by socio-economic group and country of birth

Abstract

Background: While perinatal mortality rates have decreased in Ireland in recent years, it is not known if this reduction was shared equally among all groups. The aim of this study is to examine inequalities in perinatal mortality by country of birth and socio-economic group in Ireland between 2004 and 2019. Methods: Data for the analysis was obtained from the National Perinatal Reporting System dataset, which includes all births (including stillbirths) in Ireland. The rate and risk ratios for perinatal death were calculated for mothers' socio-economic group and country of birth for two time periods (2004-11 and 2012-19). Adjustment was made for mothers' age, marital status, parity and country of birth/socio-economic group. A total of 995 154 births and 5710 perinatal deaths were included in the analysis. Results: With the exception of African born mothers, the perinatal mortality rate decreased for all groups over time; however, inequalities persisted. Relative to Irish born mothers, the risk for African born mothers increased from 1.63 to 2.00 over time. Adjusting for other variables including socio-economic status reduced but did not eliminate this elevated relative risk. Mothers who were classified as unemployed or engaged in home duties had a higher risk of a perinatal death relative to higher professional mothers, with the relative risk remaining relatively constant over time. Conclusions: Reducing inequalities in health is a key objective of the Irish government. Further research is required to identify why perinatal mortality continues to be higher in some groups so that targeted action can be implemented.