Inequalities in Infant Mortality work programme

Summary

This programme was undertaken to help strengthen the evidence base for interventions which reduce infant mortality and narrow the health inequalities gap.

The project generated a searchable 'evidence map' which provides a comprehensive descriptive overview of the systematic review literature relating to the effectiveness of interventions targeting:

• Infant mortality and its major medical causes (preterm birth, major congenital anomalies and SIDS/SUDI)
• Major potentially modifiable risk factors for infant mortality (smoking in pregnancy and the postnatal period, maternal obesity and risk factors for SIDS/SUDI)

Three systematic reviews were conducted. Two of these were reviews of effectiveness designed to evaluate the evidence relating to:

• Interventions focused on the organisation and delivery of antenatal care as a means of reducing infant mortality or one of its major causes (particularly preterm birth) in socially disadvantaged and vulnerable groups of women;
• Interventions to increase the early uptake of antenatal care in socially disadvantaged and vulnerable groups of women.

A third mixed methods review synthesised the qualitative literature relating the views and experiences of Black and Minority Ethnic (BME) women in the UK to identify and describe the barriers to and facilitators of early initiation of antenatal care in BME women in the UK; the review also explored ways in which existing interventions may address these barriers.

A series of briefing papers was also produced providing a statistical overview of infant mortality trends, ethnic variations in infant mortality and a review of the contribution of congenital anomalies to infant mortality.

Publications

Journal Articles

• Hollowell J, Oakley L, Kurinczuk J, Brocklehurst P, Gray R. The effectiveness of antenatal care programmes to reduce infant mortality and preterm birth in socially disadvantaged and vulnerable women in high-income countries: a systematic review. BMC Pregnancy Childbirth. 2011;11(1):13.
• Hollowell J, Kurinczuk JJ, Brocklehurst P, Gray R. Social and Ethnic Inequalities in Infant Mortality: A Perspective from the United Kingdom. Semin Perinatol. 2011;35(4):240-4.

Reports

• Kurinczuk JJ, Hollowell J, Brocklehurst P, Gray R. Inequalities in infant mortality project briefing paper 1: Infant mortality: overview and context. Oxford: NPEU. 2009.
• Gray R, Hollowell J, Brocklehurst P, Graham H, Kurinczuk JJ. Inequalities in infant mortality project briefing paper 2. Health inequalities infant mortality target: technical background. Oxford: NPEU. 2009.
• Hollowell J, Allen F, Gray R, Oakley L, Kurinczuk JJ, Brocklehurst P. Inequalities in infant mortality project evidence map report 1.The effectiveness of interventions targeting infant mortality: a user's guide to the systematic review evidence. . Oxford: NPEU. 2009.
• Allen F, Gray R, Oakley L, Kurinczuk JJ, Brocklehurst P, Hollowell J. Inequalities in Infant mortality project evidence map report 2. Technical guide to the infant mortality evidence map: systematic reviews of interventions targeting infant mortality. Oxford NPEU. 2009.
• Gray R, Headley J, Oakley L, Kurinczuk JJ, Brocklehurst P, Hollowell J. Inequalities in infant mortality project briefing paper 3.Towards an understanding of variations in infant mortality rates between different ethnic groups in England and Wales. Oxford: NPEU. 2009.
• Allen F, Gray R, Oakley L, Kurinczuk JJ, Brocklehurst P, Hollowell J. The effectiveness of interventions targeting major potentially modifiable risk factors for infant mortality: a user's guide to the systematic review evidence. Inequalities in Infant Mortality Project Evidence Map Report 3. Oxford: NPEU. 2009.
• Allen F, Gray R, Oakley L, Kurinczuk JJ, Brocklehurst P, Hollowell J. Inequalities in infant mortality project evidence map report 4. Technical guide to the infant mortality evidence map: systematic reviews of interventions targeting major potentially modifiable risk factors for infant mortality. Oxford: NPEU. 2011.
• Oakley L, Gray R, Kurinczuk JJ, Brocklehurst P, Hollowell J. A systematic review of the effectiveness of interventions to increase the early initiation of antenatal care in socially disadvantaged and vulnerable women - Final Report. Oxford: NPEU. 2009.
• Kurinczuk JJ, Hollowell J, Boyd PA, Oakley L, Brocklehurst P, Gray R. Inequalities in infant mortality project briefing paper 4. The contribution of congenital anomalies to infant mortality. Oxford: NPEU. 2010.
• Hollowell J, Oakley L, Vigurs C, Barnett-Page E, Kavanagh J, Oliver S. Increasing the early initiation of antenatal care by Black and Minority Ethnic women in the United Kingdom: a systematic review and mixed methods synthesis of women?s views and the literature on intervention effectiveness. Oxford: NPEU. 2012.