Systematic review of interventions to reduce ethnic health inequalities in maternal and perinatal health in the UK.



Esan, Oluwaseun B ORCID: 0000-0001-7903-8770, Adjei, Nicholas K, Saberian, Samira, Christianson, Lara ORCID: 0000-0002-7780-255X, Mazlan, Alya ORCID: 0009-0000-4209-228X, Khalaf, Rukun KS ORCID: 0000-0002-7666-0617, Towolawi, Olukemi Yetunde ORCID: 0009-0004-7703-6420, McHale, Philip ORCID: 0000-0002-8560-2291, Pennington, Andy ORCID: 0000-0002-3455-8825, Geary, Rebecca Sally
et al (show 1 more authors) (2025) Systematic review of interventions to reduce ethnic health inequalities in maternal and perinatal health in the UK. BMJ public health, 3 (2). e001476-. ISSN 2753-4294, 2753-4294

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Abstract

<h4>Abstract</h4><h4>Introduction</h4>There are persistent ethnic health inequalities in maternal, neonatal and infant health outcomes in the UK. We sought to examine the available evidence on interventions to reduce ethnic health inequalities in maternal, neonatal and infant outcomes during pregnancy and up to the first year of the postnatal period.<h4>Method</h4>We conducted a systematic review searching MEDLINE, CINAHL, PsycINFO, Scopus and Web of Science (Social Science Index) databases, <i>Journal of Health Visiting</i>, Google Scholar and grey literature from relevant websites (from inception up to 11 August 2023). Interventions were mapped to a priori conceptual framework consisting of six levels (patient, provider, microsystem, organisation, community and policy). The 'template for intervention description and replication' checklist was used for intervention description. Results across studies were narratively synthesised and reported following the 'synthesis without meta-analysis' guidelines.<h4>Results</h4>The electronic search identified 11 600 studies, with 16 studies describing eight types of interventions meeting the inclusion criteria. Studies were published between 1981 and 2022, predominantly in England (n=14), with a range of outcomes reported, including mode of delivery, place of birth, birth weight, stillbirth and preterm birth. The sample size varied from 21 to 20 651 participants with ethnic minority populations ranging from 18.9% to 100% of the study population. Studies mapped mainly to the patient level with policy least represented (14 and two, respectively). All studies described the reasons for the intervention with limited reporting on any modification during the study (n=2). Two studies with two types of interventions (early pre-eclampsia screening and midwifery continuity of care) demonstrated the potential for interventions to reduce ethnic health inequalities.<h4>Conclusion</h4>This review highlights the paucity of evaluated interventions to tackle ethnic health inequalities in maternal, neonatal/infant outcomes. Mapping interventions to the conceptual framework provides the evidence base for national policy interventions to tackle these long-protracted inequities.<h4>Prospero registration number</h4>CRD42023453083.

Item Type: Article
Uncontrolled Keywords: public health, social medicine, sociodemographic factors, systematic review
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Population Health
Depositing User: Symplectic Admin
Date Deposited: 07 Aug 2025 10:38
Last Modified: 07 Aug 2025 11:07
DOI: 10.1136/bmjph-2024-001476
Open Access URL: https://bmjpublichealth.bmj.com/content/3/2/e00147...
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URI: https://livrepository.liverpool.ac.uk/id/eprint/3193968