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Birth outcomes for African and Caribbean babies in England and Wales: retrospective analysis of routinely collected data
  1. Preeti Datta-Nemdharry,
  2. Nirupa Dattani,
  3. Alison J Macfarlane
  1. School of Health Sciences, City University London, London, UK
  1. Correspondence to Preeti Datta-Nemdharry; preeti.datta-nemdharry.1{at}


Objectives To compare mean birth weights, gestational ages and odds of preterm birth and low birth weight of live singleton babies of black African or Caribbean ethnicity born in 2005 or 2006 by mother's country of birth.

Design Secondary analysis of data from linked birth registration and NHS Numbers for Babies data set.

Setting Births to women in England and Wales in 2005 and 2006.

Participants Babies of African and Caribbean ethnicity born in England and Wales in 2005–2006, whose mothers were born in African and Caribbean countries or the UK. Birth outcomes for 51 599 singleton births were analysed.

Main outcome measures Gestational age and birth weight.

Results Mothers born in Eastern or Northern Africa had babies at higher mean gestational ages (39.38 and 39.41 weeks, respectively) and lower odds of preterm birth (OR=0.80 and 0.65, respectively) compared with 39.00 weeks for babies with mothers born in the UK. Babies of African ethnicity whose mothers were born in Middle or Western Africa had mean birth weights of 3327 and 3311 g, respectively. These were significantly higher than the mean birth weight of 3257 g for babies of the UK-born mothers. Their odds of low birth weight (OR=0.75 and 0.72, respectively) were significantly lower. Babies of Caribbean ethnicity whose mothers were born in the Caribbean had higher mean birth weight and lower odds of low birth weight than those whose mothers were born in the UK.

Conclusions The study shows that in babies of African and Caribbean ethnicity, rates of low birth weight and preterm birth varied by mothers' countries of birth. Ethnicity and country of birth are important factors associated with perinatal health, but assessing them singly can mask important heterogeneity in birth outcomes within categories particularly in relation to African ethnicity. These differences should be explored further.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: and

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  • To cite: Datta-Nemdharry P, Dattani N, Macfarlane AJ. Birth outcomes for African and Caribbean babies in England and Wales: retrospective analysis of routinely collected data. BMJ Open 2012;2:e001088. doi:10.1136/bmjopen-2012-001088

  • Contributors PD-N was involved in the design of the study, analysed the data, interpreted the results, drafted the article and made relevant amendments to it according to the other authors' comments. ND made significant contribution to the design, acquisition of data and commented on the various drafts. AM had the original idea for the analysis, made substantial contribution to the design of the study and made significant amendments to the final draft. All the authors approved the final version to be published.

  • Funding This work was funded by the Medical Research Council, as part of the Joint Wellcome Research Councils Electronic Patient Data Linkage Initiative. Grant number G0801801, linkage, analysis and dissemination of national birth and maternity data for England and Wales. The views expressed are those of the authors.

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the East London and the City Ethics Committee, and the Patient Information Advisory Group (now known as the National Information Governance Board) under Section 60 (now Section 251) of the Health and Social Care Act 2001.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement As the data are personal protected data, access was restricted to ONS secure research data centre, the Virtual Microdata Laboratory (VML). The original data are to be archived at the VML and will be accessible for research purposes (including verification of statistical outputs) subject to the approval of the National Information Governance Board, the Office for National Statistics and the NHS Numbers for Babies Management Board, and to the standard operating procedures of the VML.

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