Pregnancy risk tool cuts baby loss in black and Asian women

A new pregnancy screening tool cuts the risk of baby loss among women from black, Asian and ethnic minority background to the same level as white women, research suggests.

The app calculates a woman’s individual risk of pregnancy problems.

In a study of 20,000 pregnant women, baby death rates in ethnic groups were three times lower than normal when the tool was used.

Experts say the new approach can help reduce health inequalities.

The screening tool is already in use at St George’s Hospital in London and is being tried out at three other maternity units in England, with hopes it could be rolled out to 20 centres within two years.

In the UK, pregnancy risks are much higher for women from ethnic minority backgrounds.

They have two to three times higher rates of stillbirth and perinatal death – when babies die after 24 weeks of pregnancy or within a month of birth – than white women.

Black women also have a 40% higher risk of miscarriage – during the first 23 weeks of pregnancy – than white women.

A taskforce was recently set up to tackle the issue.

“What’s clear is the current way of risk assessing women isn’t providing the safest approach, and it’s vital both clinicians and health policymakers work to update it.”

Personalised care

Researchers from Tommy’s National Centre for Maternity Improvement, led by the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives, developed the new tool and have published their study of how it works in a journal.

Professor Basky Thilaganathan, who led the research team at St George’s Hospital, said the new approach could “almost eliminate a large source of the healthcare inequality facing black, Asian and minority ethnic pregnant women”.

“We can personalise care for you and reduce the chances of having a small baby, pre-eclampsia and losing your baby,” he said.

The current system of a tick-box checklist to assess pregnancy risk has been around for 70 years, and is limited.

  • Miscarriage: ‘I was in pain – they did not listen’
  • Stillbirths high for black and Asian babies in UK
  • NHS to tackle ‘unfair’ maternity outcomes

The new digital tool, which uses an algorithm to calculate a woman’s personal risk, can detect high-risk women more accurately and prevent complications in pregnancy, the researchers say.

Both pregnant women and maternity staff can upload information on their pregnancy and how they are feeling to the app during antenatal appointments and at other times.

In the study, there were nearly eight deaths per 1,000 births among mothers from ethnic minority backgrounds, compared with 2.63 deaths per 1,000 births among white mothers, when the current checklist was used to assess risk.

But in pregnant women using the algorithm tool, there was no difference in death rates between white and non-white ethnic groups, because three out of four deaths linked to placenta problems had been avoided.

Safest approach

Dr Edward Morris, president of the Royal College of Obstetricians and Gynaecologists, said it was “unacceptable” that black, Asian and minority ethnic women faced huge inequalities on maternity outcomes.

“The digital tool provides a practical way to support women with personalised care during pregnancy and make informed decisions about birth.

“What’s clear is the current way of risk assessing women isn’t providing the safest approach, and it’s vital both clinicians and health policymakers work to update it.”

Gill Walton, chief executive of the Royal College of Midwives, said the new tool was already making “a tangible difference”.

“All of this great work and effort must continue to be supported with the right levels of funding and resources to enable it to be implemented effectively,” she added.