Socioeconomic inequalities in survival in neonates

Access to good intensive care blunts the effects of deprivation In the linked prospective cohort study (doi:10.1136/bmj.b4702), Smith and colleagues assessed socioeconomic inequalities in survival and neonatal care provision among very preterm infants.1 A cohort of 7449 infants born during a 10 year period (1998-2007) at between 22+0 and 32+6 weeks’ gestation were followed up until discharge from neonatal care. What do the findings suggest about equity of neonatal care provision? Preterm birth is a leading cause of infant mortality worldwide and a substantial cause of childhood disability in survivors. The risks of death are highest in babies born before 33 weeks’ gestation—the very preterm group. Furthermore, both preterm birth and infant mortality are associated with socioeconomic position, with the risks being highest in those from the most deprived socioeconomic groups.2 3 As might be expected, the most striking socioeconomic inequalities in neonatal survival are seen from a global perspective, with 98% of neonatal deaths occurring in less developed countries.4 However, even in high income …