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Updated: Sep 16, 2025

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Socio-Economic Inequalities in Stillbirth and Preterm Birth Rates Across Europe: A Population-Based Study.

Lucy Smith1, Marianne Philibert2, Sonya Scott3

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BJOG : an International Journal of Obstetrics and Gynaecology
|July 10, 2025
PubMed
Summary

Socio-economic inequalities in stillbirth and preterm birth are widespread across Europe. Targeted policies are needed to prevent adverse outcomes in low socio-economic status populations.

Keywords:
preterm birthsocioeconomic inequalitiesstillbirth

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Area of Science:

  • Perinatal epidemiology
  • Public health
  • Socio-economic determinants of health

Background:

  • Socio-economic status (SES) significantly impacts perinatal health outcomes.
  • Existing data on SES inequalities in stillbirth and preterm birth across Europe are limited.
  • Routine national data offer a valuable resource for monitoring these disparities.

Purpose of the Study:

  • To quantify socio-economic inequalities in stillbirth and preterm birth rates across European countries.
  • To utilize population-based routine data for estimating these disparities.
  • To identify variations in inequalities among different European nations.

Main Methods:

  • A cross-sectional study design was employed, analyzing national-level data.
  • Data from 24 countries within the Euro-Peristat network were included, covering approximately 17 million births (2015-2019).
  • Rates of stillbirth, very preterm birth (VPB), and moderate/late preterm birth (MLPB) were derived from routine national birth records.

Main Results:

  • Higher rates of stillbirth, VPB, and MLPB were observed in lower SES groups compared to higher SES groups.
  • The excess burden of adverse outcomes associated with lower SES varied considerably across countries, particularly for stillbirth.
  • Concentration indices revealed significant and diverse socio-economic inequalities in perinatal outcomes across Europe.

Conclusions:

  • Widespread, yet variable, socio-economic inequalities in stillbirth and preterm birth exist across European countries.
  • These inequalities appear independent of the overall rates of adverse outcomes.
  • Targeted policy interventions focusing on low SES populations are crucial for preventing stillbirth and preterm birth; routine data facilitate international monitoring.