The study argues that improving outcomes for the most vulnerable babies requires addressing broader social conditions that shape health before, during, and after pregnancy.

Inequalities in neonatal survival arise independently from deprivation and ethnicity; each factor contributes to mortality beyond the other, and one does not fully explain the other.

Findings align with evidence of higher stillbirth and mortality gaps among Black babies and a rise in neonatal unit mortality, triggering potential scrutiny of NHS maternity services and systemic biases in care.

Experts from the Royal College of Midwives and University of Liverpool call for urgent, coordinated action, including workforce investment, equitable and culturally safe care, and maternity service redesign.

Lead author Samira Saberian notes that socioeconomic and ethnic inequalities independently shape survival in neonatal units, with maternal and birth factors explaining only about half of the disparities.

She adds that the inequalities persist beyond what maternal and birth factors explain, advocating integrated improvements in clinical care and broader drivers of inequality.

The research is funded by NIHR and Care Research and is the first to jointly examine socioeconomic and ethnic inequalities in neonatal units.

Commentary from David Taylor-Robinson stresses the need for integrated approaches that strengthen clinical care while addressing broader societal drivers of inequality to improve outcomes for vulnerable babies.

A Lancet Child and Adolescent Health study using NHS data from over 700,000 neonatal unit admissions in England and Wales (2012–2022) reveals significant racial and socioeconomic disparities in neonatal mortality.

The same study analyzed more than 700,000 babies admitted between 2012 and 2022 to assess socioeconomic and ethnic inequalities in neonatal mortality.

Policy implications include tackling upstream social determinants of perinatal health, reducing smoking in pregnancy, strengthening maternity and neonatal workforces, and embedding culturally sensitive interventions for high-risk groups.

The study underscores the urgency of turning findings into action to reduce perinatal inequalities and improve outcomes for vulnerable populations.