NHS pregnancy screening tool hopes to reduce racial inequalities in baby deaths

A new artificial intelligence pregnancy screening tool is being piloted by the NHS, with the hopes it will lesson racial disparities in baby death rates.

In the UK, studies have shown that Black and Asian babies are more likely to be stillborn and die than white babies.

A report examining baby loss in 2019 found that for babies of Black and Black British ethnicity, stillbirth rates were 7.23 per 1000 births, for Asian babies they were 5.1 per 1,000 births, and for babies of white ethnicity, they were 3.22 per 1,000 births.

This was the first time the Office of National Statistics (ONS) had broken down stillbirth and infant mortality data down by ethnicity, with analysis showing that between 2007 and 2019, black babies suffered the worst outcomes, while Asian babies consistently had the second highest rates.

Now the Tommy’s National Centre for Maternity Improvement, led by the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives, has introduced a tool that hopes to end this inequality.

The new AI tool works by assessing detailed data, gathered during antenatal appointments, to determine a woman’s specific, personalised risk of potential complications developing during pregnancy.

The new tool reduced baby deaths among mothers from ethnic backgrounds by 60 per cent.

Additionally, pregnant women found to be at high risk by the algorithm had extra monitoring during pregnancy, so care teams could act quickly to prevent problems and save babies’ lives.

When standard screening was used - which hasn’t changed since the 1970s - researchers identified huge racial disparities in pregnancy outcomes, with perinatal death rates three times higher among ethnic minority mothers (7.95 deaths per 1000 births) than among white mothers (2.63 per 1000 births).

But when the new tool was used alongside targeted care, infant mortality evened out to the same across all ethnic groups.

The NHS will begin piloting the screening tool in four areas across England - London, Yorkshire, Surrey and Lancashire - following a trial involving more than 20,000 pregnant women.

Writing in BJOG, an obstetrics and gynaecology journal, the researchers said: “First trimester combined screening for placental dysfunction is associated with a significant reduction in perinatal deaths in black, Asian and minority ethnic women – to perinatal mortality rates equivalent to those seen in white women.”

Prof Basky Thilaganathan, clinical director of the Tommy’s National Centre for Maternity Improvement, led the research team at St George’s University hospital NHS trust in London.

He told The Guardian: “It’s incredibly exciting to see that changing from the standard pregnancy risk factor checklists to our new approach can directly address and almost eliminate a large source of the healthcare inequality facing black, Asian and minority ethnic pregnant women.

“The current maternal risk-factor screening programme is limited and can contribute to ongoing racial inequalities – but our algorithm can account for these deficiencies, enabling us to truly personalise care rather than treating large groups in the same way, and ultimately improve pregnancy outcomes.

“Given this new evidence, we would urge the government to support and invest in this new system, which will allow us to roll this out more widely across the UK.”