Can benchmarking uncover the disparities in the perinatal dashboard and improve the quality of care that pregnant women of diverse ethnic backgrounds receive? A retrospective cross-sectional study.

Abstract

Objective: This study evaluates the impact of including ethnicity and English proficiency (EP) in the local perinatal dashboard to uncover outcome differences faced by pregnant women from diverse ethnic backgrounds.

Design: A retrospective cross-sectional study was conducted at the University Hospitals of Leicester between September 2020 and December 2020, including 2862 singleton pregnancies at booking and 2407 deliveries. Data from the maternity server covered demographics and key performance indicators (KPIs), such as gestational age at booking, uptake of first trimester screening test (FTST), perinatal outcome, third- and fourth-degree perineal tears and post-partum haemorrhage (PPH). The NHS perinatal surveillance dashboard categorised these KPIs by ethnicity and EP.

Results: The booking cohort comprised 62% White, 26% Asian, 3% Black, 2% mixed race and 2.5% any other ethnic group. Late antenatal booking was highest in the mixed-race cohort (15%). Women who do not speak English as their first language (NEPL) were the largest undecided group with the FTST uptake (10%). Among the delivery group, mixed-race women had a higher stillbirth rate (21.28 per 1000 live births) and preterm births (10%). Third- and fourth-degree tear rates were highest among ethnic minority-NEPL cohorts (4.36%), although they were not statistically significant. No significant differences were observed in PPH rates.

Conclusions: This study highlights perinatal disparities among diverse ethnic groups and non-English-speaking women, necessitating targeted interventions to address these inequities for better perinatal outcomes for diverse populations. Including ethnicity and EP in perinatal dashboards reveals these disparities and aids in developing quality assurance systems to monitor and address them.