What factors predict differences in infant and perinatal mortality in primary care trusts in England? A prognostic model

In England infant mortality has been steadily declining, but this trend belies significant inequalities in avoidable deaths.1 Young mothers, those from lower socioeconomic groups, and those from some minority ethnic communities have consistently worse outcomes compared with the rest of the population.2 The latest report of the Confidential Enquiry into Maternal and Child Health indicates that the underlying risk factors of perinatal mortality cluster around young and old maternal age, high levels of social deprivation, and minority ethnic groups.
The aim of this study was to develop multivariable prognostic models to identify potential causes of variability in the rates of infant and perinatal mortality between the 303 Primary Care Trusts (PCTs) in England and to identify PCTs with worse than expected outcomes. Potential causes of variability between PCTs included population characteristics, such as ethnicity and deprivation, and health service funding for maternity services.