Babies born to black mothers in England and Wales and those from the most deprived areas are significantly more likely to die while in neonatal units, according to analysis revealing the “deeply concerning” figures.
The study, led by academics at the University of Liverpool and published in The Lancet Child & Adolescent Health, examined data on more than 700,000 babies admitted to an NHS neonatal unit across England and Wales between 2012 and 2022.
Babies born to black mothers had the highest mortality rates for the majority of years in the study, with an 81% higher risk of dying before discharge compared with babies born to white mothers.
The highest mortality rate for black babies stood at 29.7 deaths per 1,000 babies, with the highest rate for white babies at 16.9 deaths per 1,000 babies.
For babies born to mothers living in the most deprived areas of England and Wales, the elevated risk stood at 63% compared with the least deprived babies.
The highest mortality rate for babies born to the most deprived mothers was 25.9 deaths per 1,000 babies in 2022, compared with 12.8 deaths per 1,000 for their least deprived counterparts.
Samira Saberian, a PhD student at the University of Liverpool and the lead author of the study, said the analysis showed that “socioeconomic and ethnic inequalities independently shape survival in neonatal units, and maternal and birth factors explain only over half of the socioeconomic and ethnic inequalities”.
She added: “To reduce these inequalities, we need integrated approaches that strengthen clinical care while also tackling the wider conditions affecting families.
“By improving services and addressing the root drivers of inequality, we can give the most vulnerable babies a better chance of survival.”
Funded by the National Institute for Health and Care Research (NIHR), the study is the first to examine both socio-economic and ethnic inequalities in neonatal units.
The figures come as previous reports have found that black babies are almost twice as likely as white babies to be stillborn. A national investigation launched into NHS maternity services across England, due to conclude at the end of this year, will be looking at racial disparities within maternity care, among other issues.
The study also found that babies born to Asian mothers had a 36% higher risk of death than their white counterparts, even after adjusting for other factors that could contribute towards the higher rate of death.
The research concluded: “There are stark socioeconomic and ethnic inequalities in babies admitted to and who die in neonatal units in England and Wales.”
Rachel Drain, the quality and standards adviser at the Royal College of Midwives, said that the findings were “deeply concerning” and that “urgent, coordinated action” was needed to tackle the root causes of the disparities.
“That means investing in the maternity and neonatal workforce, providing equitable and culturally safe care, and ensuring services are designed with women at their heart,” Drain said.
“Every baby deserves the same chance of survival regardless of their ethnicity, background or circumstances.
She added that the findings “point to systemic issues in how care is delivered and in the wider social conditions that shape women’s health before, during and after pregnancy. It is unacceptable that mortality rates in neonatal units are rising and inequalities are widening.”
David Taylor-Robinson, professor of public health and policy in the Institute of Population Health at University of Liverpool, said: “Our Labour government has pledged to create the healthiest generation of children in our nation’s history.
“Yet our findings reveal, in stark detail that, even in 2025, too many children face significant challenges from birth – and for some, even before they are born.
He added: “I hope this evidence drives real action to address the wider factors that shape health outcomes.
“Our research also highlights how existing biases and injustices in society are reflected in clinical settings, disproportionately affecting women and babies. These are inequalities we cannot afford to ignore.”
