System privilege and advantage occur for some wāhine/people, pēpi and whānau at risk of, and/or experiencing, preterm birth, but not for all. These differences are unjust and unfair.
Asian and European whānau experience preterm birth less often than Māori, Pacific and Indian whānau. In 2021, our most recent national annual data, rates of preterm birth were:
European 7.3% Asian 7.0% Māori 8.9% Pacific 8.4% Indian 7.7%
Asian and European pēpi are also more likely to survive after very early preterm birth (before 28 weeks) than Māori, Pacific and Indian pēpi.
Systemic issues such as the effects of colonisation and racism (including structural, institutional, interpersonal and internalised) are major contributing factors to these differences. Other significant drivers of differences seen in preterm birth experiences include disparities by ethnicity in:
- Income and socioeconomic status
- Access to healthcare, housing and food security
- Discovering pregnancy early or late
- Whānau support
- Speaking a language other than English
Differences in rates of preterm birth are also known to occur by geography in Aotearoa with variations from 6.8% to 10.6% by Te Whatu Ora health region of residence. There is also a higher chance of survival for those born very early in metropolitan areas compared with those living more rurally. Many factors contribute to these differences, but several can be reduced or avoided with a more consistent and national approach to using high-quality, evidenced-based care that meets the individual needs of each wāhine/person, pēpi and whānau.
Other sociodemographic equity factors are likely to contribute to differences in preterm birth outcomes. For example, whānau from the Rainbow community, refugee and migrant communities, and people living with health conditions or impairments. However, currently no national pregnancy data identifies these groups, making it impossible to assess any impact on preterm birth and its outcomes.