• deprivation
• health inequalities
• perinatal mortality
• fetal growth retardation

Neighbourhood deprivation has been theorised to capture the material conditions of the residential environment,1 and has been extensively linked with health across the life course in empirical research over the last two decades.2 Neighbourhood deprivation is not only an influential driver of lifelong health inequalities,2 but is also accountable for the intergenerational transmission of inequalities from parents to offspring. A robust literature has found that babies who are born to mothers living in areas of higher deprivation have an increased risk of adverse birth outcomes, such as prematurity and restricted fetal growth.3 Given that these suboptimal outcomes lead to poorer developmental trajectories in childhood4 and chronic diseases in later adulthood,5 health at birth is a profoundly important priority for public health and social care. Despite substantial improvements in perinatal morbidity and mortality over time in Europe as a whole, advances have been slower in the Netherlands.4

Bertens et al report that neighbourhood deprivation-related inequalities in perinatal mortality, premature birth and small for gestational age (SGA) in the Netherlands have decreased in absolute terms, but persisted in relative terms, from 2003 to 2017.4 This begs the question, have perinatal inequalities in the Netherlands improved or not? The magnitude of absolute and relative health inequalities may be differentially influenced by the overall level of health in the population6 and helps to explain the observed inconsistency between absolute versus relative trends in perinatal inequalities. The authors estimate that …