Objective: To explore socioeconomic inequalities in short-term survival and service provision among very preterm infants.

Methods: We included 10 025 infants (22 + 0–32 + 6 weeks) born between 1 January 1994 and 31 December 2005 in the UK (former Trent health region ∼1/12 UK births). Intrapartum stillbirth and neonatal mortality rates were calculated using two denominators: rate per 1000 live births assessed inequalities in mortality due to very preterm birth in the whole population; rate per 1000 very preterm births assessed inequalities in mortality adjusted for incidence rate differences. Inpatient care provision was assessed using length of stay and respiratory support.

Results: Mothers from very deprived areas were twice as likely to have a very preterm infant who died before 28 days than mothers from affluent areas (rate/1000 births). However, after adjusting for socioeconomic gradients in incidence (rate/1000 very preterm births), mortality rates among very preterm infants were similar across all deprivation groups. For infants surviving >28 days, length of stay and provision of respiratory support was also similar across all deprivation groups.

Conclusions: The burden of mortality due to very preterm birth is greater among women from deprived areas due to increased incidence rates. However, adjusted for incidence differences, survival rates and service use are similar for all infants.