Background Birmingham has one of the highest rates of stillbirth and infant mortality in the country. Over half of Birmingham births occur in minority ethnic groups, where consanguineous unions are common.

Methods Birmingham stillbirths and infant deaths for a 5-year period were selected from the regional, population-based registers of congenital anomaly and mortality. Anomaly cases were linked to clinical genetics referrals.

Deaths from congenital anomaly for a 2-year subset were reviewed to determine the likely inheritance pattern.

Results There were 377 stillbirths and infant deaths from congenital anomaly in Birmingham during 2006–2010 (4.4/1,000 births) of which 51.2% were linked to clinical genetics records.

Of the 151 deaths from anomaly during 2009–10, 53 cases were categorised as having anomalies that were “definitely” or “probably” AR; of these 49 (92.5%) were linked to clinical genetics records.

Overall, deaths from AR anomalies comprised 10.4% of mortality from all causes and 35.1% of deaths from congenital anomaly. In Pakistani births, AR anomalies comprised 26.5% of stillbirths and infant mortality from all causes and 61.5% of deaths from congenital anomaly.

Mortality from AR anomalies was significantly higher in Pakistani (4.9/1,000 births, OR 37.7; 95% CI9.1–156.1) and Bangladeshi (2.98/1,000 births, OR 22.9; 95% CI4.4–118.2) groups, when compared to the White European group. Mortality rates from anomalies with non-AR patterns of inheritance in these two ethnic groups were not significantly different to the White European group.

Conclusions Deaths from AR conditions contribute to the excess of stillbirth and infant mortality seen in Pakistani and Bangladeshi births in Birmingham.