tetano
Editor, Senior Moderator
Ann Epidemiol
. 2023 Nov 10:S1047-2797(23)00212-0.
doi: 10.1016/j.annepidem.2023.11.005. Online ahead of print. Severe Maternal Morbidity by Race and Ethnicity Before vs. During the COVID-19 Pandemic
Jihong Liu[SUP] 1 [/SUP], Peiyin Hung[SUP] 2 [/SUP], Jiajia Zhang[SUP] 3 [/SUP], Bankole Olatosi[SUP] 4 [/SUP], Yiwen Shih[SUP] 5 [/SUP], Chen Liang[SUP] 6 [/SUP], Berry A Campbell[SUP] 7 [/SUP], Neset Hikmet[SUP] 8 [/SUP], Xiaoming Li[SUP] 9 [/SUP]
Affiliations
Purpose: To examine the change in racial disparity in severe maternal morbidity (SMM) during the COVID-19 pandemic and the associations between SARS-CoV-2 infection and SMM.
Methods: This retrospective cohort study used linked databases of all livebirths delivered between 2018-2021 in South Carolina (n=162,576). Exposures were 1) pre-pandemic and pandemic periods (before vs. March 2020 onwards); 2) SARS-CoV-2 infection, severity, and timing of first infection. Log-binomial regression models were used.
Results: SMM rate was higher among pandemic childbirths than pre-pandemic period (p=0.06). The risk of SMM among Hispanics was doubled from pre-pandemic to pandemic periods (adjusted relative risk (aRR)= 2.50, 95% CI: 1.27, 4.94). During pre-pandemic, compared to White women, Black women (aRR=1.37, 95% CI: 1.14-1.64), while Hispanics had lower risk of SMM (aRR=0.42, 95% CI: 0.24-0.73). During the pandemic, the Black-White difference in the risk of SMM persisted (aRR=1.24, 95% CI: 1.00-1.54) and Hispanic-White difference in SMM risk became insignificant (aRR=0.85, 95% CI: 0.54, 1.34). SARS-CoV-2 infection, its severity, and the late diagnosis were associated with 1.78-5.06 times higher risk of SMM.
Conclusions: During pandemic, Black-White racial disparity in SMM persisted but the relative pre-pandemic advantage in SMM among Hispanic women over White women disappeared during the pandemic.
Keywords: Health disparity; Maternal morbidity; Postpartum; Pregnancy; SARS-CoV-2 infection; SARS-CoV-2 severity; Severe disease; Social Determinants of Health; coronavirus.
. 2023 Nov 10:S1047-2797(23)00212-0.
doi: 10.1016/j.annepidem.2023.11.005. Online ahead of print. Severe Maternal Morbidity by Race and Ethnicity Before vs. During the COVID-19 Pandemic
Jihong Liu[SUP] 1 [/SUP], Peiyin Hung[SUP] 2 [/SUP], Jiajia Zhang[SUP] 3 [/SUP], Bankole Olatosi[SUP] 4 [/SUP], Yiwen Shih[SUP] 5 [/SUP], Chen Liang[SUP] 6 [/SUP], Berry A Campbell[SUP] 7 [/SUP], Neset Hikmet[SUP] 8 [/SUP], Xiaoming Li[SUP] 9 [/SUP]
Affiliations
- PMID: 37952778
- DOI: 10.1016/j.annepidem.2023.11.005
Purpose: To examine the change in racial disparity in severe maternal morbidity (SMM) during the COVID-19 pandemic and the associations between SARS-CoV-2 infection and SMM.
Methods: This retrospective cohort study used linked databases of all livebirths delivered between 2018-2021 in South Carolina (n=162,576). Exposures were 1) pre-pandemic and pandemic periods (before vs. March 2020 onwards); 2) SARS-CoV-2 infection, severity, and timing of first infection. Log-binomial regression models were used.
Results: SMM rate was higher among pandemic childbirths than pre-pandemic period (p=0.06). The risk of SMM among Hispanics was doubled from pre-pandemic to pandemic periods (adjusted relative risk (aRR)= 2.50, 95% CI: 1.27, 4.94). During pre-pandemic, compared to White women, Black women (aRR=1.37, 95% CI: 1.14-1.64), while Hispanics had lower risk of SMM (aRR=0.42, 95% CI: 0.24-0.73). During the pandemic, the Black-White difference in the risk of SMM persisted (aRR=1.24, 95% CI: 1.00-1.54) and Hispanic-White difference in SMM risk became insignificant (aRR=0.85, 95% CI: 0.54, 1.34). SARS-CoV-2 infection, its severity, and the late diagnosis were associated with 1.78-5.06 times higher risk of SMM.
Conclusions: During pandemic, Black-White racial disparity in SMM persisted but the relative pre-pandemic advantage in SMM among Hispanic women over White women disappeared during the pandemic.
Keywords: Health disparity; Maternal morbidity; Postpartum; Pregnancy; SARS-CoV-2 infection; SARS-CoV-2 severity; Severe disease; Social Determinants of Health; coronavirus.