Changes in Racial and Ethnic Inequities in Pregnancy-Associated Death in the United States During the COVID-19 Pandemic

Author:

Margerison Claire E.1,Wang Xueshi1,Goldman-Mellor Sidra1,Muzik Maria1,Gemmill Alison1

Affiliation:

1. Claire E. Margerison is with the Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing. Xueshi Wang is with the Department of Economics, College of Social Science, Michigan State University. Sidra Goldman-Mellor is with the Department of Public Health, School of Social Sciences, Humanities, and Arts, University of California, Merced. Maria Muzik is with the Departments of Psychiatry and Obstetrics & Gynecology, University of Michigan‒Michigan...

Abstract

Objectives. To examine changes in cause-specific pregnancy-associated deaths during the COVID-19 pandemic by race and ethnicity and assess changes in racial and ethnic inequities in pregnancy-associated deaths. Methods. We used US vital statistics mortality data from 2018 to 2021 to identify pregnancy-associated deaths among females aged 15 to 44 years. We calculated crude pregnancy-associated death rates (deaths per 100 000 live births) by year, cause, and race/ethnicity, percent change in death rate, and the inequity (difference) in rate for each racial or ethnic group compared with non-Hispanic White people. Results. The pregnancy-associated death rate for obstetric, drug-related, homicide, and other causes of death increased during 2020, and obstetric deaths continued to increase in 2021. Overall estimates mask 2021 increases in drug-related deaths among Hispanic, non-Hispanic American Indian and Alaska Native (AI/AN), and non-Hispanic Asian people; increases in homicide among most racial and ethnic groups; and increases in suicide among Hispanic, non-Hispanic AI/AN, and non-Hispanic Asian people. Conclusions. We found disproportionate increases in pregnancy-associated deaths from nonobstetric causes among minoritized racial and ethnic groups during the COVID-19 pandemic. ( Am J Public Health. 2024;114(7):733–742. https://doi.org/10.2105/AJPH.2024.307651 )

Publisher

American Public Health Association

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