Structural racism and risk of SARS-CoV-2 in pregnancy

Autor: Rachel Pope, Prakash Ganesh, Jill Miracle, Romona Brazile, Honor Wolfe, Johnie Rose, Kurt C. Stange, Terry Allan, Heidi Gullett
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: EClinicalMedicine, Vol 37, Iss , Pp 100950- (2021)
Druh dokumentu: article
ISSN: 2589-5370
69206627
DOI: 10.1016/j.eclinm.2021.100950
Popis: Background: Structural racism leads to adverse health outcomes, as highlighted by inequities in COVID-19 infections. We characterized Black/White disparities among pregnant women with SARS-CoV-2 in Cuyahoga County which has some of the most extreme health disparities in the U.S., such as a rate of Black infant mortality that is three times that of White counterparts. Methods: This was a retrospective cohort study using data collected as part of public health surveillance between March 16, 2020 until October 1, 2020. This study aimed to compare Black and Non-Black pregnant women infected with SARS-CoV-2 to understand how the distribution of risk factors may differ by race. Outcomes included age, gestational age at infection, medical co-morbidities, exposure history, socio-economic status, occupation, symptom severity and pregnancy complications. Findings: One hundred and sixty-two women were included. 81 (50%) were Black, 67 (41%) White, 9 (0·05%) Hispanic, 2 (0·01%) Asian; and three did not self-identify with any particular race. More than half who supplied occupational information (n = 132) were essential workers as classified by the CDC definition (55%, n = 73). Black women were younger (p = 0·0062) and more likely to identify an occupational contact as exposing them to SARS-CoV-2 (p = 0·020). Non-Black women were more likely to work from home (p = 0·018) and indicate a personal or household contact as their exposure (p = 0·020). Occupation was a risk factor for severe symptoms (aOR 4·487, p = 0·037). Most Black women lived in areas with median income
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