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Preterm Birth Rates and Racial Disparities during the COVID-19 Pandemic at a Single Institution in the Southeastern United States.

Publication ,  Journal Article
Cate, JJM; Craig, AM; Hughes, BL; Dotters-Katz, SK; Wheeler, SM
Published in: Am J Perinatol
February 21, 2023

OBJECTIVE:  The COVID pandemic has been associated with varied effects on preterm birth (PTB). We sought to compare rates of PTB during the pre- and post vaccination COVID periods with pre-pandemic PTB rates, stratified by race and ethnicity. STUDY DESIGN:  Retrospective cohort comparing all deliveries over 20 weeks at a single tertiary center during "early" (March 2020-June 2020) versus "late" COVID (March 2021-June 2021), and "late" COVID versus pre-COVID (March to June 2014-2019). PTBs <37, <34, and <28 weeks were compared and stratified by race/ethnicity. RESULTS:  A total of 16,483 deliveries occurred including 2,068 "early" COVID, 2,115 "late" COVID, and 12,300 pre-COVID. The PTB rate during "late" COVID was lower compared to "early" COVID (12.1 vs. 14.6%, p = 0.02). Rate of PTB <34 was also lower during "late" COVID (4.4 vs. 5.7%, p = 0.05). PTB <28 did not differ. When controlling for prior PTB, "late" COVID remained associated with a decreased risk of PTB compared to "early" COVID, adjusted odds ratio (aOR) of 0.82 (95% confidence interval [CI]: 0.68, 0.98). Although there was no difference in PTB among Hispanic individuals when comparing "late" COVID versus pre-COVID, when further subdivided, a small number of Hispanic Puerto Rican individuals had higher odds of PTB < 37 during "late" COVID versus pre-COVID (aOR = 4.29 [95% CI: 1.12, 16.4]). Additionally, White individuals had reduced odds of PTB <37 (aOR = 0.80 [95% CI: 0.65, 0.98]) during "late" COVID versus pre-COVID while the PTB rate was unchanged when comparing "late" COVID versus pre-COVID in all other racial and ethnic groups. CONCLUSION:  During 2021, PTB rates decreased from rates observed in 2020 at the height of COVID restrictions. Among White birthing individuals, PTB decreased in 2021 compared to pre-COVID rates. This decrease was not observed in Black and Hispanic birthing individuals. These data highlight the continued racially disparate impact of the COVID-19 pandemic on PTB rates. KEY POINTS: · The COVID-19 pandemic has been associated with varied effects on the preterm birth (PTB) rate.. · PTB rates decreased in "late" COVID compared to "early" COVID.. · When stratified, PTB decreased among white individuals, but not in Black or Hispanic individuals..

Duke Scholars

Published In

Am J Perinatol

DOI

EISSN

1098-8785

Publication Date

February 21, 2023

Location

United States

Related Subject Headings

  • Obstetrics & Reproductive Medicine
  • 4204 Midwifery
  • 3215 Reproductive medicine
  • 3213 Paediatrics
  • 1114 Paediatrics and Reproductive Medicine
  • 1103 Clinical Sciences
 

Citation

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Chicago
ICMJE
MLA
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Cate, J. J. M., Craig, A. M., Hughes, B. L., Dotters-Katz, S. K., & Wheeler, S. M. (2023). Preterm Birth Rates and Racial Disparities during the COVID-19 Pandemic at a Single Institution in the Southeastern United States. Am J Perinatol. https://doi.org/10.1055/a-2008-8229
Cate, Jennifer J. M., Amanda M. Craig, Brenna L. Hughes, Sarah K. Dotters-Katz, and Sarahn M. Wheeler. “Preterm Birth Rates and Racial Disparities during the COVID-19 Pandemic at a Single Institution in the Southeastern United States.Am J Perinatol, February 21, 2023. https://doi.org/10.1055/a-2008-8229.
Cate JJM, Craig AM, Hughes BL, Dotters-Katz SK, Wheeler SM. Preterm Birth Rates and Racial Disparities during the COVID-19 Pandemic at a Single Institution in the Southeastern United States. Am J Perinatol. 2023 Feb 21;
Cate, Jennifer J. M., et al. “Preterm Birth Rates and Racial Disparities during the COVID-19 Pandemic at a Single Institution in the Southeastern United States.Am J Perinatol, Feb. 2023. Pubmed, doi:10.1055/a-2008-8229.
Cate JJM, Craig AM, Hughes BL, Dotters-Katz SK, Wheeler SM. Preterm Birth Rates and Racial Disparities during the COVID-19 Pandemic at a Single Institution in the Southeastern United States. Am J Perinatol. 2023 Feb 21;
Journal cover image

Published In

Am J Perinatol

DOI

EISSN

1098-8785

Publication Date

February 21, 2023

Location

United States

Related Subject Headings

  • Obstetrics & Reproductive Medicine
  • 4204 Midwifery
  • 3215 Reproductive medicine
  • 3213 Paediatrics
  • 1114 Paediatrics and Reproductive Medicine
  • 1103 Clinical Sciences