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Public Health/Global Health

Poster Session 3

(915) Health Inequity Observed in Demographic Correlations with Pregnancy-Associated Hypertensive Morbidity During the Coronavirus Pandemic

Wednesday, February 14, 2024
8:30 AM – 10:00 AM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level

    Primary & Presenting Author(s)

  • Yanling Dong, MD

    University of Rochester Medical Center
    Rochester, NY, United States

    • Coauthor(s)

  • Stefanie J. Hollenbach, MD, PhD (she/her/hers)

    Assistant Professor, Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology
    The University of Rochester Medical Center
    Rochester, NY, United States

Objective: To characterize race and ethnicity associations with the prevalence of hypertensive (HTN) morbidity during pregnancy in relationship to the COVID-19 pandemic. 

Study Design: Retrospective, ecological cohort study of a 10-county birth certificate database with a pre-pandemic cohort from April 2018 to February 2019 and a pandemic cohort from April 2020 to February 2021, excluding transitional deliveries during the emerging pandemic. Cohorts were analyzed for the primary outcome of diagnosed HTN morbidity in pregnancy (including pregnancy related HTN and chronic HTN) and eclampsia among different ethnicity groups, as well as a secondary outcome of neonatal morbidities. Data analysis was performed via T-Test and Chi-squared Test.

Results: 19062 deliveries were included, 9726 in the pre-pandemic and 9335 in the pandemic cohorts. Patient demographics, including maternal age, gestational age and BMI were not significantly different between the two cohorts. Prevalence of HTN morbidity (from 14.9% to 20.2%, OR 1.45, CI 1.34-1.56, p< 0.05) and eclampsia (from 0.1% to 0.7%, OR 6.8, CI 3.50-13.3, p< 0.05) during the COVID pandemic increased. The increased prevalence of HTN morbidity persisted among patients identifying as non-Hispanic White (from 14.3% to 18.6%, OR1.37, CI 1.24-1.50, p< 0.005), non-Hispanic Black (from 20.7% to 28.3%, OR 1.51, CI 1.29-1.78, p< 0.005), and Hispanic (from 13.1% to 16.8%, OR 1.34, CI 1.05-1.71, p=0.015). The increased prevalence of eclampsia was also persistent and profound (Figure 1). There was no clinically significant change in neonatal outcomes, including birth weight, preterm delivery rate, APGAR scores and NICU admission rates.

Conclusion:

These data demonstrate an increased prevalence of HTN morbidity and eclampsia during the COVID-19 pandemic across different race/ethnicity groups, with most significant increase of HTN morbidity experienced in those identifying as non-Hispanic Black and eclampsia in Hispanic populations. These trends reveal disparate concentrations of morbidity across populations that may be a reflection of differing burden of baseline health disparities.