- A new study of 427 pregnant women in the UK who were admitted to the hospital with COVID-19 found that more than half were black or from other minority ethnic groups.
- More research is “urgently needed” to help identify why pregnant women of colour are disproportionately affected by COVID-19, the authors wrote.
- Prior research has shown women of colour in the UK are five times more likely to die in pregnancy, childbirth, or immediately postpartum than white women.
- Pregnant women are still more likely to develop a pregnancy complication than COVID-19, so they should not avoid their prenatal appointments for fear of contracting the virus.
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More than half of pregnant women admitted to UK hospitals with COVID-19 were black or from other ethnic minority groups, according to a study out today in the British Medical Journal.
The finding was startling to researchers since women of colour make up about 20 per cent of the typical pregnant population in the country.
Other factors, like maternal age and obesity, did not explain the disparities.
And, while women’s health specialists are aware of disparities among pregnant women in the UK – where black women are five times more likely to die in pregnancy, childbirth, or immediately postpartum than white women – these inequities were “much more than was expected,” lead study author Marian Knight, a professor in the University of Oxford’s Nuffield Department of Population Health told Insider.
Knight said more qualitative research involving talking to women about their experiences is “urgently needed” to help understand what puts pregnant women of colour at such risk for COVID-19, be it household arrangements or jobs that make physical distancing difficult, restricted access to healthcare, something else, or all of the above.
The answers will likely differ between minority groups, making the questions even trickier to answer, Knight said. “We have to accept that it’s difficult, but that doesn’t mean we shouldn’t be trying to tackle it,” she said.
For the study, Knight’s team looked at data from 427 pregnant women who were admitted to the hospital with COVID-19 between March 1 and April 14 in order to learn more about what they had in common.
They found that 25% of the women were Asian, 22% were black, 70% were overweight or obese, 40% were 35-years-old or older, and a third had pre-existing conditions.
Fortunately, most women had good outcomes, with only 10% needing respiratory support. While five women died, three from complications related to COVID-19, women of colour didn’t seem to be any more susceptible to that outcome, Knight said, though it’s hard to tell with such a small sample.
Only 12 of the babies tested positive for COVID-19, half of whom were diagnosed within the first 12 hours after birth.
Maternal mortality rates are five times higher among black women in the UK than white women
While race didn’t seem to affect the low death rate in the current study, prior work has shown black women in the UK are five times more likely to die from pregnancy or childbirth complications than white women. In the US, reports suggest they’re three to four times more at risk for maternal mortality.
Dying in pregnancy or childbirth is still, rare, though, with a rate of 0.04% among black women in the UK.
Doctors, public-health professionals, and even celebrities like Beyonce and Serena Williams have pointed to a variety of factors that could help explain the outcomes, including socioeconomic status, access to prenatal treatment, racial bias in the medical system, a culture that doesn’t encourage black women to speak up about their health concerns, and medical complications during pregnancy like pre-eclampsia.
Beyonce’s experience with preeclampsia, a complication involving high blood pressure and protein in the urine, for one, put her on bed rest for more than a month prior to an emergency C-section.
Serena Williams also had an emergency C-section, followed by a pulmonary embolism that almost killed her, she wrote for CNN. Both women have emphasised that not many black women, and those in poorer countries, aren’t so lucky to receive the kind of life-saving treatment they did.
“Every mother, everywhere, regardless of race or background deserves to have a healthy pregnancy and birth,” Williams wrote.
Pregnant women should not avoid their appointments for fear of COVID-19
While pregnancy does weaken the immune system, it doesn’t seem to make women susceptible to COVID-19 the way age or conditions like lung or heart disease does, Dr. Jane van Dis, an OB-GYN who serves as medical director at the telemedicine network Maven, previously told Insider.
Indeed, pregnant women are more likely to have a complication like pre-eclampsia than they are to get COVID-19, so it’s critical they continue on with their prenatal appointments, Knight emphasised. If they’re especially worried about contracting the virus at a hospital or clinic, they can consider telehealth options, she said.
“The worst outcome of a study like this is if it stopped women from prenatal visits,” she said.
Still, pregnant women should be aware that they’re considered an at-risk population for COVID-19,” according to the American College of Obstetricians and Gynecologists, since they’re at greater risk of severe morbidity and mortality from other respiratory infections like the flu.
COVID-19 can also make it more likely for pregnant women to have complications, namely preterm birth, according to the CDC, though they don’t seem to be able to transmit the virus to their babies in utero.
Knight said she’s reassured to see professional groups in the UK encourage women of colour to talk to their OB-GYNs early about any potential COVID-19 symptoms and OB-GYNs to have a “lower threshold of concern” when it comes to addressing them.
Still, much more work is needed to understand what may make minority groups more vulnerable to COVID-19 so that infection can be better prevented, Knight said. “I don’t want people to think [talking to their doctors about their symptoms] is the solution” to fighting disparities, she said.