Maternal Mortality Worsened during COVID-19.
Maternal Mortality Worsened during COVID-19
A new study coauthored by Eugene Declercq found that Black and Hispanic mothers bore the greatest burden of maternal deaths after 2020.
The COVID-19 pandemic and its impacts have taken a disproportionate toll on American mothers who were pregnant or just gave birth. Maternal mortality increased by 18 percent between 2019-2020, according to data from the National Center for Health Statistics, exceeding the roughly 16 percent overall in US mortality in 2020.
Now, a new analysis coauthored by a School of Public Health researcher shows the maternal death rate after the start of the COVID-19 pandemic was even higher, and disproportionately impacted Black and Hispanic mothers.
A research letter published in JAMA Network Open by Eugene Declercq, professor of community health sciences, and Marie Thoma, assistant professor of family science at the University of Maryland School of Public Health, explores the jump in maternal mortality and the differences by race/ethnicity and cause of death. Overall, they found large increases in maternal death (33 percent increase) and late maternal deaths (41 percent increase) after March 2020 compared with before the pandemic, and conspicuous increases among Black and Hispanic mothers.
Strikingly, says Declercq, “for the first time in more than a decade, the maternal mortality rate for Hispanic women during the pandemic was higher than that for non-Hispanic White women, a shift that may be related to COVID and deserves greater attention moving forward.” The study also showed that existing and new disparities emerged after the pandemic with a 40% jump among already high rates for non-Hispanic Black women and a 74% jump among formerly lower rates in Hispanic women.
“The increase was really driven by deaths after the start of the pandemic, which are higher than what we see for overall excess mortality in 2020,” says Thoma, the study’s corresponding author.
COVID-19 was listed as a secondary cause of death in 14.9 percent of maternal deaths in the last nine months of 2020, with it being a contributing factor for 32 percent of Hispanic, 12.9 percent of Black and 7 percent of non-Hispanic white women giving birth.
In their analysis of causes of maternal death, they found the largest increases were due to conditions directly related to COVID-19 (respiratory or viral infection) and conditions made worse by COVID-19 infection, such as diabetes or cardiovascular disease. However, it is also possible that interruptions to the healthcare system could have led to delayed prenatal care that could have meant that risk factors for pregnancy complications went undetected.
“We need more detailed data on the specific causes of maternal deaths overall and those associated with COVID-19,” Thoma says. “Potentially we could see improvements in 2021 due to the rollout of vaccines, as well as the extension of postpartum care provided for Medicaid recipients as part of the American Rescue Act of 2021 in some states. We’re going to continue to examine this.”