1068 Racial and ethnic disparities in pregnancy related to SARS-CoV-2 infection

Objective: To describe racial/ethnic differences in COVID-19 disease and perinatal outcomes among pregnant women delivering during the COVID-19 pandemic. Study Design: This is a retrospective cohort analysis of pregnant women delivering at a single institution in NYC who were universally tested for SARS-CoV-2 by RT-PCR or serology from March 13 to August 5, 2020. Women were classified by self-reported race/ethnicity into five groups - non-Hispanic Black ("Black"), non-Hispanic White ("White"), Hispanic, Asian and "other". Data on baseline characteristics, SARS-CoV-2 presentation and outcomes, and perinatal outcomes were collected and examined across groups of race/ethnicity in SARS-CoV-2 infected and uninfected women using Wilcoxon rank sum test for continuous variables and Fisher's exact test for categorical variables. The odds ratios (OR) for SARS-CoV-2 positivity and cesarean delivery were determined by logistic regression models with adjustment for demographic, medical and obstetric factors. Result(s): Of 2489 women who delivered, 1338 (53.8%) were Hispanic, 531 (21.3%) White, 252 (10.1%) Black, 127 (5.1%) Asian and 241 (9.7%) "other". The SARS-CoV-2 positivity rate was 11.1% (n=276). There was a significantly higher SARS-CoV-2 infection rate among Hispanic women compared to White women (15.6% vs 6.0%, p<=0.01), which persisted after controlling for confounders (OR 2.12, 95% CI 1.05, 4.27). The infection rate did not differ significantly among other racial/ethnic groups compared to White women. (Table 1) Hispanic and Black women were more likely to undergo cesarean (51% and 39% vs 28 %, p<=0.05), which persisted in Hispanic women after controlling for SARS-CoV-2 infection and confounders (OR 3.57, 95% CI 1.30, 9.80), but not in Black women. There were no differences in SARS-CoV-2 infection-associated outcomes or other perinatal complications. (Table 2) Conclusion(s): Hispanic women were disproportionately affected by SARS-CoV-2 in this population and were more likely to undergo cesarean compared to SARS-CoV-2-infected White women. This cesarean rate disparity could not be accounted for by SARS-CoV-2 infection. [Formula presented] [Formula presented]Copyright © 2020