(1080) Racial disparities in maternal mortality before, during, and after the COVID-19 pandemic in the U.S.

Objective: To evaluate racial disparities in maternal mortality before, during, and after the Coronavirus Disease 2019 (COVID-19) pandemic.

Study Design: We conducted difference-in-differences (DID) analyses using the Centers for Disease Control and Prevention’s WONDER database. Data on the number of births and maternal mortality were aggregated into monthly intervals. We compared changes in maternal mortality during pregnancy and up to 1 year after delivery per 100,000 births between White and Black or African Americans before (Jan 2018–Mar 2020), during (Apr 2020–Mar 2022), and after (Apr 2022–Jun 2024) the COVID-19 pandemic. Predicted incidence of maternal mortality and DID with 95% confidence intervals (95% CI) were calculated using negative binomial regression models with interactions between race and periods.

Results: There were 3,694,282 Black individuals and 17,284,929 White individuals who gave birth during that period, with 2,513 (68 per 100,000) and 4,547 (26 per 100,000) death, respectively (Figure 1). Mortality per 100,000 from before COVID-19 to during COVID-19 increased by 29.4 (95% CI: 19.8-39.1) for Black and 11.8 (95% CI: 8.2-15.4) for White individuals, with a DID of 17.6 (95% CI: 7.3-28.0) in favor of White (Table 1). Mortality per 100,000 from before COVID-19 to after COVID-19 increased by 9.5 (95% CI: 3.2-15.9) for Black and 1.6 (95% CI: -0.4-3.7) for White with a DID of 7.9 (95% CI: 1.2-14.6), suggesting that Black-White disparity worsened after COVID-19 pandemic.

Conclusion: The findings highlight that racial disparity in maternal mortality, which disproportionately affects Black individuals, was further exacerbated by the COVID-19 pandemic. The gap in maternal mortality between Black and White individuals increased post-pandemic, underscoring the need for targeted interventions to address systemic inequities in maternal healthcare.