Objectives. To compare pregnancy-related mortality ratios (PRMRs) associated with COVID-19 by race/ethnicity, by region of residence, and in states with and without Medicaid expansion. Methods. We used 2020-2021 data from the US Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research in our analysis. We stratified PRMRs by race/ethnicity, census regions, and Medicaid expansion and nonexpansion states. Results. The 2020-2021 PRMR was 40.3 per 100 000 live births. American Indian/ Alaska Native pregnant people had the greatest PRMR, followed by non-Hispanic Blacks and non-Hispanic Native Hawaiians/other Pacific Islanders. PRMRs associated with COVID-19 in the southern region were at least 2 times higher than in other regions and were highest for all pregnant people in the various racial/ethnic groups. PRMRs associated with COVID-19 were lower in Medicaid expansion states than in nonexpansion states. Conclusions. The US COVID-19 epidemic exacerbated racial and ethnic disparities in pregnancy-related mortality. Public Health Implications. The alarming increase in disparities among racial and ethnic pregnant people during the COVID-19 pandemic underscores the need to address social determinants of health at the structural level. (Am J Public Health. Published online ahead of print October 24, 2024:e1-e8. https://doi.org/10.2105/AJPH.2024.307814).

中文翻译：

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COVID-19 大流行期间与妊娠相关的死亡率差异。


目标。按种族/民族、居住地区以及扩大和未扩大医疗补助的州比较与 COVID-19 相关的妊娠相关死亡率 （PRMR）。方法。我们在分析中使用了来自美国疾病控制和预防中心流行病学研究的广泛在线数据的 2020-2021 年数据。我们按种族/民族、人口普查地区以及 Medicaid 扩展和非扩展州对 PRMR 进行了分层。结果。2020-2021 年的 PRMR 为每 100 000 名活产婴儿 40.3 例。美洲印第安人/阿拉斯加原住民孕妇的 PRMR 最高，其次是非西班牙裔黑人和非西班牙裔夏威夷原住民/其他太平洋岛民。南部地区与 COVID-19 相关的 PRMR 至少是其他地区的 2 倍，并且不同种族/族裔群体的所有孕妇的 PRMR 最高。与 COVID-19 相关的 PRMR 在 Medicaid 扩张州低于非扩张州。结论。美国 COVID-19 流行加剧了妊娠相关死亡率的种族和民族差异。公共卫生影响。在 COVID-19 大流行期间，种族和民族孕妇之间的差异令人震惊地增加，这凸显了在结构层面解决健康的社会决定因素的必要性。（美国公共卫生杂志。2024 年 10 月 24 日提前在线发布：e1-e8。https://doi.org/10.2105/AJPH.2024.307814）。