Racial/Ethnic Disparities in Very Preterm Birth and Preterm Birth Before and During the COVID-19 Pandemic.
Racial/Ethnic Disparities in Very Preterm Birth and Preterm Birth Before and During the COVID-19 Pandemic.
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DOI：
10.1001/jamanetworkopen.2021.1816
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发表时间：
2021-03-01
影响因子：
13.8
通讯作者：
Howell EA
中科院分区：
文献类型：
--
作者：
Janevic T;Glazer KB;Vieira L;Weber E;Stone J;Stern T;Bianco A;Wagner B;Dolan SM;Howell EA
2019年冠状病毒病(新冠肺炎)的第一波大流行是否与纽约市早产的种族/民族差异加剧有关？这项横断面研究发现，在纽约市第一波新冠肺炎疫情期间，8,026名女性在极早产和早产方面的种族/民族差异与去年同期相似。随着新冠肺炎大流行的持续，有必要监测不良生育结果中的种族/民族差异。2019年冠状病毒病(新冠肺炎)大流行可能加剧早产方面现有的种族/族裔不平等。评估在纽约市发生的第一波新冠肺炎疫情期间，早产和早产方面的种族/族裔差异是否增加。这项横断面研究包括8026名在研究期间分娩的黑人、拉丁裔和白人妇女。通过使用从纽约市两家医院获得的电子医疗记录，对流行队列中VPTB或PTB的黑人和白人差异(DID)分析与流行前队列进行了比较。2020年3月28日至7月31日分娩的妇女被认为是大流行队列，2019年3月28日至7月31日分娩的妇女被认为是流行前队列。采用入院时经鼻咽拭子采集的样本进行逆转录聚合酶链式反应检测SARS冠状病毒2型。临床估计的胎龄被用来计算VPTB(32周)和PTB(37周)。采用对数二项回归估计黑人与白人的风险差异、大流行队列与流行前队列的风险差异以及代表DID估计值的交互作用项。协变量调整的模型包括年龄、保险、孕前体重指数和产次。在大流行队列中的3834名妇女中，492名(12.8%)自认为是黑人，678名(17.7%)是拉丁裔，2012名(52.5%)是白人，408名(10.6%)是亚裔，244名(6.4%)是其他或未指明的种族/族裔，大约一半的妇女年龄在25岁至34岁之间。流行期前队列包括4192名具有相似社会人口学特征的妇女。在流行前期队列中，黑人婴儿VPTB风险为4.4%(20/451)，PTB风险为14.4%(65/451)，而白人婴儿VPTB风险为0.8%(17/2188)，PTB风险为7.1%(156/2188)。在大流行队列中，黑人婴儿的VPTB风险为4.3%(21/491)，PTB风险为13.2%(65/491)，而白人婴儿的VPTB风险为0.5%(1994年的10%)，肺结核的风险为7.0%(1994年的240)。DID估计者表明，黑人与白人的差异没有增加(室颤的DID估计者，每百例增加0.1例[95%CI，−2.5至2.8]；DID估计者，每百例减少1.1例[95%CI，−5.8至3.6])。在协变量调整模型中，将人群限制为SARS-CoV-2检测阴性的女性时，结果具有可比性。在大流行期间，拉丁裔与白人结核病之间的差异没有发现变化。在这项对新冠肺炎疫情期间在纽约市分娩的妇女进行的横断面研究中，没有发现证据表明，在SARS-CoV-2检测呈阳性或阴性的妇女中，肺结核的种族/民族差异增加。这项横断面研究使用差异分析来评估在2019年冠状病毒大流行的第一波中，在纽约市分娩的妇女中，极早产或早产的种族/民族差异是否比大流行前一年有所增加。
Was the first wave of the coronavirus disease 2019 (COVID-19) pandemic associated with exacerbated racial/ethnic disparities in preterm birth in New York City? This cross-sectional study found that racial/ethnic disparities in very preterm birth and preterm birth among 8026 women were similar during the first wave of the COVID-19 pandemic in New York City compared with the same period the year prior. Monitoring of racial/ethnic disparities in adverse birth outcomes as the COVID-19 pandemic continues is warranted. The coronavirus disease 2019 (COVID-19) pandemic may exacerbate existing racial/ethnic inequities in preterm birth. To assess whether racial/ethnic disparities in very preterm birth (VPTB) and preterm birth (PTB) increased during the first wave of the COVID-19 pandemic in New York City. This cross-sectional study included 8026 Black, Latina, and White women who gave birth during the study period. A difference-in-differences (DID) analysis of Black vs White disparities in VPTB or PTB in a pandemic cohort was compared with a prepandemic cohort by using electronic medical records obtained from 2 hospitals in New York City. Women who delivered from March 28 to July 31, 2020, were considered the pandemic cohort, and women who delivered from March 28 to July 31, 2019, were considered the prepandemic cohort. Reverse transcription–polymerase chain reaction tests for the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were performed using samples obtained via nasopharyngeal swab at the time of admission. Clinical estimates of gestational age were used to calculate VPTB (<32 weeks) and PTB (<37 weeks). Log binomial regression was performed to estimate Black vs White risk differences, pandemic cohort vs prepandemic cohort risk difference, and an interaction term representing the DID estimator. Covariate-adjusted models included age, insurance, prepregnancy body mass index, and parity. Of 3834 women in the pandemic cohort, 492 (12.8%) self-identified as Black, 678 (17.7%) as Latina, 2012 (52.5%) as White, 408 (10.6%) as Asian, and 244 (6.4%) as other or unspecified race/ethnicity, with approximately half the women 25 to 34 years of age. The prepandemic cohort comprised 4192 women with similar sociodemographic characteristics. In the prepandemic cohort, VPTB risk was 4.4% (20 of 451) and PTB risk was 14.4% (65 of 451) among Black infants compared with 0.8% (17 of 2188) VPTB risk and 7.1% (156 of 2188) PTB risk among White infants. In the pandemic cohort, VPTB risk was 4.3% (21 of 491) and PTB risk was 13.2% (65 of 491) among Black infants compared with 0.5% (10 of 1994) VPTB risk and 7.0% (240 of 1994) PTB risk among White infants. The DID estimators indicated that no increase in Black vs White disparities were found (DID estimator for VPTB, 0.1 additional cases per 100 [95% CI, −2.5 to 2.8]; DID estimator for PTB, 1.1 fewer case per 100 [95% CI, −5.8 to 3.6]). The results were comparable in covariate-adjusted models when limiting the population to women who tested negative for SARS-CoV-2. No change was detected in Latina vs White PTB disparities during the pandemic. In this cross-sectional study of women who gave birth in New York City during the COVID-19 pandemic, no evidence was found for increased racial/ethnic disparities in PTB, among women who tested positive or tested negative for SARS-CoV-2. This cross-sectional study uses a difference-in-differences analysis to assess whether racial/ethnic disparities in very preterm birth or preterm birth increased in the first wave of the coronavirus disease 2019 pandemic vs the year prior to the pandemic among women who delivered in New York City.
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影响因子：
11.3
作者：
Gur RE;White LK;Waller R;Barzilay R;Moore TM;Kornfield S;Njoroge WFM;Duncan AF;Chaiyachati BH;Parish-Morris J;Maayan L;Himes MM;Laney N;Simonette K;Riis V;Elovitz MA
通讯作者：
Elovitz MA
影响因子：
8.1
作者：
Philip RK;Purtill H;Reidy E;Daly M;Imcha M;McGrath D;O'Connell NH;Dunne CP
通讯作者：
Dunne CP
影响因子：
5.4
作者：
Preis, Heidi;Mahaffey, Brittain;Lobel, Marci
通讯作者：
Lobel, Marci
影响因子：
7.2
作者：
Egerup, Pia;Fich Olsen, Line;Nielsen, Henriette Svarre
通讯作者：
Nielsen, Henriette Svarre
影响因子：
3.5
作者：
Hawkins, Devan
通讯作者：
Hawkins, Devan