Originally published by 2 Minute Medicine® (view original article). Reused on AccessMedicine with permission.

1. In Washington State, pregnant patients were found to be at a higher risk of SARS-CoV-2 infection.

2. Results were more pronounced if patients belonged to a non-white racial or ethnic group or received their care in a language other than English.

Evidence Level Rating: 2 (Good)

As the COVID-19 pandemic continues to exert a broad impact on global health systems, an understanding of groups at higher risk is important not only for triage but also public health interventions. In that vein, this retrospective cohort study from Washington State sought to estimate and compare the infection rates in pregnant patients with similarly aged adults, as well as examine disparities by race/ethnicity and language use. Patients across 35 hospitals and clinic systems were included for analysis. 240 cases of SARS-CoV-2 infections in pregnant patients were detected, 15.8% in the first trimester, 27.9% in the second, and 56.3% in the third. The overall infection rate in pregnancy among trial sites was 13.9/1,000 deliveries. When comparing this to the overall infection rate among those aged 20-39 years in Washington State (7.3/1,000), the infection rate in pregnancy was a significant 1.7 times higher. Furthermore, when compared with those who delivered live births in Washington State in 2018, the proportion of infections in pregnancy among most racial and ethnic minority groups was 2.0 to 3.9-fold higher. In contrast, the proportion of white and Asian pregnant women with infection was lower than expected based on 2018 data. Finally, a disproportionate number of pregnant patients experienced SARS-CoV-2 infections if receiving their care in a non-English language. Though a selection bias may have been introduced due to the incomplete collection of all cases in the state, this retrospective cohort study revealed that the SARS-CoV-2 infection rate is higher among pregnant patients compared with similarly aged non-pregnant patients, and that nearly all non-white racial and ethnic groups are disproportionately affected. Having a robust understand of the patterns of infection can help unravel the social structures impacting the spread of disease and contribute to the design of effective and equitable public health interventions.

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