Apr 10, 2023 - Health

COVID's role in increasing maternal mortality rates

Illustration of a hand holding a candle with the candle glow shaped as a covid cell. 

Illustration: Aïda Amer/Axios

The U.S. maternal mortality rate increased during the COVID-19 pandemic, disproportionately impacting Black women, with far higher odds of severe complications among pregnant patients with COVID infection at delivery, a new analysis published in JAMA Network Open found.

Why it matters: The United States has the highest maternal mortality rate of developed countries, and the pandemic made it worse — in 2021, 1,205 women died of maternal causes, data from the CDC show, compared to 861 in 2020 and 754 in 2019.

Driving the news: COVID-19 posed a serious risk to patients giving birth.

  • The JAMA analysis, led by researchers from the University of Southern California, Los Angeles, found the mortality risk of pregnant patients with COVID-19 at delivery between March 2020 and December 2020 was 14 times higher than those without the virus.

The big picture: Previous studies have found contributors to the high maternal mortality rate during the pandemic have included a lag in COVID-19 vaccination in pregnant people due to concerns over the potential effects of the vaccine that may persist despite studies showing they are safe.

  • The CDC estimates that as of April 1, approximately 71% of pregnant people have completed the primary vaccination series (below the vaccination rate for those over the age of 18), and only about 23% of pregnant people have received an updated booster dose.
  • "[I]f you have COVID-19 during pregnancy, you are at increased risk of complications that can affect your pregnancy and developing baby," said Scott Pauley, a CDC press officer, adding that the center is urging pregnant people to stay up to date on their vaccinations.

State of play: Risk factors that made someone more susceptible to severe COVID-19 are also risk factors that make a pregnancy higher risk including having higher blood pressure, cholesterol and diabetes.

  • This is part of why maternal mortality rates increased in 2021, Rachel Bond, director of women's heart health at CommonSpirit Health, told Axios.
  • The pandemic also exacerbated existing social determinants of health, and as a result disproportionately impacted women of color, who were often on the frontlines working "essential" jobs and getting sick.
  • "At the core of the maternal mortality crisis is psychosocial stresses," Bond said, adding that both sexual and racial discrimination plays a role.
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