Racial Disparities in Death of Someone Close during Pregnancy: Findings from the Pregnancy Risk Assessment Monitoring System (PRAMS), 2017-2021

Abstract

PurposeThe COVID-19 pandemic increased the mortality rate in the U.S. and exposed many to the unexpected death of someone close. No prior research has assessed whether the COVID-19 pandemic was followed by an increase in bereavement during pregnancy, and whether patterns varied by race and ethnicity. MethodsUsing data from the Pregnancy Risk Assessment Monitoring System from 2017-2021 across 23 U.S. sites (N = 107,226), we assessed trends in the odds of experiencing the death of someone close before and after the onset of the COVID-19 pandemic. ResultsFindings revealed an increased percentage of women who reported having someone close to them die in the year prior to childbirth after the start of the COVID-19 pandemic (March 2020 or later) (aPR=1.121, 95% CI (1.079 – 1.165). Analysis by mother’s race and ethnicity showed death of someone close increased significantly after the COVID-19 pandemic for Hispanic (aPR = 1.192, 95% CI = 1.062, 1.337), non-Hispanic Black (aPR = 1.115, 95% CI = 1.015 – 1.225), and American Indian-Alaskan Native pregnant women (aPR = 1.391, 1.023 – 1.891) compared to White, Non-Hispanic pregnant women. ConclusionsIncreased bereavement among pregnant women during the COVID-19 pandemic warrants routine grief screening and response training in prenatal care.