Racial disparities in death of someone close during pregnancy: Findings from the Pregnancy Risk Assessment Monitoring System (PRAMS), 2017-2021

Ann Epidemiol. 2024 Sep:97:16-22. doi: 10.1016/j.annepidem.2024.07.045. Epub 2024 Jul 17.

Abstract

Purpose: The 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.

Methods: Using 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.

Results: Findings 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.

Conclusions: Increased bereavement among pregnant women during the COVID-19 pandemic warrants routine grief screening and response training in prenatal care.

Keywords: Bereavement; Bereavement overload; COVID-19 pandemic; Communal bereavement; Pregnancy; Racial disparities; Stressful life events.

MeSH terms

  • Adult
  • American Indian or Alaska Native / psychology
  • Bereavement*
  • Black or African American / psychology
  • COVID-19
  • Ethnicity
  • Female
  • Health Status Disparities*
  • Hispanic or Latino / psychology
  • Humans
  • Pandemics*
  • Pregnancy
  • Risk Assessment
  • United States / epidemiology
  • White / psychology
  • Young Adult