Publication date: Aug 01, 2025
Background This study aimed to examine changes in racial disparities in pregnancy-related and maternal mortality before, during, and after the COVID-19 pandemic in the United States. Methodology This was a cross-sectional study using the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data from January 2018 to June 2024. We focused on pregnancy-related and maternal mortality among Black and White individuals to examine racial disparities. The study periods were defined as pre-pandemic (January 2018-March 2020), pandemic (April 2020-March 2022), and post-pandemic (April 2022-June 2024). We applied interrupted time series analysis and difference-in-difference (DID) models to assess changes in mortality trends and disparities across three periods. DID estimates with 95% confidence intervals (CI) were reported. Results From January 2018 to June 2024, there were 3,694,282 Black and 17,284,929 White individuals who gave live birth. The pregnancy-related mortality ratio (PRMR) was 68. 0 deaths per 100,000 live births among Black individuals (2,513 deaths) and 26. 3 among White individuals (4,547 deaths). The maternal mortality ratio (MMR) was 46. 5 for Black individuals (1,718 deaths) and 17. 6 for White individuals (3,044 deaths). From the pre-pandemic to pandemic period, PRMR increased by 29. 4 per 100,000 (95% CI = 19. 8-39. 1) among Black individuals and by 11. 8 (95% CI = 8. 2-15. 4) among White individuals, with a DID of 17. 6 (95% CI = 7. 3-28. 0). From the pre-pandemic to post-pandemic period, PRMR increased by 9. 5 (95% CI = 3. 2-15. 9) for Black individuals and by 1. 6 (95% CI = -0. 4-3. 7) for White individuals, with a DID of 7. 9 (95% CI = 1. 2-14. 6). Results for MMR were consistent with those for PRMR. Conclusions These findings indicate a significant and sustained increase in PRMR and MMR among Black individuals, while rates among White individuals returned to near pre-pandemic levels. Racial disparities in pregnancy-related and maternal mortality widened during the COVID-19 pandemic and continued in the post-pandemic period.
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| Concepts | Keywords |
|---|---|
| Cdc | cross-sectional studies |
| January | covid-19 |
| June | health disparities |
| Racial | maternal mortality |
| pregnancy-related mortality |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | COVID-19 Pandemic |
| disease | MESH | live birth |
| pathway | REACTOME | Reproduction |
| disease | MESH | Death |
| disease | MESH | maternal death |
| disease | MESH | causes |
| disease | IDO | intervention |
| disease | IDO | quality |
| disease | MESH | hypertension |
| disease | MESH | obesity |
| disease | MESH | complications |
| disease | MESH | chronic conditions |
| disease | MESH | psychological stress |
| disease | MESH | infection |
| disease | IDO | country |
| disease | MESH | suicide |
| disease | MESH | emergency |
| disease | MESH | morbidity |
| pathway | REACTOME | Release |
| disease | MESH | Violence |
| disease | MESH | health disparities |