Pregnant Women in Hospital With COVID-19 More Likely to Be BAME 

Nicky Broyd

June 08, 2020

A national UK survey has found more than half of pregnant women recently admitted to a UK hospital with COVID-19 were from black or other minority ethnic (BAME) groups.

The researchers believe the high number, even after excluding major urban centres from the analysis, "needs urgent investigation and explanation".

The findings are published today in the BMJ.

The Study

Published evidence on COVID-19 infection in pregnancy is limited, which is why a team of researchers from the Nuffield Department of Population Health, University of Oxford, carried out the study.

Their findings are based on data from 427 pregnant women from the UK Obstetric Surveillance System (UKOSS) admitted across all 194 obstetric units in the UK with confirmed COVID-19 infection between 1st March and 14th April 2020.

The Findings

The national, prospective, observational study found that most women were admitted in their late second or third trimester.

More than half (56% 233 women) were from black or other ethnic minority groups (25% were Asian and 22% were black), 69% were overweight or obese, 41% were aged 35 or over, and a third had pre-existing conditions.

Forty-one (10%) needed respiratory support in a critical care unit, and five (1%) women died (three as a direct result of complications of COVID-19).

Transmission of the virus to infants was uncommon and twelve (5%) of 265 babies born to study mothers tested positive for COVID-19.

Lower Threshold of Concern

Lead study author Marian Knight, professor of maternal and child population health, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, told Medscape News UK by email: "The patterns we observed in pregnancy in relation to COVID-19 reflect very similar findings to those observed in the general (non-pregnant) population. Whilst some of the difference was explained by factors such as pre-existing health problems (diabetes and hypertension), this explained only a small amount of the disparity.

"In response to the findings of the study, the Royal College of Obstetricians and Gynaecologists [RCOG] and Royal College of Midwives have reiterated the importance to women of seeking advice early, and also to clinicians to have a lower threshold of concern and consideration of admission for women from BAME groups.

"The most important measure to reduce risk will be to prevent infection, and thus maintaining social distancing, particularly in the third trimester of pregnancy remains the key message for women."

Dr Christine Ekechi, consultant obstetrician and gynaecologist, and spokesperson on racial equality for the RCOG, said: "It is of great concern that over half - 55% - of pregnant women admitted to hospital with coronavirus were from a BAME background, and this deepens our concerns around persisting vulnerabilities of this particular group of women.

 "We are updating our guidance to reflect that BAME women should be told at each contact with a health professional that they may be at higher risk of complications of coronavirus, and advised to seek help early if they are concerned about their health.

"Healthcare professionals should be aware of this increased risk, and have a lower threshold to review, admit and consider multidisciplinary escalation in women of BAME background."

Funding: National Institute for Health Research (NIHR) Health Technology Assessment programme

Research: Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK. BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m2107 (Published 08 June 2020) 

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