Brazilian Black Women are at Higher Risk for COVID-19 Complications: An Analysis of REBRACO, a National Cohort

Abstract

Objective To evaluate the impact of the race (Black versus non-Black) on maternal and perinatal outcomes of pregnant women with COVID-19 in Brazil.

Methods This is a subanalysis of REBRACO, a Brazilian multicenter cohort study designed to evaluate the impact of COVID-19 on pregnant women. From February 2020 until February 2021, 15 maternity hospitals in Brazil collected data on women with respiratory symptoms. We selected all women with a positive test for COVID-19; then, we divided them into two groups: Black and non-Black women. Finally, we compared, between groups, sociodemographic, maternal, and perinatal outcomes. We obtained the frequency of events in each group and compared them using X2 test; p-values < 0.05 were considered significant. We also estimated the odds ratio (OR) and confidence intervals (CI).

Results 729 symptomatic women were included in the study; of those, 285 were positive for COVID-19, 120 (42.1%) were Black, and 165 (57.9%) were non-Black. Black women had worse education (p = 0.037). The timing of access to the health system was similar between both groups, with 26.3% being included with seven or more days of symptoms. Severe acute respiratory syndrome (OR 2.22 CI 1.17–4.21), intensive care unit admission (OR 2.00 CI 1.07–3.74), and desaturation at admission (OR 3.72 CI 1.41–9.84) were more likely to occur among Black women. Maternal death was higher among Black women (7.8% vs. 2.6%, p = 0.048). Perinatal outcomes were similar between both groups.

Conclusion Brazilian Black women were more likely to die due to the consequences of COVID-19.

Resumo

Objetivo Avaliar o impacto da raça (negra versus não negra) nos desfechos maternos e perinatais de gestantes com COVID-19 no Brasil.

Métodos Esta é uma subanálise da REBRACO, um estudo de coorte multicêntrico brasileiro desenhado para avaliar o impacto da COVID-19 em mulheres grávidas. De fevereiro de 2020 a fevereiro de 2021, 15 maternidades do Brasil coletaram dados de mulheres com sintomas respiratórios. Selecionamos todas as mulheres com teste positivo para COVID-19; em seguida, as dividimos em dois grupos: mulheres negras e não negras. Finalmente, comparamos, entre os grupos, os resultados sociodemográficos, maternos e perinatais. Obtivemos a frequência dos eventos em cada grupo e comparamos usando o teste X2; Valores de p < 0,05 foram considerados significativos. Também estimamos o odds ratio (OR) e os intervalos de confiança (IC).

Resultados 729 mulheres sintomáticas foram incluídas no estudo; desses, 285 foram positivos para COVID-19, 120 (42,1%) eram negros e 165 (57,9%) não eram negros. As mulheres negras apresentaram pior escolaridade (p = 0,037). O tempo de acesso ao sistema de saúde foi semelhante entre os dois grupos, com 26,3% incluídos com sete ou mais dias de sintomas. Síndrome respiratória aguda grave (OR 2,22 CI 1,17–4,21), admissão em unidade de terapia intensiva (OR 2,00 CI 1,07–3,74) e dessaturação na admissão (OR 3,72 CI 1,41–9,84) foram mais prováveis de ocorrer entre mulheres negras. A mortalidade materna foi maior entre as negras (7,8% vs. 2,6%, p = 0,048). Os resultados perinatais foram semelhantes entre os dois grupos.

Conclusão Mulheres negras brasileiras tiveram maior probabilidade de morrer devido às consequências da COVID-19.

Keywords

COVID-19 - Obstetrics - Racial disparities - Black women

Palavras-chave

COVID-19 - Obstetrícia - Disparidades raciais - Mulheres negras

Contributions

All authors contributed to the design of the study and were involved in the data collection, data analysis and/or interpretation. All authors also contributed to manuscript writing/substantive editing and review and approved the final draft of the manuscript.

REBRACO Study Group: Carolina C Ribeiro Do-Valle, Adriana G Luz, Giuliane J Lajos, Guilherme M Nobrega, Thayna B Griggio, Charles M Charles, Silvana F Bento, Carla Silveira, Maria J Miele, Luis Bahamondes, Sherly Metelus, Lester Castro, Stephanie Pabon, Rachel Esteves Soeiro, Artur Antolini, Paulo S R Junior, Thais G Sardinha, Rodolfo R Japenga, Erica R F Urquiza, Maíra R Machado, Marcela Maria Simões, Larissa M Solda, Sue Yazaki-Sun, Priscilla Mota, Arimaza C Soares, Ellen Machado, Anne Bergmann, Gustavo Raupp dos Santos, Patrícia B Peres, Cristiane L Arbeli, Rafael M Quevedo, Carolina F Yamashita, Julia D Corradin, Isabella Bergamini, José Geraldo L Ramos, Maria Lúcia R Oppermann, Laisa S Quadro, Lina Marins, Érika V Paniz, Thaís Vicentini Xavier, Bruna E Parreira, Aline M Tosetto, Sabrina O Savazoni, Aline C Costa, Marina HL Almeida, Bruna FV Moura, Lidiane R França, Hanna Vieira, Rafael B Aquino, Débora F Leite, Isabella Monteiro, Marcos Nakamura-Pereira, Bruna O Guerra, Gabriela Gorga, Daisy Pinheiro, Denise Cordeiro, Priscila L Miná, Carol Dornellas, Kevin FA Oliveira, Mariana Emi Varicoda Makyama, Caio Leal, Rayra Amana, Cristiane O Santos, Marina M dos Santos, Carlos Neto, and Thiago Gomes, Isabela R Pereira, Clélia Andrade Salustrino, Valéria B Pontes, Roberto Allen da Silva Franco, João Paolo Bilibio, Gislânia P F Brito, Hana Paula C Pinto, Danielle Leal de Oliveira, Andrezza A Guerra, Andrea O Moura, Natasha Pantoja, Fernanda David, Alina Silva, Juliana Vasconcellos Freitas-Jesus, Angela M Bacha, Anderson Borovac-Pinheiro, Belmiro G Pereira, Eliana M Amaral, Elton Ferreira, Helaine MBPM Milanez, Jamil P S Caldas, Luiz F Baccaro, Marcelo Nomura, Patrícia M Rehder, Renata Z Simone, Renato Passini Jr, Cristiano Torrezan, João L P Modena, Magnun N Nunes dos Santos, Sergio T M Marba and Tábata R Zumpano dos Santos.

Publication History

Received: 06 January 2023

Accepted: 10 January 2023

Article published online:
20 June 2023

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