456 - Can Coronavirus Infection Lead to Preterm Birth? A Pilot Study on the Impact of Preterm Delivery in the Detroit Community and its Surrounding Areas.

Poster Number: 456
Publication Number: 456.130

Cindy Agu, Children's Hospital of Michigan, Detroit, MI, United States; Shanita Binyard, Children's Hospital of Michigan, Dettoit, MI, United States; Jenny Impemba, Children's Hospital of Michigan, Royal Oak, MI, United States; Ronald Thomas, Children's Hospital of Michigan, Detroit, MI, United States; Jorge Lua, Central Michigan University College of Medicine, Detroit, MI, United States; Manjari Pophale, Children's Hospital of Michigan, DETROIT, MI, United States

Background: Coronavirus disease 2019 (COVID) has infected millions of people world wide. Since the start of the pandemic, pregnant women have been subject to an increased risk of adverse events and neonates born to mothers with severe COVID symptoms are known to be at risk of prematurity.
Data in Michigan from early 2020 showed that while Black/African Americans represented 14% of the population, the rate of COVID cases in Black/African Americans was about 33%.
According to data collected by the March of Dimes, in 2019 14.6% of live births were delivered preterm in Detroit. Of the preterm births, the rate was highest for Black infants at 15.8% and Hispanics at 10.6% when compared to Whites at 9.7%. This data coupled with the higher risk of COVID-19 infection in the minority community in Detroit causes one to wonder if the rate of preterm births will rise due to COVID.

Objective: To determine whether pregnant women with COVID infection have an increased risk for preterm delivery.

Design/Methods: A retrospective review of medical records of all gravid women admitted during the COVID pandemic season, between March 1, 2020-March 31, 2021. Primary outcome is to determine the rates of early delivery (delivered < 37 weeks gestation age) between COVID positive and negative mothers. Secondary outcome, a subgroup analysis among Black/African American population cohort.

Results: Roughly three months of data (n=774) were reviewed and the percentage of all preterm deliveries was 13.6%. In COVID negative mothers (n=636) this percentage was 12.8%. In those who tested positive (n=21) the percentage was higher at 28.6%. A clinically significant difference was seen in an ethnic comparison. Of the 15 positives in the Black population 40% (6/15) were preterm deliveries compared to 0.0% (0/6) in all other ethnic groups combined (p=.12). COVID positives were more obese (6.8%) and diabetic (9.7%) than with hypertension (1.7%); p=0.29.Conclusion(s): Overall, there was a trend towards higher preterm deliveries with COVID positive pregnancy.  However, p values did not demonstrate statistically significant difference in COVID outcome with preterm delivery (p=1.00), mode of delivery (Vaginal vs C-section; p=0.82), or insurance type (Medicaid vs Private; p=1.00). An interesting area of focus lies in the rate of preterm delivery and its relation to COVID infection in the Black/African American Community. While it appeared that the overall rate of preterm delivery in the Detroit area had decreased during the study time period, there was an increased risk of preterm delivery in infants of Black/African American COVID positive mothers.
 
Coronavirus-19 Test Result by Race/EthnicityGraphic representation of the study demographic and COVID-19 results.
Incidence of COVID-19 in the Detroit AreaGraphic representation of the incidence of coronavirus-19 in the Detroit, MI community.