Black-White Disparities and Preterm Births Comparisons Following the COVID-19 Pandemic in Michigan

Document Type

Conference Proceeding

Publication Date


Publication Title

Am J Obstet Gynecol


Objective: Racial and ethnic disparities in health care have been documented throughout decades in the United States. The COVID-19 pandemic has further shown a disproportionate burden on racial and minority groups. Black women have been disproportionately impacted among other races in terms of pregnancy outcomes. The aim of this study was to compare preterm birth outcomes between black vs white women after the COVID-19 pandemic.

Study Design: A population-based retrospective cohort study was performed using the state of Michigan’s birth registry data. The timeline of interest was after the emergence of the pandemic in Michigan from March 2020 until December 2020. The pre-pandemic cohort was from March 2019 until December 2019. The main outcome of interest was preterm birth rates comparison between White and Blacks in the post-pandemic vs pre-pandemic period.

Results: Of 91,068 women in the pre-pandemic cohort, 65,420 (71.8%) identified as White, compared to 16,997 (18.7%) who identified as Black. The post-pandemic cohort included 83,240 women with 57,836 (69.5%) identifying as White, compared to 16,160 (19.4%) identifying as Black. The overall preterm birth rate decreased from 10.4% to 9.9% post-pandemic. In the pre-pandemic cohort, the preterm birth rate was 9.0% for White women compared to 16.3% for Black women, the extreme preterm birth rate (< 28 weeks gestation) was 0.42% for White women compared to 1.4% for Black women. In the post-pandemic cohort, the preterm birth rate was 8.6% for White women compared to 15.1% for Black women and the extreme preterm birth rate was 0.39% for White women compared to 1.2% for Black women.

Conclusion: Although disparities continue to persist in preterm birth rates between White vs Black women, we found no increased racial disparities in changes in preterm birth or extreme preterm birth rates between both races in the pre vs post-pandemic periods. More data in the upcoming years post-pandemic can help further confirm these findings.





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