Objective
To evaluate the characteristics of pregnant patients with COVID-19 cared for at the University of New Mexico, the primary referral center for the state of New Mexico and much of the Four Corners region. Furthermore, to evaluate whether the Native American pregnant population is at an increased risk for severe and critical COVID-19 illness compared to other pregnant populations.
Study Design
A retrospective chart review was performed of all pregnant and peripartum patients known to been infected with SARS-CoV-2 who presented to either the inpatient or outpatient services at the University of New Mexico through July 31st, 2020. Patients were classified by their most severe presentation into asymptomatic, mild-moderate, severe, or critical COVID-19 disease.
Results
Native American patients were significantly more likely to have severe or critical COVID-19 disease compared with other race groups (p<0.05). Though the Native American group had a higher incidence of medical comorbidities, this did not remain true for the sickest patients. Additionally, obesity levels were not significantly different between groups. Consistent with more severe COVID-19 disease, the proportion of hospitalized patients and length of stay was higher in the Native American group.
Conclusion
We found a greater proportion of pregnant women with severe or critical COVID-19-related illness at our institution than has been reported in the scientific literature from other populations. When evaluated by race/ethnicity, we found Native American women to be at a disproportionately higher risk of critical COVID-19 illness with all 6 patients who required critical care being Native American, predominantly from the Dine’é or Navajo Nation. This disparity is alarming; however, the causes and solutions require further investigation.
