611 Racial, ethnic and socioeconomic disparities in susceptibility to SARS-CoV-2 in pregnancy

Abstract

Previous studies suggest a relationship between ABO and Rh blood groups and susceptibility to SARS-CoV-2. Infection status in these studies was determined using polymerase chain reaction (PCR) from nasopharyngeal swabs. Antibody testing may be a more accurate method to assess susceptibility since it detects both current and past infection. Universal testing for SARS-CoV-2 in pregnant women, a generally healthy population, will more likely include a higher number of asymptomatic individuals. This is contrary to studies in the non-pregnant population who were more likely to be tested due to symptomatic presentation. Our objective was to correlate ABO and Rh blood groups to SARS-CoV-2 antibody results in pregnant women admitted to labor and delivery (L&D). STUDY DESIGN: This is a retrospective chart review of women who were admitted to L&D in seven hospitals in the Northwell Health System in New York state between 5/27/20 to 8/23/20. Women with available SARS-CoV-2 antibody results were included in the study. ABO and Rh blood groups were collected for all subjects. Categorical data were analyzed using 2-tailed chi square tests. RESULTS: Of 2930 women with available SARS-CoV-2 antibody results, 448 (15.3%) were seropositive and 2482 (84.7%) were seronegative. The prevalence of A, B, AB and O blood groups were 32.3%, 16%, 4.9% and 46.6% in the antibody positive group and 32.6%, 17.5%, 5% and 44.7% in the antibody negative group. The percentage of Rh positive women was 93.7% and 90.6% in the antibody positive and negative groups, respectively. ABO blood group was not significantly correlated with antibody status, p¼0.84. Rh negative women had a statistically significant decrease in SARS-CoV-2 seroprevalence rate, p¼0.03. CONCLUSION: This is the first study to report the association between blood type and SARS-CoV-2 infection in pregnancy. In contrast to other studies, our study found that ABO blood group is not correlated with risk of infection but Rh negative status may be protective. Further studies are necessary to confirm these findings.

SARS-CoV-2 in Pregnancy, Birth and Puerperium. Guideline of the DGGG and DGPM (S2k-Level, AWMF Registry Number 015/092, March 2022)

“…Screening has confirmed that the prevalence of infection is similar to that of the general population with regards to its regional and temporal course 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 . However, there are indications that some groups of female patients have a higher risk of infection based on their ethnicity 25 , 26 , 27 , 28 , 29 , 30 or socio-economic status 31 , 32 . A population-based British cohort study (3527 SARS-CoV-2 infections in 342 080 pregnant women) showed that SARS-CoV-2 infection occurred more often in women who were younger and were primipara, belonged to a non-white ethnic group, lived in disadvantaged areas, or had comorbidities 33 .…”

“…Screeninguntersuchungen bestätigen eine Prävalenz analog der Gesamtbevölkerung in Bezug auf regionale und zeitliche Verläufe 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 . Es bestehen jedoch Hinweise für ein höheres Infektionsrisiko unter bestimmten Patientinnengruppen in Abhängigkeit von der Ethnizität 25 , 26 , 27 , 28 , 29 , 30 oder dem sozioökonomischen Status 31 , 32 . Eine populationsbasierte britische Kohortenstudie (3527 SARS-CoV-2-Infektionen unter 342 080 Schwangeren) zeigte, dass eine SARS-CoV-2-Infektion häufiger bei Frauen auftrat, die jünger und erstgebärend waren, nichtweißen ethnischen Gruppen angehörten, in benachteiligten Gebieten wohnten oder Komorbiditäten aufwiesen 33 .…”

Empfehlungen zu SARS-CoV-2/COVID-19 in Schwangerschaft, Geburt und Wochenbett – Update November 2021 (Langfassung)

“…Im Vergleich zu nicht- hispanischen Patienten waren in einer US-amerikanischen Erhebung hispanische Patienten häufiger SARS-CoV-2-positiv (10,6 vs. 5,5%, aRR 1,73; 95% KI 1,05–2,85), ebenso wie Patienten mit öffentlicher Versicherung im Vergleich zu privat Versicherten (9,5 vs. 2,5%, aRR 3,11; 95% KI 1,12–8,64) 130 . Die Suszeptibilität für SARS-CoV-2 in der Schwangerschaft kann neben der ethnischen Zugehörigkeit auch durch sozioökonomische Faktoren beeinflusst werden 131 132 .…”