Racial disparities in prevalence, determinants, and impacts of COVID-19 in pregnancy: Protocol for a study using data from New Jersey hospitals

Introduction Racial and ethnic disparities in COVID-19 related infections, hospitalizations, and deaths have been well-documented. However, little research has examined racial and ethnic disparities in COVID-19 prevalence, determinants, and impacts among pregnant women. Within the United States, New Jersey was an early epicenter of the pandemic and experienced high rates of disease in the fall of 2020. Methods This study uses data from two New Jersey hospitals, which implemented universal testing of COVID-19 of pregnant women admitted for labor and delivery starting in March 2020. We will estimate prevalence of COVID-19 between March 2020 and November 2020 and compare prevalence rates across race and ethnicity. We will conduct multivariable logistic regression analysis to examine the associations of COVID-19 infection with patient demographic and health status predictors. We will also use multivariable linear and logistic regressions to examine the impact of COVID-19 symptomatic and asymptomatic infection on maternal and infant birth outcomes. Discussion This study will generate important policy implications on birth equity in the time of COVID-19 and guide future research studies related to COVID-19 in pregnant women. Results of this study will help to guide interventions and policies to center safe, accessible, and equitable maternity care within the strategic response to the pandemic.