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母体感染 SARS-CoV-2 对新生儿出院计划和护理的影响:加剧种族和族裔医疗保健差异。

Effects of Maternal SARS-CoV-2 Infection on Neonatal Discharge Planning and Care: Exacerbation of Racial and Ethnic Healthcare Disparities.

机构信息

Department of Pediatrics, Division of Pediatric Infectious Diseases, Portland, ME, USA.

Maine Medical Center Department of Pediatrics, Portland, ME, USA.

出版信息

J Racial Ethn Health Disparities. 2024 Oct;11(5):2530-2537. doi: 10.1007/s40615-023-01718-y. Epub 2023 Jul 27.

Abstract

OBJECTIVES

To determine if SARS-CoV-2 disproportionately impacted infants born to racial and ethnic minorities and if virus exposure led to decreased access to care.

METHODS

This study was an observational case-control study, between March 2020 and March 2022 in Portland, Maine. Forty-seven cases and 47 controls were enrolled. Cases were infants born to mothers diagnosed with SARS-CoV-2 at delivery, and controls were infants matched by date of birth, born to SARS-CoV-2 negative women. Demographic data, maternal clinical data, infant outcomes, and infant discharge plans were compared using Chi squared or Fisher Exact tests. Logistic regression was used to examine the impact of race on neonatal SARS-CoV-2 exposure.

RESULTS

Infants exposed to SARS-CoV-2 were more likely Black or Hispanic than White and Non-Hispanic early in the pandemic, with reversal during the second year. SARS-CoV-2-exposed infants experienced delays in routine newborn outpatient care, although delay improved over the pandemic.

CONCLUSION

Infants exposed to SARS-CoV-2 were initially more likely to be infants of color. During this time, infants exposed to SARS-CoV-2 were also experiencing significant delays in newborn care.

摘要

目的

确定 SARS-CoV-2 是否不成比例地影响到出生于少数族裔的婴儿,以及病毒暴露是否导致获得护理的机会减少。

方法

这是一项观察性病例对照研究,于 2020 年 3 月至 2022 年 3 月在缅因州波特兰进行。纳入了 47 例病例和 47 例对照。病例是指母亲在分娩时被诊断出患有 SARS-CoV-2 的婴儿,对照是指在 SARS-CoV-2 阴性妇女分娩的、出生日期匹配的婴儿。使用卡方检验或 Fisher 精确检验比较人口统计学数据、产妇临床数据、婴儿结局和婴儿出院计划。使用逻辑回归检验种族对新生儿 SARS-CoV-2 暴露的影响。

结果

在大流行早期,暴露于 SARS-CoV-2 的婴儿比白人或非西班牙裔婴儿更有可能是黑人和西班牙裔,而在第二年则出现逆转。SARS-CoV-2 暴露的婴儿在常规新生儿门诊护理方面出现延迟,尽管在大流行期间这种延迟有所改善。

结论

最初,暴露于 SARS-CoV-2 的婴儿更有可能是有色人种的婴儿。在此期间,暴露于 SARS-CoV-2 的婴儿也在新生儿护理方面经历了显著的延迟。

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