(1107) Sociodemographic factors associated with surge of gonorrheal infections in pregnancy during the COVID-19 pandemic

To evaluate trends in sociodemographic factors (SDFs) associated with the surge in gonorrhea (GC) infections in pregnancy during the COVID-19 pandemic in the United States (US).

Study Design: Retrospective analysis of the US Centers for Disease Control and Prevention Natality Live Birth database (2016-2020). The study group included all births between 4/1/2020 and 12/31/20 (i.e. pandemic group), whereas births between 1/1/16 and 2/29/20 comprised the comparison group (i.e. pre-pandemic group). We compared the prevalence of GC in pregnancy stratified by multiple maternal SDFs between the two groups. Statistical analysis included use of Chi-squared test with significance set at P < 0.05.

Results: Of the total 18,648,594 births, 2,719,573 (14.6%) were in the pandemic group. The prevalence of GC in pregnancy during the pandemic increased by 17% compared to the pre-pandemic period (9,430/2,719,573 [0.35%] vs. 47,611/15,929,021 [0.30%], P = < 0.001). The SDFs associated with the highest prevalence of GC in both groups were concurrent sexually transmitted infections, tobacco use, age < 20 years old, low education level, Medicaid insurance, late to prenatal care, and non-Hispanic black race (Table). Nevertheless, the highest increase in the prevalence of GC during the pandemic was seen in “low-risk groups” such as older maternal age (30% increase in > 40 years old), college graduates (24% increase), and patients with private insurance (26% increase) (Table).

Conclusion: The prevalence of GC during pregnancy increased in the US during the COVID-19 pandemic among all SDFs evaluated. Moreover, although the SDFs associated with the highest prevalence of GC were the same in both groups, we identified that low-risk groups (i.e. older age, higher education level, and private insurance) had the steepest increase in risk of infection during the COVID-19 pandemic. These data suggest that GC prevalence among various sociodemographic groups was disproportionately affected by the COVID-19 pandemic.