Association between SARS-CoV-2 Infection and Adverse Perinatal Outcomes by race/ethnicity in a Large Integrated Healthcare System.

Publication date: Apr 03, 2024

Recent studies have reported associations between SARS-CoV-2 infection during pregnancy and adverse perinatal outcomes but the extent to which these associations vary by race/ethnicity remains uncertain. Therefore, we examined how the association between prenatal SARS-CoV-2 infection and adverse perinatal outcomes may be modified by race/ethnicity. A retrospective cohort study was performed using data on 67,986 pregnant women extracted from the Kaiser Permanente Southern California electronic health records between 04/06/2020-12/31/2021. Upon admission to labor & delivery, all women were routinely tested for COVID-19 using RT-PCR test. Adjusted odds ratios (aOR) were used to estimate associations. During the study period, COVID-19 was diagnosed in 4,960 (7%) of singleton pregnancies, with the highest rates observed among Hispanics (9. 4%) and Non-Hispanic Blacks (6. 2%). Compared with Non-Hispanic Whites, Hispanics (aOR:1. 12, 95% CI: 1. 03-1. 21) with SARS-CoV-2 infection had the highest odds of a pregnancy associated with non-reassuring fetal heart rate tracing. Neonates of all races/ethnicities, except for non-Hispanic Blacks, showed significantly increased odds of SARS-CoV-2 infection, with the highest risk observed among Asians/Pacific Islanders (aOR:10. 88, 95% CI: 1. 33-89. 04). Non-Hispanic White mothers who tested positive were admitted to ICU at a higher rate at delivery and within 7 days of delivery (aOR:34. 77, 95% CI: 11. 3-107. 04; aOR:26. 48, 95% CI: 9. 55-73. 46, respectively), Hispanics were also at a significantly higher odds of admission to ICU (aOR:4. 62, 95% CI: 2. 69-7. 94; aOR:4. 42, 95% CI: 2. 58-7. 56, respectively). Non-Hispanic Black, Hispanic and Asian mothers who tested positive for SARS-CoV-2 prenatally, were at increased risk for preeclampsia/eclampsia, and preterm birth as compared to Non-Hispanic White mothers. The findings highlight racial/ethnic disparities in the association between SARS-CoV-2 infection and adverse perinatal outcomes. The risk of neonatal SARS-CoV-2 infection was highest for Asian/Pacific Islanders. We also observed a remarkably high risk of ICU admission for non-Hispanic White mothers infected with SARS-CoV-2.

Concepts Keywords
Hispanics Adverse
Pcr Aor
Pregnant Ci


Type Source Name
disease MESH SARS-CoV-2 Infection
pathway REACTOME SARS-CoV-2 Infection
disease VO pregnant women
disease MESH fetal heart rate
disease MESH preeclampsia
disease MESH eclampsia
disease MESH preterm birth

Original Article

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