Association Between Severity of COVID-19 and Social Determinants of Health with Adverse Pregnancy Outcomes in a Study of Mother-Infant Pairs in Los Angeles, California
Women · 2025
In a Los Angeles cohort of pregnant women with COVID-19, living in lower-income areas was associated with more severe COVID-19 and more pregnancy complications.
Research question
How do social determinants of health relate to COVID-19 severity and adverse pregnancy outcomes among pregnant women with COVID-19?
Clinical & scientific significance
Economic inequities may worsen maternal outcomes in COVID-19; the authors highlight social determinants as a target for improving maternal health.
Key findings reported in the paper
- Obesity was associated with severe COVID-19 (OR 3.61, 95% CI 1.44–9.46).
- Even one vaccine dose before infection was associated with lower odds of severe disease (OR 0.14, 95% CI 0.02–0.52).
- Living in low-income areas was associated with adverse pregnancy outcomes (p = 0.01) and severe COVID-19 (p = 0.009).
- Social determinants moderated the effect of severity on adverse outcomes differently in Black and non-Black women.
Objectives
To evaluate associations between social determinants of health, COVID-19 severity and adverse pregnancy outcomes (fetal loss, gestational hypertensive disorders, prolonged rupture of membranes, maternal death).
Methods
Cohort of pregnant women with confirmed SARS-CoV-2 in Los Angeles County, with data on disease severity, trimester, comorbidities, delivery, vaccination, age, insurance type, race/ethnicity and neighborhood income.
This summary is based only on the published abstract.
From maternal infection to child development: the COMP cohort design
01
Infection in pregnancy
Laboratory-confirmed SARS-CoV-2; trimester, severity and vaccination recorded.
02
Maternal immune response
Inflammatory proteins and antibodies measured in maternal blood.
03
Birth
Cord and newborn blood; neonatal outcomes such as respiratory distress.
04
Developmental follow-up
Standardized motor and developmental assessments from infancy into early childhood.
05
Biomarker discovery
Immune signatures compared with developmental outcomes.
Read the publication
Authors
Daouk S, Kerin T, Fuller T, Man O, Cambou MC, Fajardo-Martinez V, Paiola S, Mok T, Rao R, Nielsen-Saines K
Citation
Association Between Severity of COVID-19 and Social Determinants of Health with Adverse Pregnancy Outcomes in a Study of Mother-Infant Pairs in Los Angeles, California. Women (Basel). 2025; 5(2). doi:10.3390/women5020012. PMID: 40302893.
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