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Socioeconomic status as a risk factor for SARS-CoV-2 infection in pregnant women
Julia Lastinger1, Joachim Gerich2, Martina Beham-Rabanser2
1Department of Gynecology, Obstetrics and Gynecological Endocrinology, Kepler University Hospital, Johannes Kepler University, Linz, Austria.
Insights
Pregnant women with lower socioeconomic status (SES) and education levels had a higher risk of SARS-CoV-2 infection. These socioeconomic factors, alongside COVID-19, negatively impact pregnancy outcomes, necessitating targeted health interventions.
Area of Science:
- Obstetrics and Gynecology
- Public Health
- Epidemiology
Background:
- Pregnant women are a vulnerable group due to COVID-19's association with adverse pregnancy outcomes.
- Low socioeconomic status (SES) is a known risk factor for SARS-CoV-2 infection.
- The combined effects of COVID-19 and low SES may synergistically harm pregnancy outcomes.
Purpose of the Study:
- To evaluate the socioeconomic background of pregnant women who tested positive for SARS-CoV-2.
- To assess the association between self-reported SES, education, financial situation, and SARS-CoV-2 infection in pregnant women.
Main Methods:
- A case-control study involving 150 pregnant women with SARS-CoV-2 PCR-positive tests and 150 matched controls.
- Data collection via written questionnaires and hospital information system records.
- Matching was based on gestational age at birth.
Main Results:
- Pregnant women with SARS-CoV-2 infection reported lower socioeconomic status (p=0.029) and lower education levels (p=0.003).
- Mothers in the COVID-19 group were significantly younger (p=0.024), but age was not an independent risk factor after adjusting for education (p=0.326).
- The observed social gradient in infection risk was not explained by potential mediators or confounders.
Conclusions:
- A clear association exists between lower socioeconomic status and increased risk of SARS-CoV-2 infection during pregnancy.
- Health inequalities must be considered in SARS-CoV-2 prevention and healthcare strategies for pregnant women, especially those from disadvantaged backgrounds.
- Addressing socioeconomic factors is crucial for mitigating negative pregnancy outcomes associated with COVID-19.
Objectives:
Due to the association between COVID-19 and adverse pregnancy outcomes, pregnant women are considered to be a vulnerable patient group. Studies have shown that low socioeconomic status (SES) is a risk factor for SARS-CoV-2 infection. COVID-19 and low SES are likely to have a synergistic adverse effect. This study aimed to evaluate the socioeconomic background, indicated by self-reported SES, educational level, and financial situation, in pregnant women who were positive for SARS-CoV-2.
Methods:
A case-control study was conducted, including all pregnant women with positive SARS-CoV-2 PCR tests at Kepler University Hospital Linz between May 2020 and August 2021 (n=150) and a control group matched 1:1 relative to gestational age at birth (n=150). Data were collected using written questionnaires and medical records from the hospital information system.
Results:
Lower self-reported socioeconomic status (p=0.029) and lower education level (p=0.003) were detected in the COVID group. Mothers in the COVID group were significantly younger (p=0.024). However, after adjustment for educational attainment, younger age was not confirmed as a risk factor for SARS-CoV-2 infection during pregnancy (p=0.326). The social gradient was not explained by the assumed mediators and confounders.
Conclusions:
These findings confirm an association between lower socioeconomic status and the risk of SARS-CoV-2 infection during pregnancy. Since both socioeconomic factors and COVID-19 impose negative effects on pregnancy outcomes, health inequalities should be taken into consideration when implementing SARS-CoV-2 prevention measures and when providing health care for pregnant women from disadvantaged communities.
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