Pregnant women who experienced structural racism were at higher risk for COVID-19 and preterm births, according to a study published in the American Journals of Obstetrics & Gynecology Maternal-Fetal Medicine.

Researchers from the Icahn School of Medicine at Mount Sinai in New York City sought to examine how existing structures of racism and socioeconomic inequality, along with pandemic-related social and economic stressors, impact COVID-19 infection during pregnancy and as well as birth outcomes.

Researchers found that women in primarily Black and low-income neighborhoods were nearly three times more likely to contract COVID-19 compared with those in wealthy white neighborhoods.

Data were analyzed from nearly 1,000 pregnant women treated at the Mount Sinai Health System in New York City (38% white, 17% Black, 30% Latina, 9% Asian and 5% unknown race and ethnic backgrounds). Researchers evaluated structural racism and stress related to the pandemic. They then examined medical records to determine whether patients had preterm births and reviewed blood test results that measured COVID-19 antibodies.

The researchers said their study is the first to use the more reliable antibody test results as opposed to COVID-19 antigen testing data. It is also among the first to showcase the link between COVID-19–related unemployment rates and preterm birth.

The study found that in the most disadvantaged neighborhoods, those giving birth were 94% non-White, 50% had public insurance, 41% had obesity, 32% had COVID-19 antibodies, 11% delivered preterm and 12% delivered an infant that was small for its gestational age. In neighborhoods with the lowest structural disadvantages, those giving birth were 38% white, 17% had public insurance, 15% had obesity, 9% had COVID-19 antibodies and 6% delivered preterm. 

Overall, researchers determined that structural racism and community unemployment rates were associated with both contracting COVID-19 and experiencing preterm births. Specifically, communities that experienced the highest increases of unemployment during the first wave of the pandemic had a 60% higher increased risk for preterm birth compared with the lowest increase.

To learn more about the link between COVID-19 and pregnancy complications, click here.