Social determinants of health associated with COVID-19 severity during pregnancy: a multinational cohort study (in the International Registry of Coronavirus Exposure in Pregnancy).

Autor: Mack JA; Janssen Research & Development, LLC, Titusville, NJ, US., Voss EA; Janssen Research & Development, LLC, Titusville, NJ, US., Rusu R; Johnson & Johnson, Office of the Chief Medical Officer, New Brunswick, NJ, US., Hernandez MC; Janssen Research & Development, LLC, Titusville, NJ, US., Hernandez-Diaz S; Harvard T.H. Chan School of Public Health, Boston, MA, US., Wyszynski DF; Pregistry, LLC, London, England., Sylvester S; Johnson & Johnson, Office of the Chief Medical Officer, New Brunswick, NJ, US., DiSantostefano RL; Janssen Research & Development, LLC, Titusville, NJ, US. rdisanto@its.jnj.com.
Jazyk: angličtina
Zdroj: BMC public health [BMC Public Health] 2022 Dec 03; Vol. 22 (1), pp. 2256. Date of Electronic Publication: 2022 Dec 03.
DOI: 10.1186/s12889-022-14532-8
Abstrakt: Background: The COVID-19 pandemic has caused morbidity and mortality, particularly among vulnerable populations. We aimed to assess social and demographic characteristics associated with COVID-19 severity among symptomatic participants during pregnancy.
Methods: The International Registry of Coronavirus Exposure in Pregnancy is a multinational, longitudinal observational cohort study of adult participants tested for SARS-CoV-2 or who received clinical diagnosis of COVID-19 during pregnancy (NCT04366986). Disease severity status of mild, moderate, or severe was determined based on symptoms and healthcare utilization. Stratified by current versus recent pregnancy at enrollment, univariate mixed-effects logistic regression modeling was used to characterize association between social and demographic characteristics with COVID-19 severity, using a cumulative mixed effect model with country as a random effect.
Results: The odds of developing more severe COVID-19 (odds ratio [95% confidence interval]) were higher among participants with lower socioeconomic status (poor: 2.72 [2.01,3.69]; lower-middle class: 2.07 [1.62,2.65] vs wealthy), among participants with lower educational attainment (high school: 1.68 [1.39,2.03]; < high school (1.77 [1.25,2.51] vs graduate education). Participants over 25 years of age had lower odds of severe COVID-19 versus participants < 25 years (25-34: 0.69 [0.56,0.85]; 35-50: 0.62 [0.48,0.80]). Employment in food services was also associated with increased odds of more severe COVID-19, whereas employment in healthcare and within home, and primiparity were associated with lower severity.
Conclusions: Findings suggest that employment setting and economic status have strong associations with COVID-19 severity, which warrants considering social determinants of health in the context of assessing risk factors of more severe COVID-19 during pregnancy.
Trial Registration: IRCEP was registered with the European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (ENCePP) [EUPAS37360] and clinicaltrials.gov [NCT04366986].
(© 2022. The Author(s).)
Databáze: MEDLINE
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