COVID-19 Linked to Increased Preterm Birth and Other Pregnancy Complications

by Ella

A recent study conducted in California has revealed that COVID-19 infections during pregnancy are associated with a higher risk of preterm birth (PTB), high blood pressure, and severe maternal morbidity. This large-scale study, which separates the effects of individual SARS-CoV-2 infections from the broader COVID-19 pandemic period, offers significant insights into the impacts of the virus on perinatal health. The findings were published as a research letter in JAMA Network Open.


Study Overview

Researchers analyzed live birth data from California hospital discharge records spanning 2019 to 2020. They compared three distinct groups: pregnant women with COVID-19 in 2020, pregnant women without COVID-19 in 2020, and pregnant women from the pre-pandemic year 2019. This comparative approach allowed for a clear differentiation between the effects of the COVID-19 pandemic environment and the direct impacts of SARS-CoV-2 infections.


Demographic Insights

The study revealed that parents infected with COVID-19 were more likely to be Hispanic, have lower educational attainment, rely on public insurance, and reside in lower-income neighborhoods compared to the other groups. These socioeconomic factors highlight the intersectionality of health disparities exacerbated by the pandemic.


Key Findings

Increased Risk of Preterm Birth

The analysis showed a notable increase in the incidence of preterm birth among women infected with COVID-19. Compared to 2020 births without COVID-19 infections, the incidence of PTB was higher by 2.8% (95% confidence interval [CI], 2.1% to 3.5%). Preterm birth, defined as delivery before 37 weeks of gestation, poses significant risks to neonatal health, including respiratory issues, developmental delays, and long-term health complications.


High Blood Pressure and Severe Maternal Morbidity

Pregnant women with COVID-19 also exhibited a higher prevalence of high blood pressure during pregnancy. The study reported a 3.3% increase (95% CI, 2.4% to 4.1%) compared to those without the infection. High blood pressure during pregnancy, or gestational hypertension, can lead to serious complications such as preeclampsia, which can endanger both mother and child.

Severe maternal morbidity (SMM), which encompasses life-threatening health conditions during pregnancy, labor, and postpartum, was also more common among women with COVID-19. The study noted a 2.3% increase (95% CI, 1.9% to 2.7%) in SMM rates. Conditions classified under SMM include severe infections, hemorrhage, and organ failure.

Broader Implications

The findings of this study underscore the heightened risks associated with SARS-CoV-2 infections during pregnancy. “This study adds to understanding of the associations between COVID-19 and perinatal health in a large, diverse population by distinguishing the connections of SARS-CoV-2 infection from those of the COVID-19 pandemic period with PTB and birth parent conditions,” the authors concluded.

Socioeconomic and Sociocultural Contexts

The study’s demographic findings highlight the compounded vulnerabilities faced by certain populations. Pregnant women from lower socioeconomic backgrounds and minority communities not only have higher rates of COVID-19 infection but also face increased risks of adverse pregnancy outcomes. This calls for targeted public health interventions and resource allocation to support these at-risk groups.

Future Directions

While the current study provides valuable insights, further research is necessary to explore the long-term effects of COVID-19 on maternal and child health. This includes understanding the mechanisms driving these adverse outcomes and developing strategies to mitigate the risks. Additionally, there is a need for continuous monitoring and support for pregnant women during and post-pandemic to ensure their health and safety.


The study from California presents compelling evidence linking COVID-19 infections during pregnancy to increased risks of preterm birth, high blood pressure, and severe maternal morbidity. These findings highlight the critical need for heightened vigilance and care for pregnant women during the pandemic. Addressing the socioeconomic disparities that exacerbate these risks is also essential in improving health outcomes for all expectant mothers and their babies.


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