Influence of Socioeconomic Status on SARS-CoV-2 Infection in Spanish Pregnant Women. The MOACC-19 Cohort.

Javier Llorca,María J Cabero-Pérez,Inés Gómez-Acebo,Pilar Gortázar,Trinidad Dierssen-Sotos,Rocío Cuesta-González,Carolina Lechosa-Muñiz,Lorena Lasarte-Oria,Marcos López-Hoyos

doi:10.3390/ijerph18105133

Abstract

Little is known on socio-economic factors associated with SARS-CoV-2 infection in pregnant women. Here, we analyze the relationship between educational, occupational, and housing variables with SARS-CoV-2 infection in a cohort of 988 pregnant women in Spain. Pregnant women were recruited at the University Hospital Marques de Valdecilla, Santander, Spain, among those delivering from 23 March 2020 onwards or consulting for their 12th week of pregnancy from 26 May 2020 onwards. Information on occupational variables and housing characteristics was self-reported. Pregnant women were tested for a current or past infection of SARS-CoV-2 using both PCR and antibodies detection (ELISA). Logistic regression models were used to analyze factors associated with SARS-CoV-2 infection, adjusting for age and country of origin. Infection by SARS-CoV-2 was not associated with educational level or occupational variables, except for where the pregnant woman was a healthcare worker (odds ratio (OR) = 2.87, 95% confidence interval (CI): 0.84–9.79). Housing with four or more rooms (OR = 2.07, 95% CI: 0.96–4.47), four or more people in the household (OR = 1.91, 95% CI: 0.89–4.14), lack of heating (OR = 2.81, 95% CI: 1.24–6.34) and less than 23 square meters per person (OR = 3.97, 95% CI: 1.43–11.1) were the housing characteristics associated with SARS-CoV-2 infection. Housing characteristics, but not occupational or educational variables, were associated with SARS-CoV-2 infection. Guidelines on the prevention of COVID-19 should reinforce household measures to prevent pregnant women from becoming infected by their relatives.

Highlights

We study the association between socio-economic status—as measured by educational level, employment and housing characteristics—and infection by SARSCoV-2 during pregnancy in a cohort of Spanish women
Taking together the increase in risk associated with housing characteristics and the lack of association between working variables and coronavirus infection would support the hypothesis that pregnant women have been especially exposed to SARS-CoV-2 transmission in the household rather than in the workplace
The only occupational group we found to be associated with higher risk of positivity to SARS-CoV-2 was healthcare workers

Summary

Introduction

Several studies have reported a socio-economic gradient in SARS-CoV-2 infection, hospitalization and death. Lower educational level, living in a rented accommodation and households with lower average income were associated with being more likely to require testing [1]. Risk of infection was higher in the most deprived and unskilled people [2], those living with more people, renting or owning with a mortgage or with lower educational attainment [1]. Being admitted to hospital because of COVID-19 was more frequent in people of lower socio-economic status [1], and mortality was higher in the most deprived [3].

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Results

Conclusion