Chow Ting, Martinez Mayra P, Carter Sarah A, Gilliland Frank D, Chen Zhanghua, Xiang Anny H
Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.
Department of Preventive Medicine, Keck School of Medicine of USC, Los Angeles, CA, USA.
J Community Med Public Health. 2025;9(1). doi: 10.29011/2577-2228.100491. Epub 2025 Jan 4.
This study aims to assess rates of COVID-19 exposure during pregnancy among children born during the original, Delta and Omicron waves, and to identify potential disparities.
This birth cohort includes 125,152 children born from 3/1/2020 to 2/28/2023 in southern California. Data on maternal COVID-19 infection, demographics, and health status were extracted from electronic medical records. Rates were calculated for each wave and subgroup. Poisson regression tested trends over waves and compared rates within each subgroup.
A total of 20,187 (16.1%) children were born to mothers with COVID-19 during pregnancy. Rates were 2.8%, 13.6% and 26.5% during the original, Delta and Omicron waves respectively (p<0.0001). Younger mothers (age <25 and 25-35 years) had higher rates during the original and Delta waves but not during Omicron. Children of Black women had 47% higher rates during the original wave; and children of Hispanic women had 156% and 81% higher rates during the original and Delta waves, respectively. No significant differences were observed for Omicron. Higher neighbourhood deprivation index and Medicaid insurance had higher rates during the original and Delta waves. Higher maternal parity and obesity were associated with higher rates in all waves, with greater disparities during the original and Delta waves. Maternal diabetes, asthma or autoimmune disease were associated with higher rates during the Omicron wave.
Substantial disparities exist for COVID-19 exposure during the original and Delta waves, but not for Omicron. These findings are important for public health and future research.
本研究旨在评估在新冠疫情原始毒株、德尔塔毒株和奥密克戎毒株流行期间出生的儿童在孕期感染新冠病毒的比例，并确定潜在的差异。
该出生队列包括2020年3月1日至2023年2月28日在南加州出生的125,152名儿童。从电子病历中提取产妇新冠病毒感染、人口统计学和健康状况的数据。计算每一波疫情及各亚组的感染率。采用泊松回归分析各波疫情的趋势，并比较各亚组的感染率。
共有20,187名（16.1%）儿童的母亲在孕期感染了新冠病毒。原始毒株、德尔塔毒株和奥密克戎毒株流行期间的感染率分别为2.8%、13.6%和26.5%（p<0.0001）。年轻母亲（年龄<25岁和25 - 35岁）在原始毒株和德尔塔毒株流行期间感染率较高，但在奥密克戎毒株流行期间并非如此。黑人女性的孩子在原始毒株流行期间感染率高47%；西班牙裔女性的孩子在原始毒株和德尔塔毒株流行期间感染率分别高156%和81%。奥密克戎毒株流行期间未观察到显著差异。邻里贫困指数较高和参加医疗补助保险的人群在原始毒株和德尔塔毒株流行期间感染率较高。产妇较高的产次和肥胖与各波疫情期间的感染率较高相关，在原始毒株和德尔塔毒株流行期间差异更大。产妇患有糖尿病、哮喘或自身免疫性疾病在奥密克戎毒株流行期间感染率较高。
在新冠疫情原始毒株和德尔塔毒株流行期间，新冠病毒暴露存在显著差异，但奥密克戎毒株流行期间不存在。这些发现对公共卫生和未来研究具有重要意义。
