National Trends and Sociodemographic Factors in Perinatal Health Outcomes Before and During the COVID-19 Pandemic

The aim of this study was to evaluate sociodemographic factors associated with perinatal health outcomes before and during the COVID-19 pandemic among US maternal-infant dyads. Using the 2016-2022 Centers for Disease Control and Prevention (CDC) Pregnancy Risk Assessment Monitoring System (PRAMS) data, we evaluated maternal and infant characteristics during the pre-COVID and COVID periods (pre-COVID: 2016-2019; COVID: 2020-2022) for preterm birth, low birthweight, and cesarean delivery, and performed multivariable logistic regression models for each outcome. Compared with births in pre-COVID, births during COVID had a higher prevalence of older mothers with diabetes and hypertension. Overall, Non-Hispanic Black (NHB) and Hispanic mothers had less favorable perinatal health outcomes compared to Non-Hispanic White (NHW) mothers. In testing of time*race/ethnicity interaction, Hispanic infants had lower odds of low birthweight during COVID. While disparities were not exacerbated during COVID, they remained persistent, with NHB and Hispanic mothers having less favorable perinatal health outcomes. Further research is needed to investigate potential longer-term health implications for maternal and infant health.