{"doi":"10.1371/journal.pone.0256891","title":"COVID-19 prevalence, symptoms, and sociodemographic disparities in infection among insured pregnant women in Northern California","abstract":"BACKGROUND: Research on COVID-19 during pregnancy has mainly focused on women hospitalized for COVID-19 or other reasons during their pregnancy. Little is known about COVID-19 in the general population of pregnant women. OBJECTIVE: To describe the prevalence of COVID-19, symptoms, consequent healthcare use, and possible sources of COVID-19 exposure among a population-based sample of pregnant women residing in Northern California. METHODS: We analyzed data from 19,458 members of Kaiser Permanente Northern California who were pregnant between January 2020 and April 2021 and responded to an online survey about COVID-19 testing, diagnosis, symptoms, and their experiences during the COVID-19 pandemic. Medical diagnosis of COVID-19 during pregnancy was defined separately by self-report and by documentation in electronic health records (EHR). We examined relationships of COVID-19 with sociodemographic factors, underlying comorbidities, and survey measures of COVID-19-like symptoms, consequent healthcare utilization, and possible COVID-19 exposures. RESULTS: Among 19,458 respondents, the crude prevalence of COVID-19 was 2.5% (n = 494) according to self-report and 1.4% (n = 276) according to EHR. After adjustment, the prevalence of self-reported COVID-19 was higher among women aged <25 years compared with women aged ≥35 years (prevalence ratio [PR], 1.75, 95% CI: 1.23, 2.49) and among Hispanic women compared with White women (PR, 1.91, 95% CI: 1.53, 2.37). Prevalence of self-reported COVID-19 was higher among women affected by personal or partner job loss during the pandemic (PR, 1.23, 95% CI: 1.02, 1.47) and among women living in areas of high vs. low neighborhood deprivation (PR, 1.74, 95% CI: 1.33, 2.27). We did not observe differences in self-reported COVID-19 between women with and without underlying comorbidities. Results were similar for EHR-documented COVID-19. Loss of smell or taste was a unique and common symptom reported among women with COVID-19 (42.3% in self-reported; 54.0% in EHR-documented). Among women with symptomatic COVID-19, approximately 2% were hospitalized, 71% had a telehealth visit, and 75% quarantined at home. Over a third of women with COVID-19 reported no known exposure to someone with COVID-19. CONCLUSIONS: Observed COVID-19 prevalence differences by sociodemographic and socioeconomic factors underscore social and health inequities among reproductive-aged women. Women with COVID-19 reported unique symptoms and low frequency of hospitalization. Many were not aware of an exposure to someone with COVID-19.","journal":"PLoS ONE","year":2021,"id":165895,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":35,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9112,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":381696,"name":"Assiamira Ferrara","orcid":"0000-0002-7505-4826","position":1,"is_corresponding":false},{"id":275850,"name":"Lyndsay A. Avalos","orcid":"0000-0001-8748-0614","position":2,"is_corresponding":false},{"id":503440,"name":"Sylvia E. Badon","orcid":"0000-0002-2868-4067","position":3,"is_corresponding":false},{"id":690432,"name":"Mara Greenberg","orcid":"0000-0003-3110-4438","position":4,"is_corresponding":false},{"id":322969,"name":"Monique M. Hedderson","orcid":"0000-0003-1768-0412","position":5,"is_corresponding":false},{"id":690433,"name":"Michael W. Kuzniewicz","orcid":"0000-0002-3271-2999","position":6,"is_corresponding":false},{"id":688834,"name":"Yinge Qian","orcid":null,"position":7,"is_corresponding":false},{"id":315600,"name":"Kelly C. Young‐Wolff","orcid":"0000-0002-6177-534X","position":8,"is_corresponding":false},{"id":453254,"name":"Ousseny Zerbo","orcid":"0000-0002-8380-6215","position":9,"is_corresponding":false},{"id":322966,"name":"Yeyi Zhu","orcid":"0000-0002-7296-738X","position":10,"is_corresponding":false},{"id":275581,"name":"Lisa Croen","orcid":"0000-0001-7849-9428","position":11,"is_corresponding":false},{"id":477311,"name":"Jennifer Ames","orcid":"0000-0003-0906-9162","position":0,"is_corresponding":true}],"reference_count":43,"raw_metadata":null,"created_at":"2026-07-18T23:45:45.220559Z","pmid":"34478463","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}