# Environmental and Social Health Determinants of Pregnancy Outcomes Related to COVID-19 Pandemic

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA-IRVINE · 2021 · $771,695

## Abstract

The COVID-19 pandemic is uniquely challenging for pregnant women. Adverse pregnancy outcomes (e.g.
gestational diabetes, pre-eclampsia & eclampsia, preterm birth, antepartum depression, and postpartum
depression) are likely worsened by the COVID-19 pandemic. A few recent studies have shown that ambient
fine particulate matter < 2.5 µm (PM2.5) and nitrogen dioxide (NO2) may increase the susceptibility to SARS-
CoV-2 infection, severity of illness, and mortality in the general population. It is reasonable to hypothesize that
ambient air pollution may likely increase the risk of adverse pregnancy outcomes related to COVID-19
pandemic. But the effect of air pollution coupled with maternal comorbidities and sociodemographic
determinants on adverse pregnancy outcomes related to COVID-19 pandemic has not been established. This
time-sensitive competing revision will extend the scope of the parent study of Air Pollution and Pregnancy
Complications in Complex Urban Environments: Risks, Heterogeneity, and Mechanisms (R01ES030353) by
examining associations of air pollution with major adverse maternal outcomes related to COVID-19 pandemic
among the large diverse pregnant women population from the electronic health record database of Kaiser
Permanente Southern California (Aim 1), and further studying the role of SARS-CoV-2 infection, preexisting
comorbidity, and sociodemographic factors on these associations (Aim 2). We have a multi-disciplinary team
with expertise in environmental exposure assessment, environmental epidemiology, maternal-fetal medicine,
and biostatistics to examine the specific aims. To our knowledge, this is the first study to determine the
association of air pollution with adverse pregnancy outcomes related to COVID-19 pandemic. The proposed
study has several major innovations and methodological strengths, including 1) large (67,000 deliveries during
the COVID-19 pandemic and 45,000 deliveries before the pandemic) and diverse population (the majority from
racial and ethnic minority groups); 2) high quality, prospectively-recorded, and time-resolved individual-level
clinical data for both outcomes and potential effect modifiers, including COVID-19 case data based on
universal screening of pregnant women; 3) investigation associations between air pollution exposure and
antepartum and postpartum depression; 4) analysis of effect modification by SARS-CoV-2 infection,
comorbidity, and sociodemographic factors; 5) high spatiotemporal resolution PM2.5 exposure estimates based
on dense ground-level senor network data; and 6) thorough examination of potential confounding from
individual-level maternal factors (e.g. smoking, physical activity) and other environment exposures (e.g.
heatwave and green space). This study will generate new knowledge about the impact of air pollution on
adverse maternal outcomes related to COVID-19 pandemic. As air pollution is a modifiable risk factor, this
study can help advance interventions to reduce the adverse pregn...

## Key facts

- **NIH application ID:** 10401114
- **Project number:** 3R01ES030353-03S1
- **Recipient organization:** UNIVERSITY OF CALIFORNIA-IRVINE
- **Principal Investigator:** Darios Getahun
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $771,695
- **Award type:** 3
- **Project period:** 2021-09-24 → 2022-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10401114

## Citation

> US National Institutes of Health, RePORTER application 10401114, Environmental and Social Health Determinants of Pregnancy Outcomes Related to COVID-19 Pandemic (3R01ES030353-03S1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10401114. Licensed CC0.

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