In this cross-sectional study explored the association between built environments, markers of neighbourhood socioeconomic status (SES) and SARS-CoV-2 prevalence using universal testing in 434 pregnant women admitted to the labor and delivery unit at New YorkPresbyterian/Columbia University Irving Medical Center or Allen Hospital between March 22, 2020 and April 21, 2020. Demographic and socioeconomic data from the US Census Bureau’s American Community Survey, real estate tax data from New York’s Department of City Planning, and building level variables were linked to patients. Women living in buildings with very high assessment values were found to have the lowest probability of infection (8.2%), while those living in neighborhoods with high household memberships had the highest probability of infection (23.9%). Lower odds of infection were found among women living in buildings with more units, in neighbourhoods with higher median incomes, and higher assessed values (interdecile OR of 0.34, 0.32, and 0.29 respectively). Alternatively, higher odds of infection were found among women living in neighbourhoods with high unemployment rates, greater household crowding, and large household membership (interdecile OR of 2.13, 2.27, and 3.16, respectively). This study provides support for the hypothesis that urban environment could be a social determinant of SARS-CoV-2 transmission.