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Maternal and Perinatal Outcomes Associated With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection During Pregnancy, Florida, 2020-2021: A Retrospective Cohort Study.
Doyle, Timothy J; Kiros, Gebre Egziabhe; Schmitt-Matzen, Emily N; Propper, Randy; Thompson, Angela; Phillips-Bell, Ghasi S.
  • Doyle TJ; Division of Disease Control and Health Protection, Florida Department of Health, Tallahassee, Florida, USA.
  • Kiros GE; Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  • Schmitt-Matzen EN; Division of Disease Control and Health Protection, Florida Department of Health, Tallahassee, Florida, USA.
  • Propper R; College of Pharmacy and Pharmaceutical Sciences, Institute of Public Health, Florida Agricultural and Mechanical University, Tallahassee, Florida, USA.
  • Thompson A; Division of Disease Control and Health Protection, Florida Department of Health, Tallahassee, Florida, USA.
  • Phillips-Bell GS; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Clin Infect Dis ; 75(Supplement_2): S308-S316, 2022 Oct 03.
Article in English | MEDLINE | ID: covidwho-2051338
ABSTRACT

BACKGROUND:

The objective was to estimate risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in pregnancy and assess adverse maternal and perinatal outcomes.

METHODS:

We used a population-based, retrospective cohort of all pregnancies with a live birth or fetal death in Florida from 1 March 2020 to 30 April 2021. Coronavirus disease 2019 (COVID-19) case reports were matched to vital registries. Outcomes assessed were risk of infection in pregnancy, preterm birth, maternal or neonatal admission to an intensive care unit (ICU), perinatal or fetal death, and maternal death. Modified Poisson and multinomial logistic regression models were used to derive relative risk estimates.

RESULTS:

Of 234 492 women with a live birth or fetal death during the study period, 12 976 (5.5%) were identified with COVID-19 during pregnancy. Risk factors for COVID-19 in pregnancy included Hispanic ethnicity (relative risk [RR] = 1.89), Black race (RR = 1.34), being unmarried (RR = 1.04), and being overweight or obese pre-pregnancy (RR = 1.08-1.32). COVID-19 during pregnancy was associated with preterm birth (RR = 1.31), Cesarean delivery (RR = 1.04), and neonatal (RR = 1.17) and maternal (RR = 3.10) ICU admission; no association was found with increased risk of perinatal (RR = 0.72) or fetal death (RR = 0.86). Women infected during any trimester showed increased risk of preterm birth. Fourteen maternal deaths were identified among COVID-19 cases; of those who died, 12 were obese. The death rate per 10 000 was 22.09 among obese and 1.22 among non-obese gravida with COVID-19 during pregnancy (RR = 18.99, P = .001).

CONCLUSIONS:

Obesity is a risk factor for SARS-CoV-2 infection in pregnancy and for more severe COVID-19 illness among pregnant women. SARS-CoV-2 infection is associated with preterm birth.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pregnancy Complications, Infectious / Premature Birth / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Female / Humans / Infant, Newborn / Pregnancy Country/Region as subject: North America Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2022 Document Type: Article Affiliation country: Cid

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pregnancy Complications, Infectious / Premature Birth / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Female / Humans / Infant, Newborn / Pregnancy Country/Region as subject: North America Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2022 Document Type: Article Affiliation country: Cid