Obstetric Hemorrhage Risk Associated with Novel COVID-19 Diagnosis from a Single-Institution Cohort in the United States.
Am J Perinatol
; 37(14): 1411-1416, 2020 12.
Article
in English
| MEDLINE | ID: covidwho-811504
ABSTRACT
OBJECTIVE:
The study aimed to compare the quantitative blood loss (QBL) and hemorrhage-related outcomes of pregnant women with and without a coronavirus disease 2019 (COVID-19) diagnosis. STUDYDESIGN:
This retrospective cohort study of all live deliveries at Boston Medical Center between April 1, 2020 and July 22, 2020 compares the outcomes of pregnant women with a laboratory-confirmed COVID-19 positive diagnosis and pregnant women without COVID-19. The primary outcomes are QBL and obstetric hemorrhage. The secondary outcomes analyzed were a maternal composite outcome that consisted of obstetric hemorrhage, telemetry-level (intermediate care unit) or intensive care unit, transfusion, length of stay greater than 5 days, or intraamniotic infection, and individual components of the maternal composite outcome. Groups were compared using Student's t-test, Chi-squared tests, or Fisher's exact. Logistic regression was used to adjust for confounding variables.RESULTS:
Of 813 women who delivered a live infant between April 1 and July 22, 2020, 53 women were diagnosed with COVID-19 on admission to the hospital. Women with a COVID-19 diagnosis at their time of delivery were significantly more likely to identify as a race other than white (p = 0.01), to deliver preterm (p = 0.05), to be diagnosed with preeclampsia with severe features (p < 0.01), and to require general anesthesia (p < 0.01). Women diagnosed with COVID-19 did not have a significantly higher QBL (p = 0.64). COVID-19 positive pregnant patients had no increased adjusted odds of obstetric hemorrhage (adjusted odds ratio [aOR] 0.41, 95% confidence interval [CI] 0.17-1.04) and no increased adjusted odds of the maternal morbidity composite (aOR 0.98, 95% CI 0.50-1.93) when compared with those without a diagnosis of COVID-19.CONCLUSION:
Pregnant women with COVID-19 diagnosis do not have increased risk for obstetric hemorrhage, increased QBL or risk of maternal morbidity compared with pregnant women without a COVID-19 diagnosis. Further research is needed to describe the impact of a COVID-19 diagnosis on maternal hematologic physiology and pregnancy outcomes. KEY POINTS · Information about blood loss associated with peripartum COVID-19 is limited.. · COVID-19 diagnosis is not associated with increase in obstetric hemorrhage.. · COVID-19 diagnosis is not associated with increase in blood loss..
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Pregnancy Complications, Infectious
/
Pregnancy Outcome
/
Coronavirus Infections
/
Betacoronavirus
/
Postpartum Hemorrhage
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Adult
/
Female
/
Humans
/
Infant, Newborn
/
Pregnancy
Country/Region as subject:
North America
Language:
English
Journal:
Am J Perinatol
Year:
2020
Document Type:
Article
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