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. 2022 Jul;36(4):456-465.
doi: 10.1111/ppe.12808. Epub 2021 Sep 1.

Severity of illness by pregnancy status among laboratory-confirmed SARS-CoV-2 infections occurring in reproductive-aged women in Colombia

Nathaly Rozo  1 , Diana Valencia  2 , Suzanne M Newton  2 , Greace Avila  1 , Maritza A Gonzalez  1 , Christina L Sancken  2 , Veronica K Burkel  2 , Sascha R Ellington  2 , Suzanne M Gilboa  2 , Carol Y Rao  2 , Eduardo Azziz-Baumgartner  2 , Martha L Ospina  1 , Franklyn E Prieto  1 , Van T Tong  2
Affiliations

Severity of illness by pregnancy status among laboratory-confirmed SARS-CoV-2 infections occurring in reproductive-aged women in Colombia

Nathaly Rozo et al. Paediatr Perinat Epidemiol. 2022 Jul.

Abstract

Background: Multiple studies have described increased risk of severe coronavirus disease (COVID-19) among pregnant women compared to nonpregnant women. The risk in middle-income countries where the distributions of age groups and preexisting conditions may differ is less known.

Objectives: To determine whether pregnant women with SARS-CoV-2 infection are at increased risk for severe COVID-19 compared to nonpregnant women in Colombia.

Methods: We analysed national surveillance data from Colombia, of women aged 15-44 years with laboratory-confirmed infection with SARS-CoV-2 by molecular or antigen testing, from 6 March 2020 to 12 December 2020. An enhanced follow-up of pregnant women with COVID-19 was established to monitor pregnancy and birth outcomes.

Results: Of 371,363 women aged 15-44 years with laboratory-confirmed SARS-CoV-2 infection, 1.5% (n = 5614) were reported as pregnant; among those, 2610 (46.5%) were considered a complete pregnancy for reporting purposes at the time of analysis. Hospitalisation (23.9%) and death (1.3%) occurred more frequently among pregnant symptomatic women compared to nonpregnant symptomatic women (2.9% and 0.3%, respectively). Compared to nonpregnant symptomatic women, pregnant symptomatic women were at increased risk of hospitalisation (adjusted risk ratio [RR] 2.19, 95% confidence interval [CI] 2.07, 2.32) and death (RR 1.82, 95% CI 1.60, 2.07), after adjusting for age, type of health insurance and presence of certain underlying medical conditions. Among complete pregnancies, 55 (2.1%) were pregnancy losses, 72 (2.8%) resulted in term low birthweight infants and 375 (14.4%) were preterm deliveries.

Conclusions: Although pregnant women were infrequently reported with laboratory-confirmed SARS-CoV-2 infection, pregnant symptomatic women with COVID-19 were at increased risk for hospitalisation and death compared to nonpregnant symptomatic women. Almost all infections we reported on were third-trimester infections; ongoing follow-up is needed to determine pregnancy outcomes among women infected earlier in pregnancy. Healthcare providers should counsel pregnant women about preventive measures to protect from SARS-CoV-2 infection and when to seek care.

Keywords: COVID-19; SARS-CoV-2; birth outcomes; congenital infection; pregnancy.

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Conflict of interest statement

All authors have no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Epidemic curve of laboratory‐confirmed SARS‐CoV‐2 infections among reproductive‐aged women by pregnancy status, with cases presented on linear scale (panel A) and logarithmic scale (panel B), Colombia [Colour figure can be viewed at wileyonlinelibrary.com]
FIGURE 2
FIGURE 2
Counts of laboratory‐confirmed SARS‐CoV‐2 infections among women of reproductive age (WRA) by department, Colombia [Colour figure can be viewed at wileyonlinelibrary.com]
See this image and copyright information in PMC

References

    1. Zambrano LD, Ellington S, Strid P, et al. Update: characteristics of symptomatic women of reproductive age with laboratory‐confirmed SARS‐CoV‐2 infection by pregnancy status ‐ United States, January 22‐October 3, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(44):1641‐1647. 10.15585/mmwr.mm6944e3 - DOI - PMC - PubMed
    1. Allotey J, Stallings E, Bonet M, et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta‐analysis. BMJ 2020;370:m3320. 10.1136/bmj.m3320 - DOI - PMC - PubMed
    1. Martinez‐Portilla RJ, Sotiriadis A, Chatzakis C, et al. Pregnant women with SARS‐CoV‐2 infection are at higher risk of death and pneumonia: propensity score matched analysis of a nationwide prospective cohort (COV19Mx). Ultrasound Obstetrics Gynecol. 2021;57(2):224‐231. 10.1002/uog.23575 - DOI - PubMed
    1. Wei SQ, Bilodeau‐Bertrand M, Liu S, Auger N. The impact of COVID‐19 on pregnancy outcomes: a systematic review and meta‐analysis. Can Med Assoc J. 2021;193(16):E540‐E548. cmaj.202604. 10.1503/cmaj.202604 - DOI - PMC - PubMed
    1. Sola A, Rodríguez S, Cardetti M, Dávila C. Perinatal COVID‐19 in Latin America TT ‐ COVID‐19 perinatal en América Latina. Rev Panam Salud Publica. 2020;44:e47. 10.26633/RPSP.2020.47 - DOI - PMC - PubMed