. 2022 Nov 30;75(11):1950-1961.

doi: 10.1093/cid/ciac294.

Severe Acute Respiratory Syndrome Coronavirus 2 Infection and Pregnancy in Sub-Saharan Africa: A 6-Country Retrospective Cohort Analysis

Jean B Nachega^{1

2

3

4}, Nadia A Sam-Agudu^{5

6

7}, Rhoderick N Machekano⁸, Philip J Rosenthal⁹, Sonja Schell¹⁰, Liesl de Waard¹⁰, Adrie Bekker¹¹, Onesmus W Gachuno¹², John Kinuthia^{12

13}, Nancy Mwongeli¹³, Samantha Budhram¹⁴, Valerie Vannevel¹⁵, Priya Somapillay¹⁶, Hans W Prozesky¹, Jantjie Taljaard¹, Arifa Parker¹, Elizabeth Agyare¹⁷, Akwasi Baafuor Opoku¹⁸, Aminatu Umar Makarfi¹⁹, Asara M Abdullahi²⁰, Chibueze Adirieje⁵, Daniel Katuashi Ishoso²¹, Michel Tshiasuma Pipo²², Marc B Tshilanda²², Christian Bongo-Pasi Nswe^{23

24}, John Ditekemena²¹, Lovemore Nyasha Sigwadhi⁸, Peter S Nyasulu⁸, Michel P Hermans²⁵, Musa Sekikubo²⁶, Philippa Musoke²⁷, Christopher Nsereko²⁸, Evans K Agbeno²⁹, Michael Yaw Yeboah¹⁹, Lawal W Umar³⁰, Mukanire Ntakwinja³¹, Denis M Mukwege³¹, Etienne Kajibwami Birindwa³², Serge Zigabe Mushamuka³², Emily R Smith³³, Edward J Mills³⁴, John Otokoye Otshudiema³⁵, Placide Mbala-Kingebeni³⁶, Jean-Jacques Muyembe Tamfum³⁶, Alimuddin Zumla^{37

38}, Aster Tsegaye³⁹, Alfred Mteta⁴⁰, Nelson K Sewankambo⁴¹, Fatima Suleman⁴², Prisca Adejumo⁴³, Jean R Anderson⁴⁴, Emilia V Noormahomed⁴⁵, Richard J Deckelbaum⁴⁶, Jeffrey S A Stringer⁴⁷, Abdon Mukalay⁴⁸, Taha E Taha³, Mary Glenn Fowler⁴⁹, Judith N Wasserheit⁵⁰, Refiloe Masekela⁵¹, John W Mellors⁵², Mark J Siedner^{53

54}, Landon Myer⁵⁵, Andre-Pascal Kengne⁵⁶, Marcel Yotebieng⁵⁷, Lynne M Mofenson⁵⁸, Eduard Langenegger¹⁰; AFREhealth Research Collaboration on COVID-19 and Pregnancy

Affiliations

¹ Division of Infectious Diseases, Department of Medicine, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, South Africa.
² Department of Epidemiology, Infectious Diseases, and Microbiology, and Center for Global Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
³ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
⁴ Department of International Health, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland, USA.
⁵ International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria.
⁶ Department of Paediatrics and Child Health, University of Cape Coast School of Medical Sciences, Cape Coast, Ghana.
⁷ Institute of Human Virology and Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA.
⁸ Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
⁹ Department of Medicine, Division of Infectious Diseases, University of California, San Francisco, California, USA.
¹⁰ Department of Obstetrics and Gynecology, Tygerberg Teaching Hospital and Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
¹¹ Department of Paediatrics and Child Health; Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
¹² Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya.
¹³ Department of Research, Department of Reproductive Health, Kenyatta National Hospital, Nairobi, Kenya.
¹⁴ Department of Obstetrics and Gynecology, University of KwaZulu Natal, Durban, South Africa.
¹⁵ Department of Obstetrics and Gynecology, Kalafong Hospital, University of Pretoria, Pretoria, South Africa.
¹⁶ Maternal Foetal Medicine; Steve Biko Hospital, University of Pretoria, Pretoria, South Africa.
¹⁷ Department of Microbiology, School of Medical Sciences, University of Cape Coast and Cape Coast Teaching Hospital, Cape Coast, Ghana.
¹⁸ Department of Obstetrics and Gynaecology, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
¹⁹ Department of Obstetrics and Gynaecology, College of Health Sciences, Ahmadu Bello University and Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
²⁰ Department of Medicine, College of Health Sciences, Ahmadu Bello University and Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
²¹ University of Kinshasa School of Medicine, Kinshasa, Democratic Republic of the Congo.
²² Monkole Hospital Center, Kinshasa, Democratic Republic of the Congo.
²³ Department of Public Health, Centre Interdisciplinaire de Recherche en Ethnopharmacologie, Faculty of Medicine, Université Notre-Dame du Kasayi, Kananga, Democratic Republic of the Congo.
²⁴ Faculty of Public Health, Université Moderne de Kinkole, Kinshasa, Democratic Republic of the Congo.
²⁵ Department of Endocrinology and Nutrition, Cliniques Universitaires St-Luc, Brussels, Belgium.
²⁶ Department of Obstetrics and Gynaecology, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
²⁷ Department of Paediatrics and Child Health, School of Medicine, Makerere University, Kampala, Uganda.
²⁸ Department of Medicine, Entebbe Regional Reference Hospital, Entebbe, Uganda.
²⁹ Department of Obstetrics and Gynecology, School of Medical Sciences, University of Cape Coast and Cape Coast Teaching Hospital, Cape Coast, Ghana.
³⁰ Department of Pediatrics, College of Health Sciences, Ahmadu Bello University and Ahmadu Bello Teaching Hospital, Zaria, Nigeria.
³¹ Gynaecology and General Surgery, Panzi General Referral Hospital, Bukavu, and Université Evangelique en Afrique (UEA), Bukavu, Democratic Republic of the Congo.
³² Hôpital Provincial Général de Référence de Bukavu and Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo.
³³ Department of Global Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA.
³⁴ Department of Health Research Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Canada.
³⁵ Epidemiological Surveillance Team, COVID-19 Response, Health Emergencies Program, World Health Organization, Kinshasa, Democratic Republic of the Congo.
³⁶ Department of Medical Microbiology and Virology, Faculty of Medicine, University of Kinshasa, National Institute of Biomedical Research, Kinshasa, Democratic Republic of the Congo.
³⁷ Division of Infection and Immunity, Department of Infection, Centre for Clinical Microbiology, University College London, London, United Kingdom.
³⁸ National Institute for Health Research Biomedical Research Centre, University College London Hospitals, London, United Kingdom.
³⁹ Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
⁴⁰ Kilimanjaro Christian Medical University College, Moshi, United Republic of Tanzania.
⁴¹ School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
⁴² Discipline of Pharmaceutical Sciences, University of KwaZulu-Natal, Durban, South Africa.
⁴³ Department of Nursing, University of Ibadan, Ibadan, Nigeria.
⁴⁴ Department of Obstetrics and Gynecology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
⁴⁵ Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique.
⁴⁶ Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA.
⁴⁷ Department of Obstetrics and Gynecology, University of North Carolina, School of Medicine, Chapel Hill, North Carolina, USA.
⁴⁸ Faculty of Medicine, University of Lubumbashi, Lubumbashi, Democratic Republic of the Congo.
⁴⁹ Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
⁵⁰ Departments of Global Health and Medicine, Schools of Medicine and Public Health, University of Washington, Seattle, Washington, USA.
⁵¹ Department of Pediatrics and Child Health, School of Clinical Medicine, College of Health Sciences, University of KwaZulu Natal, Durban, South Africa.
⁵² Department of Medicine, Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
⁵³ Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts, USA.
⁵⁴ Mbarara University of Science and Technology, Mbarara, Uganda.
⁵⁵ Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
⁵⁶ Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa.
⁵⁷ Department of Medicine, Albert Einstein College of Medicine, New York, New York, USA.
⁵⁸ Elizabeth Glaser Pediatric AIDS Foundation, Washington, DC, USA.

PMID: 36130257
PMCID: PMC9214158
DOI: 10.1093/cid/ciac294

Severe Acute Respiratory Syndrome Coronavirus 2 Infection and Pregnancy in Sub-Saharan Africa: A 6-Country Retrospective Cohort Analysis

Jean B Nachega et al. Clin Infect Dis. 2022.

. 2022 Nov 30;75(11):1950-1961.

doi: 10.1093/cid/ciac294.

Authors

Affiliations

¹ Division of Infectious Diseases, Department of Medicine, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, South Africa.
² Department of Epidemiology, Infectious Diseases, and Microbiology, and Center for Global Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
³ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
⁴ Department of International Health, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland, USA.
⁵ International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria.
⁶ Department of Paediatrics and Child Health, University of Cape Coast School of Medical Sciences, Cape Coast, Ghana.
⁷ Institute of Human Virology and Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA.
⁸ Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
⁹ Department of Medicine, Division of Infectious Diseases, University of California, San Francisco, California, USA.
¹⁰ Department of Obstetrics and Gynecology, Tygerberg Teaching Hospital and Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
¹¹ Department of Paediatrics and Child Health; Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
¹² Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya.
¹³ Department of Research, Department of Reproductive Health, Kenyatta National Hospital, Nairobi, Kenya.
¹⁴ Department of Obstetrics and Gynecology, University of KwaZulu Natal, Durban, South Africa.
¹⁵ Department of Obstetrics and Gynecology, Kalafong Hospital, University of Pretoria, Pretoria, South Africa.
¹⁶ Maternal Foetal Medicine; Steve Biko Hospital, University of Pretoria, Pretoria, South Africa.
¹⁷ Department of Microbiology, School of Medical Sciences, University of Cape Coast and Cape Coast Teaching Hospital, Cape Coast, Ghana.
¹⁸ Department of Obstetrics and Gynaecology, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
¹⁹ Department of Obstetrics and Gynaecology, College of Health Sciences, Ahmadu Bello University and Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
²⁰ Department of Medicine, College of Health Sciences, Ahmadu Bello University and Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
²¹ University of Kinshasa School of Medicine, Kinshasa, Democratic Republic of the Congo.
²² Monkole Hospital Center, Kinshasa, Democratic Republic of the Congo.
²³ Department of Public Health, Centre Interdisciplinaire de Recherche en Ethnopharmacologie, Faculty of Medicine, Université Notre-Dame du Kasayi, Kananga, Democratic Republic of the Congo.
²⁴ Faculty of Public Health, Université Moderne de Kinkole, Kinshasa, Democratic Republic of the Congo.
²⁵ Department of Endocrinology and Nutrition, Cliniques Universitaires St-Luc, Brussels, Belgium.
²⁶ Department of Obstetrics and Gynaecology, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
²⁷ Department of Paediatrics and Child Health, School of Medicine, Makerere University, Kampala, Uganda.
²⁸ Department of Medicine, Entebbe Regional Reference Hospital, Entebbe, Uganda.
²⁹ Department of Obstetrics and Gynecology, School of Medical Sciences, University of Cape Coast and Cape Coast Teaching Hospital, Cape Coast, Ghana.
³⁰ Department of Pediatrics, College of Health Sciences, Ahmadu Bello University and Ahmadu Bello Teaching Hospital, Zaria, Nigeria.
³¹ Gynaecology and General Surgery, Panzi General Referral Hospital, Bukavu, and Université Evangelique en Afrique (UEA), Bukavu, Democratic Republic of the Congo.
³² Hôpital Provincial Général de Référence de Bukavu and Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo.
³³ Department of Global Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA.
³⁴ Department of Health Research Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Canada.
³⁵ Epidemiological Surveillance Team, COVID-19 Response, Health Emergencies Program, World Health Organization, Kinshasa, Democratic Republic of the Congo.
³⁶ Department of Medical Microbiology and Virology, Faculty of Medicine, University of Kinshasa, National Institute of Biomedical Research, Kinshasa, Democratic Republic of the Congo.
³⁷ Division of Infection and Immunity, Department of Infection, Centre for Clinical Microbiology, University College London, London, United Kingdom.
³⁸ National Institute for Health Research Biomedical Research Centre, University College London Hospitals, London, United Kingdom.
³⁹ Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
⁴⁰ Kilimanjaro Christian Medical University College, Moshi, United Republic of Tanzania.
⁴¹ School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
⁴² Discipline of Pharmaceutical Sciences, University of KwaZulu-Natal, Durban, South Africa.
⁴³ Department of Nursing, University of Ibadan, Ibadan, Nigeria.
⁴⁴ Department of Obstetrics and Gynecology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
⁴⁵ Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique.
⁴⁶ Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA.
⁴⁷ Department of Obstetrics and Gynecology, University of North Carolina, School of Medicine, Chapel Hill, North Carolina, USA.
⁴⁸ Faculty of Medicine, University of Lubumbashi, Lubumbashi, Democratic Republic of the Congo.
⁴⁹ Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
⁵⁰ Departments of Global Health and Medicine, Schools of Medicine and Public Health, University of Washington, Seattle, Washington, USA.
⁵¹ Department of Pediatrics and Child Health, School of Clinical Medicine, College of Health Sciences, University of KwaZulu Natal, Durban, South Africa.
⁵² Department of Medicine, Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
⁵³ Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts, USA.
⁵⁴ Mbarara University of Science and Technology, Mbarara, Uganda.
⁵⁵ Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
⁵⁶ Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa.
⁵⁷ Department of Medicine, Albert Einstein College of Medicine, New York, New York, USA.
⁵⁸ Elizabeth Glaser Pediatric AIDS Foundation, Washington, DC, USA.

PMID: 36130257
PMCID: PMC9214158
DOI: 10.1093/cid/ciac294

Abstract

Background: Few data are available on COVID-19 outcomes among pregnant women in sub-Saharan Africa (SSA), where high-risk comorbidities are prevalent. We investigated the impact of pregnancy on SARS-CoV-2 infection and of SARS-CoV-2 infection on pregnancy to generate evidence for health policy and clinical practice.

Methods: We conducted a 6-country retrospective cohort study among hospitalized women of childbearing age between 1 March 2020 and 31 March 2021. Exposures were (1) pregnancy and (2) a positive SARS-CoV-2 RT-PCR test. The primary outcome for both analyses was intensive care unit (ICU) admission. Secondary outcomes included supplemental oxygen requirement, mechanical ventilation, adverse birth outcomes, and in-hospital mortality. We used log-binomial regression to estimate the effect between pregnancy and SARS-CoV-2 infection. Factors associated with mortality were evaluated using competing-risk proportional subdistribution hazards models.

Results: Our analyses included 1315 hospitalized women: 510 pregnant women with SARS-CoV-2, 403 nonpregnant women with SARS-CoV-2, and 402 pregnant women without SARS-CoV-2 infection. Among women with SARS-CoV-2 infection, pregnancy was associated with increased risk for ICU admission (adjusted risk ratio [aRR]: 2.38; 95% CI: 1.42-4.01), oxygen supplementation (aRR: 1.86; 95% CI: 1.44-2.42), and hazard of in-hospital death (adjusted sub-hazard ratio [aSHR]: 2.00; 95% CI: 1.08-3.70). Among pregnant women, SARS-CoV-2 infection increased the risk of ICU admission (aRR: 2.0; 95% CI: 1.20-3.35), oxygen supplementation (aRR: 1.57; 95% CI: 1.17-2.11), and hazard of in-hospital death (aSHR: 5.03; 95% CI: 1.79-14.13).

Conclusions: Among hospitalized women in SSA, both SARS-CoV-2 infection and pregnancy independently increased risks of ICU admission, oxygen supplementation, and death. These data support international recommendations to prioritize COVID-19 vaccination among pregnant women.

Keywords: Africa; COVID-19; maternal; neonate; pregnancy.

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Conflict of interest statement

Potential conflicts of interest. J. B. N. is an infectious disease internist and epidemiologist and Principal Investigator (PI) of NIH/FIC grant numbers 1R25TW011217-01, 1R21TW011706-01, and 1D43TW010937-01A1; and payment to University of Pittsburgh. N. A. S.-A. is a clinician-scientist in Pediatric Infectious Diseases and implementation research; she is supported by the NIH National Institute of Child Health and Human Development (NICHD) grant number R01HD089866; by an NIH/FIC award through the Adolescent HIV Prevention and Treatment Implementation Science Alliance (AHISA) for the Central and West Africa Implementation Science Alliance (CAWISA) (payment to institution); and by NIH/FIC grant number 1D43TW012280-01. F. S., N. K. S., and A. P. are supported as PIs by NIH/FIC grant number 1R25TW011217-01. A. Z. is PIs of the Pan-African Network on Emerging and Re-Emerging Infections (PANDORA-ID-NET; https://www.pandora-id.net) funded by the European Developing Countries Clinical Trial Partnership (EDCTP) and the European Union Horizon 2020 Framework Program for Research and Innovation, paid to institution (University College London, London, UK). R. N. M. reports grants or contracts unrelated to this work, and payment to their institution: NIH/FIC1D43TW010547-01—The African Center for Biostatistical Excellence (ACBE). P. J. R. reports the following grants or contracts unrelated to this work and paid to their institution: 5R01AI075045-12, 5R01AI139179-04, and 5R01AI117001-07. E. R. S. reports a Bill and Melinda Gates Foundation grant for a prospective meta-analysis of COVID-19 in pregnancy, unrelated to this work, and payment to George Washington University. A. B. reports grants or contracts unrelated to this work—NIH: IMPAACT Vice-chair Funding for P1106; and UNITAID: Benefit KIDS funding for PETITE Study. P. A. reports grants or contracts unrelated to this work and paid to the University of Ibadan, Nigeria: NIH/FIC R25 grant number 1R25TW011217-01 to AFREhealth. J. W. N. reports grants paid to the University of Pittsburgh from the NIH to the Pitt-Ohio State Clinical Trials Unit (UM1 AI068636), the University of Pittsburgh Virology Support Laboratory (UM1 AI106701), the I4C Martin Delaney Collaboratory for an HIV Cure (UM1 AI126603), the REACH Martin Delaney Collaboratory for HIV Cure (UM1 AI164565), and from the National Cancer Institute through Leidos contract numbers HHSN261200800001E and 75N91019D00024 USAID; Gilead Sciences, Inc; and Janssen Pharmaceuticals. J. W. N. also reports consulting fees from Gilead Sciences, Inc (Scientific Advisory Board), Accelevir Diagnostics (Consulting Agreement), and Merck (Consulting Agreement); shares from Abound Bio, Inc, share options from Co-Crystal Pharma, Inc, and share options from Infectious Diseases Connect; a consulting agreement with Xi’an Yufan Biotechnologies; and employment with the University of Pittsburgh. M. S. reports grants or contracts unrelated to this work and paid to their institution (MGH-Boston, MA, USA): NIH/NIA R01AG059504-03 and NIH/NHLBI R01 HL141053-04. A.-P. K. reports research support unrelate to this work paid to their institution (South African Medical Research Council): NIH/FIC 1R21TW011706-01-Dolutegravir, Weight Gain and Metabolic Outcomes in South Africa. L. M. reports consulting fees from the World Health Organization on COVID in pregnancy and mother to child SARS-CoV-2 transmission (this contract is now completed); and payment from Virology Education for a talk on SARS-CoV-2 in pregnancy and possibility of mother-to-child SARS-CoV-2 transmission for continuing education sponsored by Virology Education. M. Y. is PI of the NIH/National Institute of Allergy and Infectious Diseases (NIH/NIAID) grant number 5U01AI096299-13 of the Central Africa-International epidemiology to Evaluate AIDS (CA-IeDEA). M. Y. also reports grants or contracts unrelated to this work and paid to their institution: NIH grant numbers 5U01AI096299 (NIAID), R01HD087993 (NICHD), U54CA254568 (National Cancer Institute), and R01HD105526 (NICHD). All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

**Figure 1.**
Clinical outcomes among pregnant SARS-CoV-2–infected compared with nonpregnant SARS-CoV-2–infected and pregnant SARS-CoV-2–uninfected women (total N = 1315). Abbreviations: ICU, intensive care unit; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.

**Figure 2.**
Unadjusted (A) and adjusted (B) comparisons of outcomes between pregnant (n = 510) and nonpregnant (n = 403) women with SARS-CoV-2 infection. Unadjusted (C) and adjusted (D) comparisons of outcomes between SARS-CoV-2–infected pregnant women (n = 510) and SARS-CoV-2–uninfected pregnant women (n = 402). Note: The analysis supporting panels B and D used IPPW to adjust confounding. Abbreviations: aRR, adjusted risk ratio; CI, confidence interval; ICU, intensive care unit; IPPW, inverse probability of participation-based weighting; RR, risk ratio; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.

**Figure 3.**
Cumulative incidence functions for in-hospital mortality in SARS-CoV-2–infected women according to pregnancy status (A), number of comorbidities (B), region (C), and by SARS-CoV-2 infection status in pregnant women (D). Abbreviations: aSHR, adjusted sub-distribution hazard ratio; CI, confidence interval; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.

See this image and copyright information in PMC

References

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Severe Acute Respiratory Syndrome Coronavirus 2 Infection and Pregnancy in Sub-Saharan Africa: A 6-Country Retrospective Cohort Analysis

Affiliations

Severe Acute Respiratory Syndrome Coronavirus 2 Infection and Pregnancy in Sub-Saharan Africa: A 6-Country Retrospective Cohort Analysis

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Abstract

Conflict of interest statement

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