COVID-19 Not Hypertension or Diabetes Increases the Risk of Preeclampsia among a High-Risk Population

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection has been associated with greater morbidity and increased mortality in certain populations, such as those with chronic medical conditions, the elderly, and pregnant women. Our goal was to determine if COVID-19 infection during pregnancy increased the risk of preeclampsia in a population of women with increased risk factors for preeclampsia. We present a prospective observational matched case-control study of 100 deliveries with confirmed SARS-CoV2. Specifically, we investigated the maternal and neonatal outcomes in a high-risk population of pregnant women. Among women with COVID-19, the severity of symptoms was associated with the incidence of preeclampsia, but not with pre-existing diabetes or hypertension. Women with more severe symptoms were more likely to delivery pre-term with smaller babies. After adjusting for diabetes, hypertensive women with COVID-19 had an increased risk of preeclampsia aOR4.3 [1.5,12.4] compared to non-hypertensive women with COVID-19. After adjusting for hypertension, women with diabetes and COVID-19 had an increased risk of preeclampsia aOR3.9 [1.2,12.5]. This relationship was not seen among women without COVID-19. For women who had pre-existing diabetes or hypertension, the risk of developing preeclampsia was only increased if they were also diagnosed with COVID-19, suggesting that in our population of women the risk of preeclampsia is not associated with pre-existing diabetes or hypertension.

Keywords: SARS-CoV2; diabetes; hypertension; obesity; preeclampsia.

Figure 1

(A). Body mass index was compared between women with and without preeclampsia (PreE) within racial and ethnic groups. (B). Infant birthweight was compared for the length of time between gestational age at COVID-19 diagnosis and gestational age at delivery. The number in white denotes the number of women in each category. (C). When differences in infant birthweight was adjusted for gestational age at delivery and then compared to the time interval between gestational age at COVID-19 diagnosis and gestational age at delivery, infants who were born less than 10 following a positive COVID-19 diagnosis had statistically lower weights relative to infants born 11–90 days following a positive maternal COVID-19 diagnosis. * denotes p < 0.05 between the indicated groups.