Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Aug 21;51(9):1171-1178.
doi: 10.1515/jpm-2023-0068. Print 2023 Nov 27.

Increased risk of severe COVID-19 in pregnancy in a multicenter propensity score-matched study

Liviu Cojocaru  1   2   3 , Myint Noe  4 , Autusa Pahlavan  5 , Alissa Werzen  4 , Hyunuk Seung  6 , Young Chae Jessica Yoo  4 , Patricia Tyson  7 , Shivakumar Narayanan  4 , Shifa Turan  2 , Ozhan M Turan  2 , Joel V Chua  4
Affiliations
Free article
Review

Increased risk of severe COVID-19 in pregnancy in a multicenter propensity score-matched study

Liviu Cojocaru et al. J Perinat Med. .
Free article

Abstract

Objectives: To explore the association between COVID-19 severity and pregnancy using measures such as COVID-19 ordinal scale severity score, hospitalization, intensive care unit (ICU) admission, oxygen supplementation, invasive mechanical ventilation, and death.

Methods: We conducted a retrospective, multicenter cohort study to understand the association between COVID-19 severity and pregnancy. We reviewed consecutive charts of adult females, ages 18-45, with laboratory testing for SARS-CoV-2 infection between March 1, 2020, and August 31, 2020. Cases were patients diagnosed with COVID-19 during pregnancy, whereas controls were not pregnant at the time of COVID-19 diagnosis. Primary endpoints were the COVID-19 severity score at presentation (within four hours) and the nadir of the clinical course. The secondary endpoints were the proportion of patients requiring hospitalization, ICU admission, oxygen supplementation, invasive mechanical ventilation, and death.

Results: A higher proportion of pregnant women had moderate to severe COVID-19 disease at the nadir of the clinical course than non-pregnant women (25 vs. 16.1 %, p=0.04, respectively). There was a higher rate of hospitalization (25.6 vs. 17.2 %), ICU admission (8.9 vs. 4.4 %), need for vasoactive substances (5.0 vs. 2.8 %), and invasive mechanical ventilation (5.6 vs. 2.8 %) in the pregnant cohort. These differences were not significant after applying propensity score matching.We found a high rate of pregnancy complications in our population (40.7 %). The most worrisome is the rate of hypertensive disorders of pregnancy (20.1 %).

Conclusions: In our propensity score-matched study, COVID-19 in pregnancy is associated with an increased risk of disease severity and pregnancy complications.

Keywords: COVID-19; SARS-CoV-2; emerging infectious diseases; infectious; pregnancy complications; pregnancy outcome.

PubMed Disclaimer

References

    1. Schwartz, DA, Graham, AL. Potential maternal and infant outcomes from (Wuhan) coronavirus 2019-nCoV infecting pregnant women: lessons from SARS, MERS, and other human coronavirus infections. Viruses 2020;12. https://doi.org/10.3390/v12020194 . - DOI - PubMed - PMC
    1. Siston, AM, Rasmussen, SA, Honein, MA, Fry, AM, Seib, K, Callaghan, WM, et al.. Pandemic 2009 influenza A(H1N1) virus illness among pregnant women in the United States. JAMA 2010;303:1517–25. https://doi.org/10.1001/jama.2010.479 . - DOI - PubMed - PMC
    1. Chen, L, Li, Q, Zheng, D, Jiang, H, Wei, Y, Zou, L, et al.. Clinical characteristics of pregnant women with covid-19 in Wuhan, China. N Engl J Med 2020;382. https://doi.org/10.1056/NEJMc2009226 . - DOI - PubMed - PMC
    1. Docherty, AB, Harrison, EM, Green, CA, Hardwick, HE, Pius, R, Norman, L, et al.. Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study. BMJ 2020;369:m1985. https://doi.org/10.1136/bmj.m1985 . - DOI - PubMed - PMC
    1. Zambrano, LD, Ellington, S, Strid, P, Galang, RR, Oduyebo, T, Tong, VT, 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. Morb Mortal Wkly Rep 2020;69:1641–7. https://doi.org/10.15585/mmwr.mm6944e3 . - DOI - PubMed - PMC

LinkOut - more resources