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. 2024 Jan 31;11(3):ofae042.
doi: 10.1093/ofid/ofae042. eCollection 2024 Mar.

Characteristics and Outcomes of Pregnant Women Hospitalized With Laboratory-Confirmed Respiratory Syncytial Virus Before and During the COVID-19 Pandemic

Jennifer Milucky  1 , Kadam Patel  1 , Monica E Patton  1 , Pam Daily Kirley  2 , Elizabeth Austin  3 , James Meek  4 , Evan J Anderson  5   6   7 , Alicia Brooks  8 , Chloe Brown  9 , Erica Mumm  10 , Yadira Salazar-Sanchez  11 , Grant Barney  12 , Kevin Popham  13 , Melissa Sutton  14 , H Keipp Talbot  15 , Melanie T Crossland  16 , Fiona P Havers  1 ; RSV-NET Surveillance Team
Collaborators, Affiliations

Characteristics and Outcomes of Pregnant Women Hospitalized With Laboratory-Confirmed Respiratory Syncytial Virus Before and During the COVID-19 Pandemic

Jennifer Milucky et al. Open Forum Infect Dis. .

Abstract

Background: Respiratory syncytial virus (RSV) can cause severe disease among infants and older adults. Less is known about RSV among pregnant women.

Methods: To analyze hospitalizations with laboratory-confirmed RSV among women aged 18 to 49 years, we used data from the RSV Hospitalization Surveillance Network (RSV-NET), a multistate population-based surveillance system. Specifically, we compared characteristics and outcomes among (1) pregnant and nonpregnant women during the pre-COVID-19 pandemic period (2014-2018), (2) pregnant women with respiratory symptoms during the prepandemic and pandemic periods (2021-2023), and (3) pregnant women with and without respiratory symptoms in the pandemic period. Using multivariable logistic regression, we examined whether pregnancy was a risk factor for severe outcomes (intensive care unit admission or in-hospital death) among women aged 18 to 49 years who were hospitalized with RSV prepandemic.

Results: Prepandemic, 387 women aged 18 to 49 years were hospitalized with RSV. Of those, 350 (90.4%) had respiratory symptoms, among whom 33 (9.4%) were pregnant. Five (15.2%) pregnant women and 74 (23.3%) nonpregnant women were admitted to the intensive care unit; no pregnant women and 5 (1.6%) nonpregnant women died. Among 279 hospitalized pregnant women, 41 were identified prepandemic and 238 during the pandemic: 80.5% and 35.3% had respiratory symptoms, respectively (P < .001). Pregnant women were more likely to deliver during their RSV-associated hospitalization during the pandemic vs the prepandemic period (73.1% vs 43.9%, P < .001).

Conclusions: Few pregnant women had severe RSV disease, and pregnancy was not a risk factor for a severe outcome. More asymptomatic pregnant women were identified during the pandemic, likely due to changes in testing practices for RSV.

Keywords: RSV; hospitalization; pregnant women.

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Conflict of interest statement

Potential conflicts of interest. I. A., K. Y.-H., C. B., J. M., M. S., W. S., H. K. T., and M. H. report grants from the Centers for Disease Control and Prevention during the conduct of the study. E. A. reports personal fees from Pfizer, Sanofi Pasteur, GSK, Janssen, Moderna, and Medscape; grants from MedImmune, Regeneron, PaxVax, Pfizer, GSK, Merck, Sanofi Pasteur, Janssen, Moderna, and Micron; personal fees from Kentucky Bioprocessing, Sanofi Pasteur, WCG/ACI Clinical, and Moderna outside the submitted work. E. A.’s institution has also received funding from the National Institutes of Health to conduct clinical trials of COVID-19 vaccines. N. M. B. reports consulting agreement with GSK but has not performed or received compensation to date.

Figures

Figure 1.
Figure 1.
Risk factors for severe outcomes (intensive care unit admission or in-hospital death) among women 18 to 49 years of age with laboratory-confirmed respiratory syncytial virus (RSV Hospitalization Surveillance Network, 2014–2018). Other race category includes non-Hispanic persons reported as American Indian, Alaska Native, Asian, Pacific Islander, other, or multiple races. Total number of women 18 to 49 years of age, n = 350; total with severe outcome, n = 80. aRR, adjusted risk ratio; NH, non-Hispanic.
See this image and copyright information in PMC

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