SARS-CoV-2 infection associated with increased risk for adverse pregnancy outcomes
A recently published study found that SARS-CoV-2 infection during pregnancy is associated with an increased risk for adverse pregnancy outcomes, including induced abortion, cesarean sections, preterm birth and fetal growth restriction.
“We know from experiences with previous pandemics that pregnant individuals tend to experience more severe illness from pandemic viruses. So, at the start of this pandemic, we were already wary of how this pandemic may impact pregnancy health,” Annette Regan, PhD, MPH, assistant professor and MPH faculty lead at the University of San Francisco’s Orange County Campus, told Healio.
“At the start of the COVID-19 pandemic, data started to emerge indicating that COVID-19 during pregnancy could increase the risk of hospitalization, admission to ICU and death, as well as preterm birth and other consequences for the baby, but these studies were small and somewhat limited, so we knew we wanted to do a large, national study to investigate,” Regan said.
Regan and colleagues conducted a national cohort study using de-identified administrative claims data for 78,283 pregnancies with an estimated conception date before April 30, 2020, and pregnancy end after March 11, 2020. They used diagnostic and laboratory testing data to identify infected mothers.
In total, 2,655 (3.4%) of the included pregnancies had a documented SARS-CoV-2 infection and 3.4% required admission to an ICU, invasive mechanical ventilation or extracorporeal membrane oxygenation treatment, Regan and colleagues reported.
They found that COVID-19 during pregnancy was associated with a two- to threefold higher risk for induced abortion (adjusted HR = 2.6; 95% CI, 1.17-5.78), cesarean section (aHR = 1.99; 95% CI, 1.71-2.31), clinician-initiated preterm birth (aHR = 2.88; 95% CI, 1.93, 4.30), spontaneous preterm birth (aHR = 1.79; 95% CI, 1.37-2.34), fetal growth restriction (aHR = 2.04; 95% CI, 1.72-2.43) and postpartum hemorrhage (aHR = 2.03; 95% CI, 1.6-2.63) but was not associated with risk for miscarriage, antepartum hemorrhage or stillbirth.
“In combination with the many other studies showing harmful effects of COVID-19 during pregnancy, I think it's pretty clear that infection can have serious consequences for both mother and baby,” Regan said. “We really need to prevent pregnant patients from getting COVID-19, and we know we have several different strategies to help with this, including social distancing, mask wearing, hand-washing, and I think most importantly, vaccination.”