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May 13, 2020
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Study predicts COVID-19 burden among pregnant women

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A recent model estimated that more than 16,000 pregnant women delivering at hospitals in the United States in 2020 will have COVID-19. The model also predicted there will be 52 COVID-19-related maternal mortalities, according to research published in the American College of Obstetrics & Gynecology MFM.

Perspective from Laura Sienas, MD

“We know that pregnancy alters the immune system and given the fact that the majority of American women deliver in a hospital setting, it creates a unique challenge in the fight against the novel coronavirus,” David N. Hackney, MD, director of maternal fetal medicine at UH Cleveland Medical Center, said in a press release.

“The goal of our research is to best predict the impact of COVID-19 on obstetric care in the United States in order to better prepare maternity units and caregivers,” he continued.

Hackney and colleagues used a phenomenological model that had previously been used to predict the incidence of COVID-19 in provinces in China. The model used case data reported by the CDC from Mar. 1, 2020 through Apr. 14, 2020 to forecast the daily incidence of COVID-19 in the United States through Dec. 31, 2020.

Reference: Putra M, et al. Am J Obstet Gynecol MFM. 2020;doi:10.1016/j.ajogmf.2020.100127.

The researchers also implemented the Monte-Carlo simulation using data from studies on the prevalence of pregnancy-specific critical and severe cases of COVID-19 among women aged 20 to 29 years and those aged 30 to 39 years.

Hackney and colleagues forecasted 860,475 COVID-19 cases in the general population from March through December 2020, with 16,601 cases occurring among pregnant women hospitalized for delivery (95% CI, 9,711-23,491). Among these hospitalized cases, the researchers predicted that 3,308 (95% CI, 1,755-4,861) will be severe and 681 (95% CI, 1,324-1,038) will be critical.

The researchers also predicted there will be 52 (95% CI, 23-81) maternal mortalities during delivery hospitalization due to COVID-19, yielding an overall mortality rate of 18.7 (95% CI, 18–19.5) maternal deaths per 100,000 live births in 2020, up from 17.4 maternal deaths per 100,000 live births in 2018.

“To our knowledge this is the first study on the incidence of COVID-19 in pregnancy,” Manesha Putra, MD, a fellow in maternal fetal medicine at UH Cleveland Medical Center, said in the release. “Despite its limitations, this study has the ability to guide resource allocation and better prepare hospitals and caregivers on the frontlines.” – by Erin Michael

Disclosures: The authors report no relevant financial disclosures.