Study finds adverse pregnancy outcomes similar in women with, without COVID-19
COVID-19 infection during pregnancy may not lead to adverse pregnancy outcomes, according to research published in JAMA Network Open.
“Other studies have reported significantly increased preterm birth for pregnant women with COVID-19, but we did not find that preterm birth or other poor outcomes were increased in women diagnosed during pregnancy,” Emily H. Adhikari, MD, assistant professor of obstetrics and gynecology at University of Texas Southwestern Medical Center and medical director of perinatal infectious diseases at Parkland Memorial Hospital in Dallas, told Healio Primary Care.
She added that earlier studies had focused on women hospitalized for delivery or for severe COVID-19, but not women who were isolated at home and did not require hospitalization.
Additionally, other studies have suggested that hospitalization rates for COVID-19 were higher among pregnant women, but Adhikari said her research found that the rate of hospitalization for COVID-19 was similar among pregnant women and the general population.
Adhikari and colleagues conducted an observational cohort study evaluating outcomes among women who were tested for COVID-19 during pregnancy and delivered at a health care system in Dallas from March 18 to August 22.
Adhikari identified a total of 3,374 women who were tested for COVID-19 and delivered, among whom 252 tested positive and 3,122 tested negative for the novel coronavirus.
The researchers determined that there were no significant differences in age, BMI, parity or diabetes in women with and without COVID-19 infection, and that infection was more common in Hispanic women.
They did not identify a significant difference in preterm birth, preeclampsia with severe features, and cesarean delivery for fetal indication in women with (21%) and without (23%) COVID-19 infection (RR = 0.94; 95% CI, 0.73-1.21).
Despite previous studies indicating that women with COVID-19 during pregnancy had placental abnormalities, Adhikari and colleagues did not identify placental pathologic differences based on illness severity.
Of the women who tested positive for COVID-19, 95% were initially asymptomatic or had mild symptoms, 3% developed severe or critical illness, and 6% were hospitalized.
Adhikari and colleagues found that early neonatal COVID-19 infection occurred in 3% of infants who were tested, and that these infants were usually born to women with mild symptoms or asymptomatic COVID-19.
“By studying all pregnant women with COVID-19 infection in pregnancy — including those hospitalized and not hospitalized — we found that COVID-19 is unassociated with adverse pregnancy outcomes and that being pregnant doesn’t appear to increase the risk of severe or critical illness for the majority of women,” Adhikari said. “However, for the 5% of COVID-19-positive pregnant women who get very sick — and it’s hard to predict who that will be — the risks to both mother and baby are significant.”