COVID-19 not associated with hypertensive pregnancy disorders, surprising researchers
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There was no association between SARS-CoV-2 infection and hypertensive disorders of pregnancy, according to a prospective cohort study published in the American Journal of Obstetrics & Gynecology.
“We were surprised that in a large cohort, we did not see an association between SARS-CoV-2 and hypertensive disorders of pregnancy,” Jourdan E. Triebwasser, MD, MA, a clinical assistant professor of OB/GYN at the University of Michigan, told Healio.
Between April 13 and Dec. 31, 2020, Triebwasser and colleagues collected residual sera from pregnant patients at two Philadelphia hospitals who underwent routine syphilis testing. They serologically tested the samples of 6,192 patients for immunoglobin (Ig) G and IgM antibodies.
Overall, 568 patients (9.2%) were seropositive for SARS-CoV-2. These patients did not have a greater likelihood of being diagnosed with a hypertensive disorder of pregnancy (HDP) compared with patients who did not have a SARS-CoV-2 infection (adjusted RR = 0.93; 95% CI, 0.8-1.08). There were no differences in the severity of any HDPs between seropositive and seronegative patients.
Further, the risk for HDP did not differ between patients by COVID-19 severity.
In a sensitivity analysis of 3,324 patients, there was no association between SARS-CoV-2 infection and preeclampsia (RR = 0.91; 95% CI, 0.6-1.38).
“COVID in pregnancy has many risks for maternal and fetal health, but it is not clear that preeclampsia is one of those risks,” Triebwasser said.
The researchers also examined nasopharyngeal polymerase chain reaction (PCR) results and symptoms at the time they were performed. PCR tests were positive for 37.1% of seropositive and 1.1% of seronegative patients.
Similar to patients with serologically confirmed SARS-CoV-2 infections, those with PCR-confirmed infection did not have a greater risk for HDP compared with those with a negative PCR test (aRR = 0.99; 95% CI, 0.8-1.22). HDP risk did not differ by trimester, according to the researchers.
“I would love to see a prospective study using serial PCR to assess viral exposure and timing,” Triebwasser said. “That would help us answer some of the questions that have been really limited when using convenience samples of PCR obtained for clinical reasons (eg, hospital admission or symptomatic infection).”