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Maternal and Perinatal Outcomes Associated With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection During Pregnancy, Florida, 2020-2021: A Retrospective Cohort Study.
Clin Infect Dis. 2022 10 03; 75(Suppl 2):S308-S316.CI

Abstract

BACKGROUND

The objective was to estimate risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in pregnancy and assess adverse maternal and perinatal outcomes.

METHODS

We used a population-based, retrospective cohort of all pregnancies with a live birth or fetal death in Florida from 1 March 2020 to 30 April 2021. Coronavirus disease 2019 (COVID-19) case reports were matched to vital registries. Outcomes assessed were risk of infection in pregnancy, preterm birth, maternal or neonatal admission to an intensive care unit (ICU), perinatal or fetal death, and maternal death. Modified Poisson and multinomial logistic regression models were used to derive relative risk estimates.

RESULTS

Of 234 492 women with a live birth or fetal death during the study period, 12 976 (5.5%) were identified with COVID-19 during pregnancy. Risk factors for COVID-19 in pregnancy included Hispanic ethnicity (relative risk [RR] = 1.89), Black race (RR = 1.34), being unmarried (RR = 1.04), and being overweight or obese pre-pregnancy (RR = 1.08-1.32). COVID-19 during pregnancy was associated with preterm birth (RR = 1.31), Cesarean delivery (RR = 1.04), and neonatal (RR = 1.17) and maternal (RR = 3.10) ICU admission; no association was found with increased risk of perinatal (RR = 0.72) or fetal death (RR = 0.86). Women infected during any trimester showed increased risk of preterm birth. Fourteen maternal deaths were identified among COVID-19 cases; of those who died, 12 were obese. The death rate per 10 000 was 22.09 among obese and 1.22 among non-obese gravida with COVID-19 during pregnancy (RR = 18.99, P = .001).

CONCLUSIONS

Obesity is a risk factor for SARS-CoV-2 infection in pregnancy and for more severe COVID-19 illness among pregnant women. SARS-CoV-2 infection is associated with preterm birth.

Links

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Authors+Show Affiliations

Doyle TJ
Division of Disease Control and Health Protection, Florida Department of Health, Tallahassee, Florida, USA. Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Kiros GE
Division of Disease Control and Health Protection, Florida Department of Health, Tallahassee, Florida, USA. College of Pharmacy and Pharmaceutical Sciences, Institute of Public Health, Florida Agricultural and Mechanical University, Tallahassee, Florida, USA.
Schmitt-Matzen EN
Division of Disease Control and Health Protection, Florida Department of Health, Tallahassee, Florida, USA. Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Propper R
Division of Disease Control and Health Protection, Florida Department of Health, Tallahassee, Florida, USA.
Thompson A
Division of Community Health Promotion, Florida Department of Health, Tallahassee, Florida, USA.
Phillips-Bell GS
Division of Community Health Promotion, Florida Department of Health, Tallahassee, Florida, USA. Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

MeSH

COVID-19FemaleFetal DeathFloridaHumansInfant, NewbornInfectious Disease Transmission, VerticalPregnancyPregnancy Complications, InfectiousPregnancy OutcomePremature BirthRetrospective StudiesSARS-CoV-2

Pub Type(s)

Journal Article

Language

eng

PubMed ID

35675310

Citation

Doyle, Timothy J., et al. "Maternal and Perinatal Outcomes Associated With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection During Pregnancy, Florida, 2020-2021: a Retrospective Cohort Study." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 75, no. Suppl 2, 2022, pp. S308-S316.
Doyle TJ, Kiros GE, Schmitt-Matzen EN, et al. Maternal and Perinatal Outcomes Associated With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection During Pregnancy, Florida, 2020-2021: A Retrospective Cohort Study. Clin Infect Dis. 2022;75(Suppl 2):S308-S316.
Doyle, T. J., Kiros, G. E., Schmitt-Matzen, E. N., Propper, R., Thompson, A., & Phillips-Bell, G. S. (2022). Maternal and Perinatal Outcomes Associated With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection During Pregnancy, Florida, 2020-2021: A Retrospective Cohort Study. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 75(Suppl 2), S308-S316. https://doi.org/10.1093/cid/ciac441
Doyle TJ, et al. Maternal and Perinatal Outcomes Associated With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection During Pregnancy, Florida, 2020-2021: a Retrospective Cohort Study. Clin Infect Dis. 2022 10 3;75(Suppl 2):S308-S316. PubMed PMID: 35675310.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Maternal and Perinatal Outcomes Associated With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection During Pregnancy, Florida, 2020-2021: A Retrospective Cohort Study. AU - Doyle,Timothy J, AU - Kiros,Gebre Egziabhe, AU - Schmitt-Matzen,Emily N, AU - Propper,Randy, AU - Thompson,Angela, AU - Phillips-Bell,Ghasi S, PY - 2022/6/9/pubmed PY - 2022/10/6/medline PY - 2022/6/8/entrez KW - COVID-19 KW - maternal mortality KW - obesity KW - pregnancy outcomes KW - trimester SP - S308 EP - S316 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 75 IS - Suppl 2 N2 - BACKGROUND: The objective was to estimate risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in pregnancy and assess adverse maternal and perinatal outcomes. METHODS: We used a population-based, retrospective cohort of all pregnancies with a live birth or fetal death in Florida from 1 March 2020 to 30 April 2021. Coronavirus disease 2019 (COVID-19) case reports were matched to vital registries. Outcomes assessed were risk of infection in pregnancy, preterm birth, maternal or neonatal admission to an intensive care unit (ICU), perinatal or fetal death, and maternal death. Modified Poisson and multinomial logistic regression models were used to derive relative risk estimates. RESULTS: Of 234 492 women with a live birth or fetal death during the study period, 12 976 (5.5%) were identified with COVID-19 during pregnancy. Risk factors for COVID-19 in pregnancy included Hispanic ethnicity (relative risk [RR] = 1.89), Black race (RR = 1.34), being unmarried (RR = 1.04), and being overweight or obese pre-pregnancy (RR = 1.08-1.32). COVID-19 during pregnancy was associated with preterm birth (RR = 1.31), Cesarean delivery (RR = 1.04), and neonatal (RR = 1.17) and maternal (RR = 3.10) ICU admission; no association was found with increased risk of perinatal (RR = 0.72) or fetal death (RR = 0.86). Women infected during any trimester showed increased risk of preterm birth. Fourteen maternal deaths were identified among COVID-19 cases; of those who died, 12 were obese. The death rate per 10 000 was 22.09 among obese and 1.22 among non-obese gravida with COVID-19 during pregnancy (RR = 18.99, P = .001). CONCLUSIONS: Obesity is a risk factor for SARS-CoV-2 infection in pregnancy and for more severe COVID-19 illness among pregnant women. SARS-CoV-2 infection is associated with preterm birth. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/35675310/Maternal_and_Perinatal_Outcomes_Associated_With_Severe_Acute_Respiratory_Syndrome_Coronavirus_2__SARS_CoV_2__Infection_During_Pregnancy_Florida_2020_2021:_A_Retrospective_Cohort_Study_ DB - PRIME DP - Unbound Medicine ER -