Maternal morbidity associated with delivery during COVID-19

Editor's Note

This retrospective cohort study led by researchers at Ascension Health, St Louis, finds that COVID-19 infection is a risk factor for adverse peripartum maternal outcomes.

Researchers evaluated the association of COVID-19 with severe maternal morbidities in patients delivering during four pandemic periods characterized by predominant variants—March-December 2020 (wild type), January-June 2021 (Alpha, B.1.1.7), July-November 2021 (Delta, B.1.617.2), and December 2021-January 2022 (Omicron, B.1.1.529).

Over all time periods, there were 3,129 patients with COVID-19 that were matched with 12,504 patients without COVID-19.

The researchers found that:

• Those with COVID-19 had significantly higher rates of severe maternal morbidity than those without in all time periods except Omicron.
• The risk of any severe maternal morbidity associated with COVID-19 was increased for the wild-type (odds ratio [OR], 2.74) and Alpha (OR, 2.57) variants, but the risk during the Delta period was higher (OR, 7.69).

The findings were similar for respiratory and nonrespiratory complications as well as nontransfusion outcomes.

The researchers concluded that the COVID-19 Delta variant was associated with higher rates of severe maternal morbidity events, compared with other variants. The findings underscore the importance of preventive measures, they say.