Risk for adverse outcomes in pregnant patients with COVID-19, early in pandemic

Editor's Note

This study by researchers from the University of Southern California, Los Angeles, finds substantial adverse maternal outcomes among pregnant patients with COVID-19 at delivery, during the early pandemic period.

A total of 2,578,095 patients were analyzed. During the 9-month study period (April to December 2020), 45,425 pregnant patients had COVID-19 at delivery, and 1,704 hospitals cared for these patients.

Among the findings:

• Pregnant patients with COVID-19 at delivery were more likely to develop severe maternal morbidity, compared to those without COVID-19 (46.4 vs 18.8 per 1,000), including increased risk of tracheostomy, respiratory distress syndrome, ventilation, acute myocardial infarction, sepsis, shock, cardiac arrest, and coagulopathy.
• The mortality risk for pregnant patients with COVID-19 at delivery was nearly 14 times higher, compared to those without COVID-19 (64.0 vs 4.3 per 100,000).
• Risk of failure-to-rescue after development of severe maternal morbidity increased in pregnant patients with COVID-19 at delivery (1.5% vs 0.25).
• Among pregnant patients with COVID-19 who died during the hospital admission, median time-to-death was 16 days. Between April and June 2020, median time-to-death was 6 days.

The findings highlight the importance of prevention of COVID-19 in this population of pregnant patients, the authors say.