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Oxford University Press - PMC COVID-19 Collection logoLink to Oxford University Press - PMC COVID-19 Collection
. 2022 Jun 8:ciac441. doi: 10.1093/cid/ciac441

Maternal and perinatal outcomes associated with SARS-CoV-2 infection during pregnancy, Florida, 2020–2021: A retrospective cohort study

Timothy J Doyle 1,2,, Gebre-egziabhe Kiros 3,4, Emily N Schmitt-Matzen 5,6, Randy Propper 7, Angela Thompson 8, Ghasi S Phillips-Bell 9,10
PMCID: PMC9214154  PMID: 35675310

Abstract

Background

The objective was to estimate risk of 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 March 1, 2020 to April 30, 2021. 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 = 0.001).

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.

Keywords: COVID-19, maternal mortality, obesity, pregnancy outcomes, trimester


Articles from Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America are provided here courtesy of Oxford University Press

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