Table 2.
Association between adverse outcomes and SARS-CoV-2 infection before 28 weeks of gestation compared with randomly selected controls
| Variable | SARS-CoV-2 positive at <28 wk | Not SARS-CoV-2 positive | RR (95% CI) | aRR (95% CI) |
|---|---|---|---|---|
| Number of patients | 402 | 11,705 | ||
| Hypertensive disorders of pregnancy | 88 (21.9) | 2510 (21.4) | 1.01 (0.83–1.22) | 1.00 (0.82–1.21) |
| By COVID-19 severity | ||||
| Asymptomatic | 10/63 (15.9) | |||
| Mild | 41/184 (22.3) | |||
| Moderate | 23/120 (19.2) | |||
| Severe and critical | 14/35 (40.0) | |||
| Preeclampsia with severe features | 28 (7.0) | 609 (5.2) | ||
| Preeclampsia without severe features | 9 (2.2) | 349 (3.0) | ||
| Gestational hypertension | 51 (12.7) | 1552 (13.3) | ||
| Gestational age of <37 wk at delivery | 29 (7.2) | 477 (4.1) | 1.73 (1.21–2.49) | 1.74 (1.19–2.55) |
| By COVID-19 severity | ||||
| Asymptomatic | 5/63 (7.9) | |||
| Mild | 8/184 (4.3) | |||
| Moderate | 10/120 (8.3) | |||
| Severe and critical | 6/35 (17.1) | |||
| Preeclampsia with severe features | 28 (7.0) | 609 (5.2) | 1.34 (0.93–1.93) | 1.21 (0.81–1.81) |
| By COVID-19 severity | ||||
| Asymptomatic | 4/63 (6.3) | |||
| Mild | 13/184 (7.1) | |||
| Moderate | 6/120 (5.0) | |||
| Severe and critical | 5/35 (14.3) | |||
| Gestational age of <37 wk at delivery | 17 (4.2) | 274 (2.3) | 1.80 (1.11–2.90) | 1.68 (1.00–2.83) |
| By COVID-19 severity | ||||
| Asymptomatic | 2/63 (3.2) | |||
| Mild | 7/184 (3.8) | |||
| Moderate | 3/120 (2.5) | |||
| Severe and critical | 5/35 (14.3) | |||
| Number of fetuses or neonates | 414 | 11,967 | ||
| Fetal or neonatal death | 12 (2.9) | 174 (1.5) | 2.01 (1.10–3.67) | 1.97 (1.01–3.85) |
| By COVID-19 severity | ||||
| Asymptomatic | 3/64 (4.7) | |||
| Mild | 5/190 (2.6) | |||
| Moderate | 2/123 (1.6) | |||
| Severe and critical | 2/37 (5.4) | |||
| Gestational age of <24 wk | 6/12 (50.0) | 65/174 (37.4) | ||
| Gestational age of 24 wk | 6/12 (50.0) | 109/174 (62.6) | ||
| Fetal death | ||||
| By COVID-19 severity | 7 (1.7) | 114 (1.0) | ||
| Asymptomatic | 2/64 (3.1) | |||
| Mild | 3/190 (1.6) | |||
| Moderate | 1/123 (0.8) | |||
| Severe and critical | 1/37 (2.7) | |||
| Number of days from positive test to fetal death, median (interquartile range) | 21 (16–89) | |||
| Gestational age of <24 wk | 4/7 (57.1) | 42/114 (36.8) | ||
| Gestational age of 24 wk | 3/7 (42.9) | 72/114 (63.2) | ||
| Neonatal death | 5 (1.2) | 60 (0.5) | ||
| Gestational age of <24 wk | 2/5 (40.0) | 23/60 (38.3) | ||
| Gestational age of 24 wk | 3/5 (60.0) | 37/60 (61.7) | ||
| PTB at <37 wk | 81 (19.6) | 1654 (13.8) | 1.42 (1.14–1.76) | 1.29 (1.02–1.63) |
| By COVID-19 severity | ||||
| Asymptomatic | 11/64 (17.2) | |||
| Mild | 31/190 (16.3) | |||
| Moderate | 26/123 (21.1) | |||
| Severe and critical | 13/37 (35.1) | |||
| Spontaneous | 27 (33.3) | 795 (48.1) | ||
| Indicated | 54 (66.7) | 859 (51.9) | ||
| PTB at <34 wk | 33 (8.0) | 601 (5.0) | 1.52 (1.05–2.19) | 1.45 (0.97–2.16) |
| Spontaneous | 14 (42.4) | 332 (55.2) | ||
| Indicated | 19 (57.6) | 269 (44.8) | ||
| Live birth | 407 | 11,853 | ||
| Major congenital malformations | 14 (3.4) | 504 (4.3) | 0.83 (0.49–1.40) | 0.81 (0.47–1.39) |
| Size for gestational age of <10th percentile | 47 (11.8) | 1286 (10.9) | 1.10 (0.83–1.45) | 1.08 (0.82–1.44) |
| Size for gestational age of <5th percentile | 22 (5.5) | 647 (5.5) | 1.01 (0.66–1.55) | 0.97 (0.62–1.52) |
Data are presented as number (percentage) or number/total number (percentage), unless otherwise specified. Models for hypertensive disorders of pregnancy were adjusted for maternal age, BMI, any comorbidity (asthma or COPD, pregestational diabetes mellitus, or chronic hypertension), and obstetrical history (no previous pregnancy, previous pregnancy without PTB or preeclampsia, or previous pregnancy with PTB or preeclampsia). All other models were adjusted for maternal age, BMI, and any comorbidity (asthma or COPD, pregestational diabetes mellitus, or chronic hypertension).
aRR, adjusted relative risk; BMI, body mass index; CI, confidence interval; COPD, chronic obstructive pulmonary disease; PTB, preterm birth; RR, relative risk.
Hughes. Early SARS-CoV-2 infection and subsequent pregnancy outcomes. Am J Obstet Gynecol 2023.