tetano
Editor, Senior Moderator
Am J Obstet Gynecol MFM
. 2023 Jul 1;101077.
doi: 10.1016/j.ajogmf.2023.101077. Online ahead of print. Delivery Outcomes in a Cohort of Pregnant Patients with COVID-19 With and Without Viral Pneumonia
Ms Brianna DuBose[SUP] 1 [/SUP], Ms Yazmeen Tembunde[SUP] 1 [/SUP], Katherine E Goodman[SUP] 2 [/SUP], Ms Lisa Pineles[SUP] 3 [/SUP], Gita Nadimpalli[SUP] 2 [/SUP], Jonathan D Baghdadi[SUP] 2 [/SUP], Jacqueline G Parchem[SUP] 4 [/SUP], Anthony D Harris[SUP] 2 [/SUP], Beth L Pineles[SUP] 5 [/SUP]
Affiliations
Background: Among pregnant people, coronavirus disease 2019 (COVID-19) can lead to adverse outcomes, but the specific pregnancy outcomes that are affected by the disease are unclear. In addition, the effect of the severity of COVID-19 on pregnancy outcomes has not been clearly identified.
Objective: To evaluate the associations between COVID-19 with and without viral pneumonia and cesarean delivery, preterm delivery, preeclampsia, and stillbirth.
Study design: We conducted a retrospective cohort study (April 2020 - May 2021) of deliveries between 20 and 42 weeks of gestation from U.S. hospitals in the Premier Healthcare Database. The primary outcomes were cesarean delivery, preterm delivery, preeclampsia, and stillbirth. We used a viral pneumonia diagnosis (ICD-10-CM codes J12.8 and J12.9) to categorize patients by severity of COVID-19. Pregnancies were categorized into three groups, NOCOVID: No COVID-19, COVID: COVID-19 without viral pneumonia, and PNA: COVID-19 with viral pneumonia. Groups were balanced for risk factors by propensity score matching.
Results: 814,649 deliveries from 853 U.S. hospitals were included (NOCOVID: n=799,132, COVID: n=14,744, PNA: n=773). After propensity score matching, the risks of cesarean delivery and preeclampsia were similar in the COVID group compared to the NOCOVID group (matched risk ratio [mRR] 0.97, 95% confidence interval [CI] 0.94-1.00, and mRR 1.02, 95% CI 0.96-1.07, respectively). The risks of preterm delivery and stillbirth were greater in the COVID group compared to the NOCOVID group (mRR 1.11, 95% CI 1.05-1.19, and mRR 1.30, 95% CI 1.01-1.66, respectively). The risks of cesarean delivery, preeclampsia, and preterm delivery were higher in the PNA group compared to COVID (mRR 1.76, 95% CI 1.53-2.03, mRR 1.37, 95% CI 1.08-1.74, and mRR 3.33, 95% CI 2.56-4.33, respectively). The risk of stillbirth was similar in the PNA group and COVID (mRR 1.17, 95% CI 0.40-3.44).
Conclusions: Within a large national cohort of hospitalized pregnant people, we found that the risk of some adverse delivery outcomes was elevated in people with COVID-19 with and without viral pneumonia, with much higher risks in the group with viral pneumonia.
Keywords: COVID; COVID-19; SARS-CoV2; cesarean; coronavirus; fetal death; fetal demise; pneumonia; preeclampsia; pregnancy; pregnant; premature; preterm; stillbirth; viral pneumonia.
. 2023 Jul 1;101077.
doi: 10.1016/j.ajogmf.2023.101077. Online ahead of print. Delivery Outcomes in a Cohort of Pregnant Patients with COVID-19 With and Without Viral Pneumonia
Ms Brianna DuBose[SUP] 1 [/SUP], Ms Yazmeen Tembunde[SUP] 1 [/SUP], Katherine E Goodman[SUP] 2 [/SUP], Ms Lisa Pineles[SUP] 3 [/SUP], Gita Nadimpalli[SUP] 2 [/SUP], Jonathan D Baghdadi[SUP] 2 [/SUP], Jacqueline G Parchem[SUP] 4 [/SUP], Anthony D Harris[SUP] 2 [/SUP], Beth L Pineles[SUP] 5 [/SUP]
Affiliations
- PMID: 37399892
- DOI: 10.1016/j.ajogmf.2023.101077
Background: Among pregnant people, coronavirus disease 2019 (COVID-19) can lead to adverse outcomes, but the specific pregnancy outcomes that are affected by the disease are unclear. In addition, the effect of the severity of COVID-19 on pregnancy outcomes has not been clearly identified.
Objective: To evaluate the associations between COVID-19 with and without viral pneumonia and cesarean delivery, preterm delivery, preeclampsia, and stillbirth.
Study design: We conducted a retrospective cohort study (April 2020 - May 2021) of deliveries between 20 and 42 weeks of gestation from U.S. hospitals in the Premier Healthcare Database. The primary outcomes were cesarean delivery, preterm delivery, preeclampsia, and stillbirth. We used a viral pneumonia diagnosis (ICD-10-CM codes J12.8 and J12.9) to categorize patients by severity of COVID-19. Pregnancies were categorized into three groups, NOCOVID: No COVID-19, COVID: COVID-19 without viral pneumonia, and PNA: COVID-19 with viral pneumonia. Groups were balanced for risk factors by propensity score matching.
Results: 814,649 deliveries from 853 U.S. hospitals were included (NOCOVID: n=799,132, COVID: n=14,744, PNA: n=773). After propensity score matching, the risks of cesarean delivery and preeclampsia were similar in the COVID group compared to the NOCOVID group (matched risk ratio [mRR] 0.97, 95% confidence interval [CI] 0.94-1.00, and mRR 1.02, 95% CI 0.96-1.07, respectively). The risks of preterm delivery and stillbirth were greater in the COVID group compared to the NOCOVID group (mRR 1.11, 95% CI 1.05-1.19, and mRR 1.30, 95% CI 1.01-1.66, respectively). The risks of cesarean delivery, preeclampsia, and preterm delivery were higher in the PNA group compared to COVID (mRR 1.76, 95% CI 1.53-2.03, mRR 1.37, 95% CI 1.08-1.74, and mRR 3.33, 95% CI 2.56-4.33, respectively). The risk of stillbirth was similar in the PNA group and COVID (mRR 1.17, 95% CI 0.40-3.44).
Conclusions: Within a large national cohort of hospitalized pregnant people, we found that the risk of some adverse delivery outcomes was elevated in people with COVID-19 with and without viral pneumonia, with much higher risks in the group with viral pneumonia.
Keywords: COVID; COVID-19; SARS-CoV2; cesarean; coronavirus; fetal death; fetal demise; pneumonia; preeclampsia; pregnancy; pregnant; premature; preterm; stillbirth; viral pneumonia.