and Prevention with either clinical or radiographic evidence of pneumonia or acute respiratory distress syndrome, without an alternative more likely diagnosis. Sixteen participating states § submitted case investigation forms containing data collected during January 19-June 3, 2020, for 199 COVID-19 patients. Among those patients, 192 (97%) reported experiencing any symptoms, six (3%) reported experiencing no symptoms, and one (<1%) had unknown symptom status. Sufficient symptom data for § States that submitted data include Alaska,
Background
Pregnant women with coronavirus disease 2019 (COVID-19) are at increased risk for severe illness compared with nonpregnant women. Data to assess risk factors for illness severity among pregnant women with COVID-19 are limited. This study aimed to determine risk factors associated with COVID-19 illness severity among pregnant women with SARS-CoV-2 infection.
Methods
Pregnant women with SARS-CoV-2 infection confirmed by molecular testing were reported during March 29, 2020–March 5, 2021 through the Surveillance for Emerging Threats to Mothers and Babies Network (SET-NET). Criteria for illness severity (asymptomatic, mild, moderate-to-severe, or critical) were adapted from National Institutes of Health and World Health Organization criteria. Crude and adjusted risk ratios for moderate-to-severe or critical COVID-19 illness were calculated for selected demographic and clinical characteristics.
Results
Among 7,950 pregnant women with SARS-CoV-2 infection, moderate-to-severe or critical COVID-19 illness was associated with age 25 years and older, healthcare occupation, pre-pregnancy obesity, chronic lung disease, chronic hypertension, and pregestational diabetes mellitus. Risk of moderate-to-severe or critical illness increased with the number of underlying medical or pregnancy-related conditions.
Conclusions
Older age and having underlying medical conditions were associated with increased risk of moderate-to-severe or critical COVID-19 illness among pregnant women. This information might help pregnant women understand their risk for moderate-to-severe or critical COVID-19 illness and inform targeted public health messaging.
patients who were confirmed with COVID-19 postoperatively (20.4%) compared with preoperatively (9.1%). Care and staffing needs differ, so preoperative COVID-19 testing and diagnoses can be helpful to ensure needs are met before complications arise. Strategies can be implemented to address more emergent surgeries where prior testing is not feasible. When making discussions, the mother, neonate, and HCWs should be considered to minimize risk and improve safety for all involved. Future research and studies should look at the clinical benefits and risks of the testing pathway, PPE use and its impact on HCW outcomes, and risks and benefits of maternal-neonate interaction after the mother tests positive for COVID-19.
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