Clinical risk factors of adverse outcomes among women with COVID-19 in the pregnancy and postpartum period: a sequential, prospective meta-analysis

Obesity during Pregnancy and SARS-CoV-2/COVID-19-Case Series of the Registry Study “COVID-19 Related Obstetric and Neonatal Outcome Study” (CRONOS-Network)

“…Another general limitation is the problem of categorizing BMI using standardized cut-off values; borderline obese cases with adverse outcomes might have screwed the results. As shown in previous studies of pregnant women with COVID infection [ 19 ], underweight women in our cohort experienced high frequencies of perinatal complications that may also have contributed to severe combined outcomes in the non-obese group. Due to lacking information, we could not include social status and quality of maternal care, with known effects on COVID outcome [ 23 ].…”

“…The admission rate was 20%, but obesity was no significant risk factor (OR 1.51; 0.81–2.81); the presence of pregestational diabetes was the only maternal condition that significantly increased the risk for admission [ 18 ]. The meta-analysis of Smith et al with 21,977 cases of SARS-CoV-2 infection in pregnancy or postpartum showed that obesity is a risk factor for severe maternal COVID-19 outcomes, including ICU admission (RR 1.81) or ventilation (RR 2.05) and pneumonia (RR 1.66) [ 19 ]. However, similar to our finding, there was no significantly increased risk for fetal or neonatal morbidity or mortality in the presence of obesity besides preterm delivery.…”

“…Our severe maternal combined outcome (preterm delivery < 32 weeks due to hypertensive pregnancy disorders; PPH > 1500 mL, ICU) consists of parameters partly with different underlying pathophysiology and different severity than those of Kleinwechter; the same is valid for Severe Combined Neonatal Outcome that included SGA, 5min-APGAR < 5 und pH artery < 7.0, preterm delivery < 32 weeks and neonatal death. Smith et al also showed that pregnant women with chronic comorbidities such as diabetes, cardiovascular disease or hypertension are at higher risk for several outcomes related to COVID-19, including mortality, preeclampsia, hypertensive disorders of pregnancy and C-sections [ 19 ]. This leads to the assumption that it is more the combination of obesity and other diseases that lead to an increase in the severity of disease in the context of SARS-CoV-2 infection rather than obesity itself.…”

Vertical Transmission of Severe Acute Respiratory Syndrome Coronavirus 2: Current Evidence and Perspectives

“…5,6 Additionally, pregnant women with severe or critical SARS-CoV-2 infection are at risk for various perinatal complications, such as cesarean section, hypertensive disorders of pregnancy, and preterm birth. 2,7 Risk factors for severe or critical SARS-CoV-2 infection include advanced maternal age, increased body mass index, and underlying medical comorbidities such as asthma, chronic hypertension, and pregestational diabetes. 2,7 However, the risk of fetal infection due to vertical transmission of SARS-CoV-2 is still a major concern and debated issue.…”

“…2,7 Risk factors for severe or critical SARS-CoV-2 infection include advanced maternal age, increased body mass index, and underlying medical comorbidities such as asthma, chronic hypertension, and pregestational diabetes. 2,7 However, the risk of fetal infection due to vertical transmission of SARS-CoV-2 is still a major concern and debated issue. 8 Vertical transmission is defined as the transmission of the infectious pathogen from the mother to fetus via the placenta or ascending infection in utero (intrauterine), body fluid contact during delivery (intrapartum), or through breastfeeding after birth (postpartum).…”