Pregnancy and the Risk of In-Hospital Coronavirus Disease 2019 (COVID-19) Mortality

Abstract

In a large cohort of reproductive-aged patients hospitalized with pneumonia due to coronavirus disease 2019 (COVID-19), pregnancy was not an independent risk factor for in-hospital mortality.

Liver injury in COVID-19: Clinical features, potential mechanisms, risk factors and clinical treatments

“…Despite a higher frequency of ICU admissions, in-hospital mortality was lower among pregnant patients compared with non-pregnant patients with COVID-19 viral pneumonia, at 1.1% for pregnant women and 3.5% for non-pregnant women. Pregnancy is not an independent risk factor for in-hospital mortality in COVID-19 patients[ 103 ]. In the study by Tunç et al [ 104 ], COVID-19-related hospitalization rates were 24.1% in the first trimester, 36% in the second trimester, and 57.3% in the third trimester; there was no significant relationship between pregnancy duration and the need for ICU admission.…”

“…However, pregnant women may have many comorbidities, including hypertension, chronic lung disease, diabetes, and obesity, compared with non-pregnant women[ 103 ]. Pregnant patients with COVID-19 and chronic complications such as hypertension and diabetes have an increased risk of developing inflammation and liver damage[ 101 ].…”

The impact of maternal SARS-CoV-2 infection and COVID-19 vaccination on maternal-fetal outcomes

“…It became clear early on in the COVID-19 pandemic that pregnant people are at elevated risk of harm from SARS-CoV-2 infection compared to non-pregnant women of reproductive age. [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] People with a SARS-CoV-2 infection during pregnancy also have worse maternal outcomes than those that do not. [6] , [10] , [11] , [12] , [13] , [14] , [15] , [16] SARS-CoV-2 infection and related complications has also disproportionately impacted minority populations and people with lower socioeconomic status.…”

“… [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] Pregnant people have 1.8-5.4 fold higher hospitalization rates, [1] , [3] , [4] , [6] , [7] , [9] and 1.3-5.5 fold higher ICU admission rates ( Table 1 ). [1] , [2] , [5] , [6] , [7] Results are more mixed on the relative risk of severe COVID-19 (0.8-2.0 fold difference), [8] , [26] mechanical ventilation (0.4-2.7 fold difference), [1] , [2] , [3] , [5] , [6] and death (0.1-13.6) [1] , [2] , [3] , [4] , [5] , [6] during COVID-19 for pregnant people compared to non-pregnant women of reproductive age ( Table 1 ). Mechanical ventilation and death remain rare, which may explain discrepancies in reporting on the relative risk in pregnant people compared to non-pregnant people.…”

“…Pregnancy increases the risk of more severe COVID-19 outcomes and people with COVID-19 during pregnancy have worse maternal outcomes than those that do not. [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] Unfortunately, throughout the pandemic COVID-19 has disproportionately impacted pregnant people who are more vulnerable. [10] , [11] , [15] , [16] , [18] , [30] , [36] , [37] , [38] , [39] COVID-19 also increases the risk for several perinatal outcomes, which can have a lifelong impact on a child’s health.…”