Pregnant women infected with SARS – CoV – 2 are at increased risk of death and severe pneumonia: analysis matched to the propensity score of a prospective national cohort study (COV19Mx) – Martinez – Portilla – – Ultrasound in Obstetrics and Gynecology

background

Limited and unmatched data have reported low complication rates in pregnant women with COVID-19. This study compared COVID-19 findings in pregnant women versus non-pregnant women after adjusting for potential risk factors for serious outcomes.

Methods

The data was obtained from Mexico’s national COVID – 19 data registry, which is an ongoing prospective cohort of people of any age with suspected SARS – CoV – 2 infection clinically and admitted to 475 monitoring hospitals. This study included pregnant and non-reproductive age women (15-49 years) with COVID-19 confirmed by reverse transcription polymerase chain reaction. To adjust for underlying risk factors, propensity score matching for chronic obstructive pulmonary disease, asthma, smoking, hypertension, cardiovascular disease, obesity, diabetes, and age was conducted. The primary outcome was death. Secondary outcomes were pneumonia, intubation, and intensive care unit (ICU) admission.

Results

The initial sample included 5183 COVID patients – 19 pregnant and 175,908 non-pregnant. Crude (unmatched) rates of death, pneumonia, intubation and ICU admission in pregnant and non-pregnant women were 1.5% vs 1.5%, 9.9% vs 6.5%, 8.1% versus 9.9%, 13.0% versus 6.9%, respectively. After matching the propensity score (5183 pregnant women and 5183 non-pregnant women matched), pregnant women were more likely to die (odds ratio [OR] 1 · 65, 95% CI 1 · 30–2.09), pneumonia (OR 1 · 99, 95% CI 1 · 81–2 · 19) and ICU admission (OR 2.25, 95% CI 1 · 86-271) compared to non-pregnant women, but similar probabilities of intubation (OR 0.93, 95% CI 0.70-1.25).

Conclusions

After adjusting for underlying medical and demographic factors, pregnancy is a risk factor for death, intubation, and ICU admission in women of reproductive age with SARS – CoV – 2 infection.

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