Some studies have suggested that pregnant women are at greater risk of serious complications related to coronavirus disease 2019 (COVID-19) than non-pregnant women. In a paper recently uploaded to the preprint server medRxiv*, the impact of pregnancy on SARS-CoV-2 infection outcomes has been evaluated on a broad scale, which may inform future public messages and COVID-19 prevention strategies.
How was the study conducted?
The group examined 5,963 CDC patient records collected between the period March 29, 2020, to January 8, 2021, related to pregnant women, categorizing the severity of COVID-19 disease. along with demographic information and medical history. Information including age, ethnicity, health insurance status and being in previous medical conditions was collected to compare pregnant women with such conditions with those with one, two, or three basic conditions, with or without SARS-CoV-2 infection.
This allowed the group to construct a risk ratio outlining each of these factors relevant to pregnant women and publish this in a comprehensive table format.
What risk factors have been identified?
Age has been identified as a major risk factor, with women over 30 at increased risk of moderate to severe COVID-19 exposure. Heavy health care workers were also found to be at higher risk compared to non-health care workers, and, as might be expected, those with a growing number and higher risk were found to be at higher risk. worse than previous medical conditions. Possession of one of the pre-defined underlying conditions, on average, contributed to a 25% increase in the risk of developing moderate to severe COVID-19, while possession of two or three co-occurrences associated with 52% and 100% increases, respectively.
Some previous studies have identified a relationship between trimester pregnancy and COVID-19 risk. In this study, the trimester in which the women were exposed to SARS-CoV-2 infection did not appear to have a significant effect on the severity of disease outcome, nor did the individual have some form of health insurance.
The difference in risk between ethnic groups appears very small at first, although it is evident when adjusted for age as a variable, where the “Black, Neo” category was found to be at greater risk. -Hispanic ”over the control of“ White, Neo- Hispanic Group ”. This may be due to the lower age of the previous group being lower at the time of pregnancy.
The associations between risk and age, occupation, underlying health status, and ethnicity identified in this study are consistent with findings in the broader literature for non-pregnant women. All have been associated with worse COVID-19 production. Unlike other studies, however, women in the “Hispanic or Latina” category did not have a significantly higher risk, even when reporting age. These women represented nearly half of the participants and half of moderate to severe COVID-19 outcomes. This was a ratio that was representative of the region in which the study was conducted, although not nationally.
In addition, the group addresses the prevalence of women in the study in the second or third trimester compared to those in the first, making it difficult to identify trimester-related risks. The group notes that misclassification of disease data may have contaminated some of the captured data and that it is difficult to collect detailed data on demographic characteristics in an emergency situation.
However, the study included a large number of women, and could draw valuable conclusions regarding the risks associated with pregnancy. Of the underlying medical conditions examined, type 1 or 2 diabetes and cardiovascular disease were both associated with a 54% increase in risk, chronic lung disease by 39%, and obesity with a 32% increase. – they all tend to rise further from this average with age. Those over the age of 35 had a 44% increase in risk compared to those under 20, and women aged 30 to 34 had a 35% increase, while women aged 20-24 or 25-29 had an increased risk. an increase of 9 or 19%, respectively.
* Important message
medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be seen as final, guiding health-related clinical practice / behavior, or treated as fixed information.