Risk for Stillbirth Among Women With and Without COVID-19 at Delivery Hospitalization — United States, March 2020–September 2021
Carla L. DeSisto, Bailey Wallace, Regina M. Simeone, Kara N.D. Polen, Jean Y. Ko, Dana Meaney‐Delman, Sascha Ellington
Abstract
Pregnant women are at increased risk for severe COVID-19related illness, and COVID-19 is associated with an increased risk for adverse pregnancy outcomes and maternal and neonatal complications (1-3). To date, studies assessing whether COVID-19 during pregnancy is associated with increased risk for stillbirth have yielded mixed results (2-4). Since the B.1.617.2 (Delta) variant of SARS-CoV-2 (the virus that causes COVID-19) became the predominant circulating variant,* there have been anecdotal reports of increasing rates of stillbirths in women with COVID-19. CDC used the Premier Healthcare Database Special COVID-19 Release (PHD-SR), a large hospital-based administrative database, to assess whether a maternal COVID-19 diagnosis documented at delivery hospitalization was associated with stillbirth during March 2020-September 2021 as well as before and during the period of Delta variant predominance in the United States (March 2020-June 2021 and July-September 2021, respectively). Among 1,249,634 deliveries during March 2020-September 2021, stillbirths were rare (8,154; 0.65%): 273 (1.26%) occurred among 21,653 deliveries to women with COVID-19 documented at the delivery hospitalization, and 7,881 (0.64%) occurred among 1,227,981 deliveries without COVID-19. The adjusted risk for stillbirth was higher in deliveries with COVID-19 compared with deliveries without COVID-19 during March 2020-September 2021 (adjusted relative risk [aRR] = 1.90; 95% CI = 1.69-2.15), including during the pre-Delta (aRR = 1.47; 95% CI = 1.27-1.71) and Delta periods (aRR = 4.04; 95% CI = 3.28-4.97). COVID-19 documented at delivery was associated with increased risk for stillbirth, with a stronger association during the period of * https://covid.cdc.gov/covid-data-tracker/#datatracker-home https://msdh.ms.gov/msdhsite/_static/23,23645,341.html PHD-SR, formerly known as the PHD COVID-19 Database, is a large U.S. hospital-based, service-level, all-payor database that includes inpatient and hospital-based outpatient (e.g., emergency department or clinic) health care encounters from >900 geographically diverse nonprofit, nongovernmental, community, and teaching hospitals and health systems from rural and urban areas. PHD-SR represents approximately 20% of inpatient admissions in the United States. Data for this study represent a subset of 736 hospitals with delivery hospitalizations that contributed inpatient encounters to the PHD-SR during March 2020-September 2021.