Risk Factors for Illness Severity Among Pregnant Women With Confirmed Severe Acute Respiratory Syndrome Coronavirus 2 Infection—Surveillance for Emerging Threats to Mothers and Babies Network, 22 State, Local, and Territorial Health Departments, 29 March 2020–5 March 2021
Romeo R. Galang, Suzanne Newton, Kate R. Woodworth, Isabel Griffin, Titilope Oduyebo, Christina L. Sancken, Emily O’Malley Olsen, Kathryn Aveni, Heather Wingate, Hanna Shephard, Chris Fussman, Zahra S. Alaali, Kristin Silcox, Samantha Siebman, Umme‐Aiman Halai, Camille Delgado López, Mamie Lush, Ayomide Sokale, Jerusha Barton, Ifrah Chaudhary, Paul H. Patrick, Levi Schlosser, Bethany Reynolds, Nicole Gaarenstroom, Sarah Chicchelly, Jennifer S. Read, Leah de Wilde, Deborah Mbotha, Eduardo Azziz‐Baumgartner, Aron J. Hall, Van T. Tong, Sascha Ellington, Suzanne M. Gilboa, Jennifer L. Beauregard, Jason Hsia, Kellianne King, Jean Y. Ko, Elizabeth Lewis, Susan E. Manning, Varsha Neelam, Mirna Perez, Emily E. Petersen, Megan R. Reynolds, Aspen Riser, Maria Rivera, Nicki Roth, Regina M. Simeone, John Sims, Ashley N. Smoots, Margaret Christine Snead, Penelope Strid, Diana Valencia, Bailey Wallace, Tineka Yowe-Conley, Laura D. Zambrano, Lauren B. Zapata, Amanda Akosa, John F. Nahabedian, Amitsingh Rathore, Neha Shinde, Veronica Burkel, Dena Cherry, Daniel Chang, Charise Fox, Emily Reeves, Ayzsa Tannis, Susanna L. Trost
Abstract
BACKGROUND: Pregnant women with coronavirus disease 2019 (COVID-19) are at increased risk for severe illness compared with nonpregnant women. Data to assess risk factors for illness severity among pregnant women with COVID-19 are limited. This study aimed to determine risk factors associated with COVID-19 illness severity among pregnant women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. METHODS: Pregnant women with SARS-CoV-2 infection confirmed by molecular testing were reported during 29 March 2020-5 March 2021 through the Surveillance for Emerging Threats to Mothers and Babies Network (SET-NET). Criteria for illness severity (asymptomatic, mild, moderate-to-severe, or critical) were adapted from National Institutes of Health and World Health Organization criteria. Crude and adjusted risk ratios for moderate-to-severe or critical COVID-19 illness were calculated for selected demographic and clinical characteristics. RESULTS: Among 7950 pregnant women with SARS-CoV-2 infection, moderate-to-severe or critical COVID-19 illness was associated with age 25 years and older, healthcare occupation, prepregnancy obesity, chronic lung disease, chronic hypertension, and pregestational diabetes mellitus. Risk of moderate-to-severe or critical illness increased with the number of underlying medical or pregnancy-related conditions. CONCLUSIONS: Older age and having underlying medical conditions were associated with increased risk of moderate-to-severe or critical COVID-19 illness among pregnant women. This information might help pregnant women understand their risk for moderate-to-severe or critical COVID-19 illness and can inform targeted public health messaging.