Maternal outcomes and risk factors for COVID-19 severity among pregnant women

Vouga, Manon; Favre, Guillaume; Martinez-Perez, Oscar; Pomar, Leo; Acebal, Laura Forcen; Abascal-Saiz, Alejandra; Hernandez, Maria Rosa Vila; Hcini, Najeh; Lambert, Véronique; Carles, Gabriel; Sichitiu, Joanna; Salomon, Laurent; Stirnemann, Julien; Ville, Yves; de Tejada, Begoña Martinez; Goncé, Anna; Hawkins-Villarreal, Ameth; Castillo, Karen; Solsona, Eduard Gratacos; Trigo, Lucas; Cleary, Brian; Geary, Michael; Bartels, Helena; Al-Kharouf, Feras; Malone, Fergal; Higgins, Mary; Keating, Niamh; Knowles, Susan; Poncelet, Christophe; Ribeiro-do-Valle, Carolina Carvalho; Surita, Fernanda; Dantas-Silva, Amanda; Borrelli, Carolina; Luz, Adriana Gomes; Fuenzalida, Javiera; Carvajal, Jorge; Canales, Manuel Guerra; Hernandez, Olivia; Grechukhina, Olga; Ko, Albert I.; Reddy, Uma; Figueiredo, Rita; Moucho, Marina; Pinto, Pedro Viana; De Luca, Carmen; De Santis, Marco; de Campos, Diogo Ayres; Martins, Inês; Garabedian, Charles; Subtil, Damien; Bohrer, Betania; Da Rocha Oppermann, Maria Lucia; Wender, Maria Celeste Osorio; Schuler-Faccini, Lavinia; Sanseverino, Maria Teresa Vieira; Giugliani, Camila; Friedrich, Luciana; Scherer, Mariana Horn; Mottet, Nicolas; Ducarme, Guillaume; Pelerin, Helene; Moreau, Chloe; Breton, Bénédicte; Quibel, Thibaud; Rozenberg, Patrick; Giannoni, Eric; Granado, Cristina; Monod, Cécile; Mueller, Doris; Hoesli, Irene; Bassler, Dirk; Heldstab, Sandra; Kölble, Nicole Ochsenbein; Sentilhes, Loïc; Charvet, Melissa; Deprest, Jan; Richter, Jute; Van der Veeken, Lennart; Eggel-Hort, Béatrice; Plantefeve, Gaetan; Derouich, Mohamed; Calvache, Albaro José Nieto; Lopez-Giron, Maria Camila; Burgos-Luna, Juan Manuel; Escobar-Vidarte, Maria Fernanda; Hecher, Kurt; Tallarek, Ann-Christin; Hadar, Eran; Haratz, Karina Krajden; Amikam, Uri; Malinger, Gustavo; Maymon, Ron; Yogev, Yariv; Schäffer, Leonhard; Toussaint, Arnaud; Rossier, Marie-Claude; De Sa, Renato Augusto Moreira; Grawe, Claudia; Aebi-Popp, Karoline; Radan, Anda-Petronela; Raio, Luigi; Surbek, Daniel; Böckenhoff, Paul; Strizek, Brigitte; Kaufmann, Martin; Bloch, Andrea; Boulvain, Michel; Johann, Silke; Heldstab, Sandra Andrea; Bernasconi, Monya Todesco; Grant, Gaston; Feki, Anis; Brochut, Anne-Claude Muller; Giral, Marylene; Sedille, Lucie; Papadia, Andrea; Brugger, Romina Capoccia; Weber, Brigitte; Fischer, Tina; Kahlert, Christian; Saines, Karin Nielsen; Cambou, Mary; Kanellos, Panagiotis; Chen, Xiang; Yin, Mingzhu; Haessig, Annina; Ackermann, Sandrine; Baud, David; Panchaud, Alice

Pregnant women may be at higher risk of severe complications associated with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which may lead to obstetrical complications. We performed a case control study comparing pregnant women with severe coronavirus disease 19 (cases) to pregnant women with a milder form (controls) enrolled in the COVI-Preg international registry cohort between March 24 and July 26, 2020. Risk factors for severity, obstetrical and immediate neonatal outcomes were assessed. A total of 926 pregnant women with a positive test for SARS-CoV-2 were included, among which 92 (9.9%) presented with severe COVID-19 disease. Risk factors for severe maternal outcomes were pulmonary comorbidities [aOR 4.3, 95% CI 1.9–9.5], hypertensive disorders [aOR 2.7, 95% CI 1.0–7.0] and diabetes [aOR2.2, 95% CI 1.1–4.5]. Pregnant women with severe maternal outcomes were at higher risk of caesarean section [70.7% (n = 53/75)], preterm delivery [62.7% (n = 32/51)] and newborns requiring admission to the neonatal intensive care unit [41.3% (n = 31/75)]. In this study, several risk factors for developing severe complications of SARS-CoV-2 infection among pregnant women were identified including pulmonary comorbidities, hypertensive disorders and diabetes. Obstetrical and neonatal outcomes appear to be influenced by the severity of maternal disease.