Risk factors for illness severity among pregnant women with confirmed SARS-CoV-2 infection – Surveillance for Emerging Threats to Mothers and Babies Network, 22 state, local, and territorial health departments, March 29, 2020 -March 5, 2021

Galang, Romeo R; Newton, Suzanne M; Woodworth, Kate R; Griffin, Isabel; Oduyebo, Titilope; Sancken, Christina L; Olsen, Emily O'Malley; Aveni, Kathryn; Wingate, Heather; Shephard, Hanna; Fussman, Chris; Alaali, Zahra S; Silcox, Kristin; Siebman, Samantha; Halai, Umme-Aiman; Lopez, Camille Delgado; Lush, Mamie; Sokale, Ayomide; Barton, Jerusha; Chaudhary, Ifrah; Patrick, Paul H; Schlosser, Levi; Reynolds, Bethany; Gaarenstroom, Nicole; Chicchelly, Sarah; Read, Jennifer S; de Wilde, Leah; Mbotha, Deborah; Azziz-Baumgartner, Eduardo; Hall, Aron J; Tong, Van T; Ellington, Sascha; Gilboa, Suzanne M

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 SARS-CoV-2 infection. METHODS: Pregnant women with SARS-CoV-2 infection confirmed by molecular testing were reported during March 29, 2020–March 5, 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 7,950 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, pre-pregnancy 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 inform targeted public health messaging.