Risk factors for illness severity among pregnant women with confirmed SARS-CoV-2 infection - Surveillance for Emerging Threats to Mothers and Babies Network, 20 state, local, and territorial health departments, March 29, 2020 -January 8, 2021

Galang, R. R.; Newton, S. M.; Woodworth, K. R.; Griffin, I.; Oduyebo, T.; Sancken, C. L.; O'Malley Olsen, E.; Aveni, K.; Wingate, H.; Shephard, H.; Fussman, C.; Alaali, Z. S.; Siebman, S.; Halai, U.-A.; Delgado Lopez, C.; Barton, J.; Lush, M.; Patrick, P. H.; Schlosser, L.; Sokale, A.; Chaudhary, I.; Reynolds, B.; Sowunmi, S.; Gaarenstroom, N.; Read, J. S.; Chicchelly, S.; de Wilde, L.; Azziz-Baumgartner, E.; Hall, A. J.; Tong, V. T.; Ellington, S.; Gilboa, S. M.; Team, CDC COVID-19 Response Pregnancy and Infant Linked Outcomes

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-January 8, 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 5,963 pregnant women with SARS-CoV-2 infection, moderate-to-severe or critical COVID-19 illness was associated with age 30-39 years, Black/Non-Hispanic race/ethnicity, healthcare occupation, pre-pregnancy obesity, chronic lung disease, chronic hypertension, cardiovascular disease, pregestational diabetes mellitus or gestational diabetes. Risk of moderate-to-severe or critical illness increased with the number of underlying medical or pregnancy-related conditions. Conclusions: Pregnant women with moderate-to-severe or critical COVID-19 illness were more likely to be older and have underlying medical conditions compared to pregnant women with asymptomatic infection or mild COVID-19 illness. This information might help pregnant women understand their risk for moderate-to-severe or critical COVID-19 illness and inform targeted public health messaging.