Characteristics and outcomes of COVID‐19 pneumonia in pregnancy compared with infected nonpregnant women

Abstract

Objective To compare the clinical and paraclinical features and outcomes of pregnant and nonpregnant women with COVID‐19. Methods A multicenter retrospective cohort study of pregnant and nonpregnant women of reproductive age hospitalized between March and October 2020 in Tehran, Iran. Medical records were reviewed and women who tested positive for SARS‐CoV‐2 on RT‐PCR were included. Extracted data were compared and logistic regression performed. Results A total of 110 pregnant and 234 nonpregnant COVID‐19‐positive women were included. Frequency of severe disease was higher in nonpregnant women than pregnant women (29% vs 11.8%; P < 0.001). Symptoms including cough, dyspnea, chill, fatigue, and headache were more frequent in nonpregnant women (P < 0.05). Pregnant women had higher oxygen saturation levels and lower lymphocyte count (P = 0.001). Six (5.5%) pregnant and 12 (5.1%) nonpregnant women died (P = 0.80). No significant differences between the groups were found for ICU admission and end organ failure. Significantly more nonpregnant women had acute respiratory distress syndrome (ARDS, 9.4% vs 0%; P = 0.001). Univariate regression indicated association between hypertension and death; oxygen saturation and ARDS; and body mass index and ICU admission. No association was found between pregnancy and death, ICU admission, or ARDS. Conclusion Pregnant women with COVID‐19 are not at higher risk of adverse outcomes compared with nonpregnant women.

Analysis of the Factors That Influence the Clinical Outcome of Severe Acute Respiratory Syndrome Caused by SARS-CoV-2 in Pregnant Women

“…Similar to non-pregnant women, pregnant women with MERS had the highest mortality, followed by those with SARS and COVID-19 [33]. These findings are corroborated by a retrospective and multicentric cohort carried out in 2020 [34] in which it was observed that the mortality rate among pregnant women (110 patients) compared to non-pregnant women (224 patients) did not show statistically significant differences. However, pregnant women had lower saturation rates and global lymphocyte counts than their peers in a statistically significant way.…”

Adverse Birth Outcomes Among Pregnant Women With and Without COVID-19: A Comparative Study From Bangladesh

“…Another brief review conducted by Parazzini et al [ 25 ] reported that vaginal delivery was disproportionately less common among COVID-19-positive women. Furthermore, studies performed on Chinese [ 26 ], Indian [ 27 ], Iranian [ 28 ], and United Kingdom [ 29 ] COVID-19-infected pregnant women also reported similar results.…”

The association between pregnancy and COVID-19: A systematic review and meta-analysis

“…We included 8 published studies [ [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] ] with 859,278 COVID-19 female patients, of which 37,578 (4.37%) cases were pregnant patients. Most study designs are cohort studies or case-control studies.…”

“…For death, we extracted RRs or ORs from 6 original studies [ 26 , 27 , 29 , 30 , 32 , 33 ]. Three studies suggest that pregnancy increases the risk of death, yet one study suggests that pregnancy is a protective factor against death.…”

“…In total, 6 studies [ 26 , 28 , 29 , [31] , [32] , [33] ] provided data on ICU admission. All but one of the studies showed that pregnancy increased the risk of ICU admission.…”