The effect of body mass index on maternal and perinatal outcomes in COVID‐19 infection during pregnancy and postpartum: Secondary analysis from the REBRACO cohort study

Abstract

ObjectivesTo compare maternal and perinatal outcomes among women with obesity, overweight, and normal body mass index, associated with COVID‐19 infection during pregnancy and postpartum.MethodProspective Cohort Study, within the REBRACO (Brazilian Network of COVID‐19 in Pregnancy) multicenter initiative. Confirmed positive cases of SARS‐CoV‐2 were included, and women categorized into three groups according to their pre‐pregnancy BMI: obesity (BMI ≥ 30), overweight (BMI <30 but >25), and normal BMI. Sociodemographic, clinical, and obstetric characteristics and different maternal and perinatal outcomes were compared, and a multiple regression analysis was performed to investigate factors independently associated with adverse maternal and perinatal outcomes.ResultsTwo hundred eighty‐nine women positive for SARS‐CoV‐2 infection were considered, and 202 had available data on maternal BMI for the current analysis. Overall, 72 (35.6%)obese, 68 (33.6%) overweight, and 60 (29.7%) normal BMI. Obesity was associated with increased adverse clinical outcomes including sepsis (P = 0.02), acute respiratory distress syndrome (P = 0.002), and the need for mechanical ventilation (P = 0.044). Considering perinatal outcomes, a multiple regression model confirmed obesity as an independent factor associated with adverse results (adjusted odds ratio 3.73, 95% CI 1.54–9.08).ConclusionObesity and overweight were associated with worse clinical outcomes, severe/critical COVID‐19, and adverse perinatal outcomes.