Pregnant Women Face Higher Severe COVID-19 Risks, Studies Say

Carolyn Crist

November 04, 2020

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

Pregnant women who contract the coronavirus are more likely to develop a severe form of the disease, die from COVID-19 and deliver prematurely, according to new studies released on Monday from the CDC.

The overall risk remains low, the CDC emphasized, but pregnant women face a "significantly higher" risk for severe consequences.

"Pregnant women should be counseled about the risk for severe COVID-19-associated illness including death," the CDC COVID-19 Response Pregnancy and Infant Linked Outcomes Team wrote in a summary.

"Measures to prevent SARS-CoV-2 infection should be strongly emphasized for pregnant women and their families during all medical encounters, including prenatal care visits," they wrote.

The team analyzed data from 400,000 women between ages 15-44 who had symptomatic COVID-19 between late January and early October, including 23,000 who were pregnant. They found that pregnant women were more likely than non-pregnant women to need intensive care, invasive ventilation and extracorporeal membrane oxygenation and were more likely to die from COVID-19.

Intensive care was "particularly notable" among Asian women and Native Hawaiian/Pacific Islander women, they wrote, and Hispanic women had more than double the risk of death. Pregnant women between ages 35-44 were also 4 times as likely to require ventilation and twice as likely to die than non-pregnant women in their age group.

In a separate report, the team wrote that pre-term births were also more common among pregnant women with COVID-19 during March through October. Among 3,900 live births with a known gestational age, nearly 13% were pre-term, or born in less than 37 weeks. In 2019, about 10% of live births were pre-term.

In addition, among the 610 infants with COVID-19 testing results, 2.6% had a positive test. Infant infection was most common among mothers who tested positive for COVID-19 within a week of delivery.

More than 84% of the reports came from COVID-19 infections in the third trimester, the CDC team wrote, so more research is needed to understand the effects of COVID-19 infection during early pregnancy. Additional information would help public health officials to provide guidance around neonatal testing and pregnancy counseling.

Overall, pregnant women and their family members should follow public health measures to slow the spread of the coronavirus, they wrote.

"To minimize the risk for acquiring SARS-CoV-2 infection, pregnant women should limit unnecessary interactions with persons who might have been exposed to or are infected with SARS-CoV-2, including those within their household, as much as possible," the team wrote.

Sources

CDC Morbidity and Mortality Weekly Report, "Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status — United States, January 22–October 3, 2020."

CDC Morbidity and Mortality Weekly Report, "Birth and Infant Outcomes Following Laboratory-Confirmed SARS-CoV-2 Infection in Pregnancy — SET-NET, 16 Jurisdictions, March 29–October 14, 2020."

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