Revisiting the Toll of COVID-19 on Pregnancy Outcomes

Previous reports have indicated that pregnant women are at excess risk for adverse outcomes of COVID-19; however, the magnitude of risk for adverse pregnancy outcomes in women with COVID-19 versus those without the disease is less clear. To get a better estimate, researchers in France conducted a retrospective nationwide cohort involving 244,645 births at gestational age ≥22 weeks between January and June 2020 (i.e., the first COVID-19 wave). During the observation period, 874 births (0.36%) occurred in women with COVID-19.

Pregnant women with COVID-19 were older (mean age, 31.1 vs. 30.5 years; 7.4% vs. 4.9% aged ≥40) and more likely to be obese, have multiple pregnancies, and have histories of hypertension than those without COVID-19. In analysis adjusted for confounders (maternal age, body mass index, smoking, parity, history of diabetes or hypertension, number of pregnancies, and assisted conception), pregnant women with COVID-19 had significantly higher risk for preeclampsia/eclampsia (adjusted odds ratio [aOR], 2.0), gestational hypertension (aOR, 1.7), amniotic infection (aOR, 2.2), preterm birth (aOR, 2.5), fetal distress (aOR, 1.4), postpartum hemorrhage (aOR, 1.7), cesarean delivery (aOR, 1.8), ICU admission (unadjusted OR, 50.8), and death (OR, 82.9).