Study: Pregnant Women With COVID-19 Face Greater Risk of Hospitalization, ICU Admission

Findings show that key factors include age, infecting variant, underlying illnesses, and vaccination status.

Pregnant women are at a greater risk of severe illness if they contract COVID-19 than non-pregnant women of childbearing age, according to findings of a study presented at the European Congress of Clinical Microbiology & Infectious Diseases in Lisbon, Portugal, from April 23, 2022, to April 26, 2022.

The results show that key risk factors include age, infecting variant, underlying illnesses, and vaccination status.

Additionally, investigators found that women were half as likely to be admitted to the intensive care unit (ICU) or hospitalized after just 1 dose of the COVID-19 vaccine and were even less likely to with 2 or more doses.

Pregnancy is associated with increased vulnerability to severe outcomes from infectious diseases for both infants and mothers. Although pregnant women could be reluctant to get the COVID-19 vaccination, the infection could have many health consequences for these women.

Investigators analyzed data from a population-based SARS-CoV-2 case file between March 16, 2020, and January 4, 2022, to determine the severity of COVID-19 outcomes for pregnant women.

Because of the dominant viral strain and likelihood of vaccination changing over time, investigators conducted a time-matched cohort study that evaluated the relative risk of severe illness in pregnant women with COVID-19 matched to COVID-19 infected females between age 10 and 49 years by date of laboratory-confirmed SARS-CoV-2.

Investigators included more than 13,600 women from Ontario’s Case and Contact Management database and compared each pregnant woman affected by COVID-19 to 5 non-pregnant women of reproductive age with COVID-19, who were matched by test date of positive SARS-CoV-2 infection.

Modeling was used to estimate the risk of severe COVID-19 outcomes of hospitalization and ICU admissions in pregnant and non-pregnant women after adjusting for age, health care worker status, infecting variant, other illnesses, and vaccination status. There were fewer than 5 maternal COVID-19 deaths during the study, so the risk of dying during pregnancy could not be evaluated.

The analyses found that though pregnant women were only half as likely to have a SARS-CoV-2 infection relative to the general population, they were 5 times as likely to be admitted to the hospital with COVID-19 compared with those who were not pregnant. They were more than 6 times as likely to require treatment in the ICU.

Investigators also found that healthy pregnant women were more than 5 times as likely to be hospitalized as healthy non-pregnant women, while pregnant women with underlying illnesses were only twice as likely to be hospitalized as non-pregnant women with comorbidities.

“These findings suggest that in otherwise healthy women, pregnancy itself seems to be a factor that increases illness severity, while among women with comorbidities it becomes one of several factors that augment risk,” Kiera Murison, a student epidemiologist from the University of Toronto, said in the statement. “Our findings underscore the need for clear accurate information to reassure pregnant women and tackle concerns about COVID-19 vaccine safety.”

The findings emphasize the importance of pregnant women getting vaccinated against COVID-19, investigators said.

Reference

Pregnant women with COVID-19 face greater risk of hospitalization and ICU admission, strengthening case for vaccination. EurekAlert. News release. April 24, 2022. Accessed April 26, 2022. https://www.eurekalert.org/news-releases/950558