(234) Characteristics of Women with COVID-19 During Pregnancy in a US Health Insurance Claims Database

Publication Number: 565

Background: The effect of COVID-19 on pregnant women is an important and rapidly progressing area of study.

Objectives: To describe women with and without COVID-19 in pregnancy, including demographics, comorbidities, and medication use.

Methods: Using the Optum Dynamic Assessment of Pregnancies and Infants (DAPI) database, pregnancies that started and ended between 01 April 2020 and 31 October 2021 were identified. COVID status was determined by ICD-10 codes and SARS-CoV-2 viral test results (identified using LOINC codes and test descriptions). Pregnancies with at least one positive test or ICD-10 code U07.1 or U07.2 were confirmed positive (CP). The remaining tested pregnancies were categorized as negative (CN) if at least one negative test was recorded or uncertain (CU) if no clear result was observed during pregnancy. Demographic characteristics and comorbidities were assessed during the year prior to pregnancy start while medications received were assessed 14 days before or after the COVID test or diagnosis.

Results: We identified 132,944 pregnancies (124,316 women) during the study period. Of these, 8,585 (6.5%) had a positive COVID test (1,695; 1.3%) or diagnosis (6,890; 5.2%), 11,148 (8.4%) had a negative test, and 1,018 (0.77%) had an unclear test result. Women in the CP group were younger (mean[std] 30.3[5.6] years) than women in the CN (31.7[5.3] years) and CU (32.6[5.1] years) groups and had fewer physician visits in the year prior to pregnancy (median 2.0 in CP, 3.0 in CN, and 3.0 in CU). Obesity was the most common comorbidity in all groups ranging from 6.8% in the CP group to 5.4% in the CN group. Asthma prevalence was similar in all groups (4.1% in CP and 4.4% in CN and CU). The percentages of women receiving at least 1 dose of a COVID vaccine during pregnancy were: 13.5%, 26.5% and 23.8% in the CP, CN and CU groups. Less than 8% of pregnancies in any group were dispensed medication within 14 days of test or diagnosis. Ibuprofen was the most common in CP (7.6%) followed by azithromycin (5.5%) and albuterol (4.2%). These percentages were 6.4 and 4.0 for ibuprofen, 1.9 and 1.3 for azithromycin, and 1.3 and 1.4 for albuterol in the CN and CU groups, respectively

Conclusions: The observed age and healthcare utilization differences may be due to the requirement that women in the CN and CU groups were tested, while the majority of the CP group did not have a recorded COVID test. Vaccination data are likely underestimated given the availability of vaccines midway through the study period and the lag between vaccination, claims submission and processing. Our results provide information about clinical and demographic characteristics of women with COVID-19 during pregnancy in the US during the first 1 ½ years of the pandemic.