Category: Infectious Diseases
Poster Session III
Although recent research supports an increased incidence of preeclampsia and preterm birth and COVID-19 disease during pregnancy, more high quality evidence is needed to further elucidate this association. The objective of this study is to further assess the relationship between SARS-CoV-2 infection and the risk of preeclampsia and preterm birth.
Study Design:
We performed a prospective cohort study at two urban tertiary care centers enrolling pregnant patients among two cohorts: cases (SARS-CoV-2 positive during pregnancy), and controls (SARS-CoV-2 negative by antibody testing at the beginning of pregnancy, every trimester and delivery), from 12/23/21-7/18/22. The primary outcome was the incidence of hypertensive disorders of pregnancy, preterm labor, and intrauterine fetal demise. The secondary outcomes were obstetric outcomes (mode of delivery, APGAR at 5 mins, umbilical artery pH) and neonatal morbidities. Multivariable logistic regression was used to adjust for confounders.
Results:
350 patients were enrolled: 143 unexposed and 207 exposed. Compared to unexposed patients, exposed patients were more likely to be Black (51.7% vs 31.9%, p< 0.01), publicly insured (46.4% vs 22.4%, p< 0.01), have pre-existing cardiovascular disease (4.0% vs 0%, p=0.04), diabetes (8.6% vs 1.9%, p=0.03), and unvaccinated against COVID-19 (34.3% vs 62.2%, p< 0.01, Table 1). COVID-19 was diagnosed at a mean gestation of 21.2 weeks, and there was no difference between cohorts in delivery gestation age of 38.1 weeks. Exposed patients had higher odds of developing hypertensive disorders of pregnancy (aOR 2.7, 95% CI 1.25-5.81), specifically gestational hypertension (aOR 3.71.4-10.1). There was no difference between cohorts for preterm birth (16.8% vs 15.9%), delivery outcomes, or neonatal morbidities (Table 2). There were no cases of intrauterine fetal demise in either cohort.
Conclusion:
A positive association between maternal COVID-19 infection and hypertensive disorders of pregnancy was shown in a multi-site prospective cohort of patients.
James D. Doss, MD (he/him/his)
Resident Physician
Washington University School of Medicine
St. Louis, Missouri, United States
Anthony O. Odibo, MD
Professor
Washington University School of Medicine
St. Louis, Missouri, United States
Fan Zhang, MD, MS
Washington University School of Medicine
St. Louis, Missouri, United States
Nandini Raghuraman, MD,MSc (she/her/hers)
Assistant Professor
Barnes Jewish Hospital, Washington University in St Louis
St. Louis, Missouri, United States
Ebony B. Carter, MD, MPH (she/her/hers)
Associate Professor, MFM; Chief, Division of Clinical Resarch
Washington University School of Medicine
St. Louis, Missouri, United States
Michael Dombrowski, MD
Washington University in St.Louis
St. Louis, Missouri, United States
Grace Gerbi, BA
Research Assistant
Washington University School of Medicine
St. Louis, Missouri, United States
Emily Diveley, BSN, N/A
Washington University in St.Louis
St. Louis, Missouri, United States
Indira U. Mysorekar, PhD
Professor of Obstetrics, Gynecology, Infectious Disease, and Medicine
Washington University School of Medicine and Baylor College of Medicine
Houston, Texas, United States
Jeannie C. Kelly, MD,FACOG,MS
Associate Professor
Washington University School of Medicine
St. Louis, Missouri, United States