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

Laura D Zambrano, Sascha Ellington, Penelope Strid, Romeo R Galang, Titilope Oduyebo, Van T Tong, Kate R Woodworth, John F Nahabedian 3rd, Eduardo Azziz-Baumgartner, Suzanne M Gilboa, Dana Meaney-Delman, CDC COVID-19 Response Pregnancy and Infant Linked Outcomes Team, Amanda Akosa, Carolyne Bennett, Veronica Burkel, Daniel Chang, Augustina Delaney, Charise Fox, Isabel Griffin, Jason Hsia, Katie Krause, Elizabeth Lewis, Susan Manning, Yousra Mohamoud, Suzanne Newton, Varsha Neelam, Emily O'Malley Olsen, Mirna Perez, Megan Reynolds, Aspen Riser, Maria Rivera, Nicole M Roth, Christina Sancken, Neha Shinde, Ashley Smoots, Margaret Snead, Bailey Wallace, Florence Whitehill, Erin Whitehouse, Lauren Zapata, Laura D Zambrano, Sascha Ellington, Penelope Strid, Romeo R Galang, Titilope Oduyebo, Van T Tong, Kate R Woodworth, John F Nahabedian 3rd, Eduardo Azziz-Baumgartner, Suzanne M Gilboa, Dana Meaney-Delman, CDC COVID-19 Response Pregnancy and Infant Linked Outcomes Team, Amanda Akosa, Carolyne Bennett, Veronica Burkel, Daniel Chang, Augustina Delaney, Charise Fox, Isabel Griffin, Jason Hsia, Katie Krause, Elizabeth Lewis, Susan Manning, Yousra Mohamoud, Suzanne Newton, Varsha Neelam, Emily O'Malley Olsen, Mirna Perez, Megan Reynolds, Aspen Riser, Maria Rivera, Nicole M Roth, Christina Sancken, Neha Shinde, Ashley Smoots, Margaret Snead, Bailey Wallace, Florence Whitehill, Erin Whitehouse, Lauren Zapata

Abstract

Studies suggest that pregnant women might be at increased risk for severe illness associated with coronavirus disease 2019 (COVID-19) (1,2). This report provides updated information about symptomatic women of reproductive age (15-44 years) with laboratory-confirmed infection with SARS-CoV-2, the virus that causes COVID-19. During January 22-October 3, CDC received reports through national COVID-19 case surveillance or through the National Notifiable Diseases Surveillance System (NNDSS) of 1,300,938 women aged 15-44 years with laboratory results indicative of acute infection with SARS-CoV-2. Data on pregnancy status were available for 461,825 (35.5%) women with laboratory-confirmed infection, 409,462 (88.7%) of whom were symptomatic. Among symptomatic women, 23,434 (5.7%) were reported to be pregnant. After adjusting for age, race/ethnicity, and underlying medical conditions, pregnant women were significantly more likely than were nonpregnant women to be admitted to an intensive care unit (ICU) (10.5 versus 3.9 per 1,000 cases; adjusted risk ratio [aRR] = 3.0; 95% confidence interval [CI] = 2.6-3.4), receive invasive ventilation (2.9 versus 1.1 per 1,000 cases; aRR = 2.9; 95% CI = 2.2-3.8), receive extracorporeal membrane oxygenation (ECMO) (0.7 versus 0.3 per 1,000 cases; aRR = 2.4; 95% CI = 1.5-4.0), and die (1.5 versus 1.2 per 1,000 cases; aRR = 1.7; 95% CI = 1.2-2.4). Stratifying these analyses by age and race/ethnicity highlighted disparities in risk by subgroup. Although the absolute risks for severe outcomes for women were low, pregnant women were at increased risk for severe COVID-19-associated illness. To reduce the risk for severe illness and death from COVID-19, pregnant women should be counseled about the importance of seeking prompt medical care if they have symptoms and 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. Understanding COVID-19-associated risks among pregnant women is important for prevention counseling and clinical care and treatment.

Conflict of interest statement

All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.

References

    1. Ellington S, Strid P, Tong VT, et al. Characteristics of women of reproductive age with laboratory-confirmed SARS-CoV-2 infection by pregnancy status—United States, January 22–June 7, 2020. MMWR Morb Mortal Wkly Rep 2020;69:769–75. 10.15585/mmwr.mm6925a1
    1. Allotey J, Stallings E, Bonet M, et al.; PregCOV-19 Living Systematic Review Consortium. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ 2020;370:m3320. 10.1136/bmj.m3320
    1. Woodworth KR, Olsen EO, Neelam V, et al. Birth and infant outcomes following laboratory-confirmed SARS-CoV-2 infection in pregnancy—SET-NET, 16 jurisdictions, March 29–October 14, 2020. MMWR Morb Mortal Wkly Rep 2020;69. Epub November 2, 2020.
    1. Vlachodimitropoulou Koumoutsea E, Vivanti AJ, Shehata N, et al. COVID-19 and acute coagulopathy in pregnancy. J Thromb Haemost 2020;18:1648–52. 10.1111/jth.14856
    1. Ramsey PS, Ramin KD. Pneumonia in pregnancy. Obstet Gynecol Clin North Am 2001;28:553–69. 10.1016/S0889-8545(05)70217-5
    1. Lipsitch M, Donnelly CA, Fraser C, et al. Potential biases in estimating absolute and relative case-fatality risks during outbreaks. PLoS Negl Trop Dis 2015;9:e0003846. 10.1371/journal.pntd.0003846
    1. World Health Organization. Immunization, vaccines and biologicals: national passive surveillance. Geneva, Switzerland: World Health Organization; 2020.
    1. Mertz D, Lo CK, Lytvyn L, Ortiz JR, Loeb M; FLURISK-INVESTIGATORS. Pregnancy as a risk factor for severe influenza infection: an individual participant data meta-analysis. BMC Infect Dis 2019;19:683. 10.1186/s12879-019-4318-3
    1. Rasmussen SA, Jamieson DJ, Uyeki TM. Effects of influenza on pregnant women and infants. Am J Obstet Gynecol 2012;207(Suppl):S3–8. 10.1016/j.ajog.2012.06.068

Source: PubMed

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