Risk factors for illness severity among pregnant women with confirmed SARS-CoV-2 infection – Surveillance for Emerging Threats to Mothers and Babies Network, 20 state, local, and territorial health departments, March 29, 2020 -January 8, 2021

  1. Romeo R. Galang
  2. Suzanne M. Newton
  3. Kate R. Woodworth
  4. Isabel Griffin
  5. Titilope Oduyebo
  6. Christina L. Sancken
  7. Emily O’Malley Olsen
  8. Kathy Aveni
  9. Heather Wingate
  10. Hanna Shephard
  11. Chris Fussman
  12. Zahra S. Alaali
  13. Samantha Siebman
  14. Umme-Aiman Halai
  15. Camille Delgado Lopez
  16. Jerusha Barton
  17. Mamie Lush
  18. Paul H. Patrick
  19. Levi Schlosser
  20. Ayomide Sokale
  21. Ifrah Chaudhary
  22. Bethany Reynolds
  23. Similoluwa Sowunmi
  24. Nicole Gaarenstroom
  25. Jennifer S. Read
  26. Sarah Chicchelly
  27. Leah de Wilde
  28. Eduardo Azziz-Baumgartner
  29. Aron J. Hall
  30. Van T. Tong
  31. Sascha Ellington
  32. Suzanne M. Gilboa
  33. CDC COVID-19 Response Pregnancy and Infant Linked Outcomes Team
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Abstract

Background

Pregnant women with coronavirus disease 2019 (COVID-19) are at increased risk for severe illness compared with nonpregnant women. Data to assess risk factors for illness severity among pregnant women with COVID-19 are limited. This study aimed to determine risk factors associated with COVID-19 illness severity among pregnant women with SARS-CoV-2 infection.

Methods

Pregnant women with SARS-CoV-2 infection confirmed by molecular testing were reported during March 29, 2020–January 8, 2021 through the Surveillance for Emerging Threats to Mothers and Babies Network (SET-NET). Criteria for illness severity (asymptomatic, mild, moderate-to-severe, or critical) were adapted from National Institutes of Health and World Health Organization criteria. Crude and adjusted risk ratios for moderate-to-severe or critical COVID-19 illness were calculated for selected demographic and clinical characteristics.

Results

Among 5,963 pregnant women with SARS-CoV-2 infection, moderate-to-severe or critical COVID-19 illness was associated with age 30–39 years, Black/Non-Hispanic race/ethnicity, healthcare occupation, pre-pregnancy obesity, chronic lung disease, chronic hypertension, cardiovascular disease, and pregestational diabetes mellitus. Risk of moderate-to-severe or critical illness increased with the number of underlying medical or pregnancy-related conditions.

Conclusions

Pregnant women with moderate-to-severe or critical COVID-19 illness were more likely to be older and have underlying medical conditions compared to pregnant women with asymptomatic infection or mild COVID-19 illness. This information might help pregnant women understand their risk for moderate-to-severe or critical COVID-19 illness and inform targeted public health messaging.

Summary

Among pregnant women with COVID-19, older age and underlying medical conditions were risk factors for increased illness severity. These findings can be used to inform pregnant women about their risk for severe COVID-19 illness and public health messaging.

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