COVID-19 Increases ICU Risk Among Pregnant Women

The article, “Pregnant Women with COVID-19 Are at Increased Risk of ICU Admission,” was originally published online on ContagionLive.

Pregnant women who contracted coronavirus disease 2019 (COVID-19) have more hospitalizations and are at an increased risk of intensive care unit admission and mechanical ventilation.

A team of investigators found 31.5% of pregnant women with COVID-19 were reported to have been hospitalized compared to just 5.8% of nonpregnant women.

The study, highlighted in a recent Morbidity and Mortality Weekly Report from the US Centers for Disease Control and Prevention (CDC), demonstrated pregnant women were more likely to be admitted to the ICU (aRR = 1.5, 95% confidence interval [CI] = 1.2—1.8) and receive mechanical ventilation (aRR = 1.7, 95% CI = 1.2–2.4).

The study period ran from January 22—June 7, with 326,335 women ages 15-44 testing positive. Of the COVID-19 positive group, 8207 were pregnant.

And Hispanic and black women who are pregnant appear to be at a greater risk to contract COIVD-19, according to the report.

In the COVID-19 pregnant grouping, Hispanics made up 46.2% of the overall group, whites were 23.0%, blacks made up 22.1%, and Asians made up 3.8%.

“These findings suggest that pregnant women who are Hispanic and black might be disproportionately affected by SARS-CoV-2 infection during pregnancy,” the MMWR reported.

In terms of mortality, both groups displayed similar results. In the pregnancy group, there were 16 (0.2%) COVID-19—related deaths, and among nonpregnant women, 208 (0.2%) such deaths.

In terms of limitations, the investigators listed the missing pregnancy status for three-quarters of women of reproductive age with the virus; the need for additional time to see the prevalence of outcomes; data on patients’ pregnancy trimester at the time of infection or whether the hospitalization was related to pregnancy conditions rather than for COVID-19; and routine case surveillance does not capture pregnancy or birth outcomes. The investigators stated that it remained unclear whether COVID-19 during pregnancy is associated with adverse pregnancy outcomes.

In looking to address the aforementioned data gaps, CDC has initiated COVID-19 pregnancy-related surveillance to report pregnancy-related information and outcomes in pregnant women with COVID-19. CDC will be collaborating with local health departments.

“To reduce severe COVID-19-associated illness, pregnant women should be aware of their potential risk for severe COVID-19 illness,” the MMWR stated.