COVID-19: confirmed in 1 in 10 pregnant or recently pregnant hospitalized women

  • Allotey J & al.
  • BMJ
  • 1 Sep 2020

  • curated by Liz Scherer
  • Clinical Essentials
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Takeaway

  • This WHO-funded systematic review found that 1 in 10 recently pregnant or pregnant women who are hospitalized have COVID-19.
  • This population has increased risk for ICU admission, the review authors found. 
  • Preterm birth risk is increased with COVID-19.

Why this matters

  • Telehealth appointments may balance need for multidisciplinary antenatal care against unnecessary virus exposure.

Key results 

  • 77 studies; 13,118 pregnant/recently pregnant women and 83,486 nonpregnant women of reproductive age.
  • Overall COVID-19 rate among pregnant/recently pregnant women:
    • 10% (95% CI, 7%-14%).
    • 26 studies; 11,432 women.
  • Compared with nonpregnant women with COVID-19, pregnant/recently pregnant women were (ORs; 95% CIs):
    • Less likely to have fever: 0.43 (0.22-0.85);
    • Less likely to have myalgia: 0.48 (0.45-0.51);
    • More likely to be admitted to ICU: 1.62 (1.33-1.96); 
    • More likely to need invasive ventilation: 1.88 (1.36-2.60).
  • Risk factors (ORs; 95% CIs) for severe COVID-19 in pregnancy:
    • Increased age (≥35 years): 1.78 (1.25-2.55);
    • High BMI (≥30 kg/m2): 2.38 (1.67-3.39);
    • Chronic hypertension: 2.0 (1.14-3.48);
    • Preexisting diabetes: 2.51 (1.31-4.80).
  • Preexisting comorbidities among pregnant women with COVID-19 were associated (ORs; 95% CIs) with:
    • ICU admission: 4.21 (1.06-16.72);
    • Invasive ventilation: 4.48 (1.40-14.37).
  • COVID-19 in pregnancy was associated (ORs; 95% CIs) with:
    • Preterm birth: 3.0 (1.15-7.85);
    • Neonatal ICU admission: 3.13 (2.05-4.78).
  • Heterogeneity among studies was low or nil.

Study design

  • Living systematic metareview.
  • Funding: WHO.

Limitations

  • Limited generalizability.
  • Small sample sizes.
  • Possible duplicate data.
  • Paucity of comparative data.