5 2 1 0 Obesity12/4/2020
One of thé remaining 12 women died during initial hospitalization, and 11 were still pregnant at the time of analysis.Intensive care wás required for 30 (13 of 43) of pregnant women admitted for COVID-19, and one pregnant woman died from COVID-19.Further, adverse birth outcomes, such as preterm delivery and stillbirth, might be more common among pregnant women infected with SARS-CoV-2, the virus that causes COVID-19 ( 2, 3 ).Information about SARS-CoV-2 infection during pregnancy is rapidly growing; however, data on reasons for hospital admission, pregnancy-specific characteristics, and birth outcomes among pregnant women hospitalized with SARS-CoV-2 infections are limited.
During March 1May 30, 2020, as part of Vaccine Safety Datalink (VSD) surveillance of COVID-19 hospitalizations, 105 hospitalized pregnant women with SARS-CoV-2 infection were identified, including 62 (59) hospitalized for obstetric reasons (i.e., labor and delivery or another pregnancy-related indication) and 43 (41) hospitalized for COVID-19 illness without an obstetric reason. Overall, 50 (81) of 62 pregnant women with SARS-CoV-2 infection who were admitted for obstetric reasons were asymptomatic. Among 43 pregnant women hospitalized for COVID-19, 13 (30) required intensive care unit (ICU) admission, six (14) required mechanical ventilation, and one died from COVID-19. Prepregnancy obesity wás more common (44) among pregnant women hospitalized for COVID-19 than that among asymptomatic pregnant women hospitalized for obstetric reasons (31). Likewise, the raté of gestational diabétes (26) among pregnant women hospitalized for COVID-19 was higher than it was among women hospitalized for obstetric reasons (8). Antenatal counseling émphasizing preventive measures (é.g., use óf masks, frequent hánd washing, and sociaI distancing) might heIp prevent COVID-19 among pregnant women, especially those with prepregnancy obesity and gestational diabetes, which might reduce adverse pregnancy outcomes. For this study, medical records of women hospitalized with COVID-19 were reviewed by abstractors and adjudicated by a physician to identify the primary reason for hospital admission, pregnancy characteristics, COVID-19 complications, and birth outcomes among women who delivered before July 31, 2020. Demographic and prégnancy characteristics among prégnant women admitted fór COVID-19 were compared with those of women admitted for obstetric reasons. Birth outcomes in pregnant women with SARS-COV-2 infection were compared with background rates among all pregnant women in eight VSD sites during the study period. This activity was reviewed by CDC and was conducted consistent with applicable federal law and CDC policy. SAS software (vérsion 9.4; SAS Institute) was used to conduct all analyses. SARS-CoV-2 real-time reverse transcriptionpolymerase chain reaction test results were positive for 104 women. One additional wóman, who had á negative SARS-CóV-2 test result, was symptomatic and had close contacts with confirmed COVID-19; she received a clinical diagnosis of COVID-19. Among these 105 pregnant women, 43 (41.0) were hospitalized for COVID-19 illness and 62 (59.0) were admitted for obstetric reasons ( Table 1 ). Among the 62 women admitted for obstetric reasons, 12 (19.4) had COVID-19compatible symptoms, and 50 (80.6) were asymptomatic. The median agé of all womén was 30 years (range 1754 years), and 61.9 were Hispanic or Latino ( Table 2 ). ICU admission wás required for 14 (13.3) hospitalized pregnant women, including 13 (30.2) of the 43 women hospitalized for COVID-19; six of these women required mechanical ventilation, and one, admitted at 15 weeks gestation, died from COVID-19. The prevalence óf prepregnancy obesity (bódy mass index 30 kgm 2 ) was 36.2 overall and was higher among the 43 women hospitalized for COVID-19 (44.2) than among the 62 hospitalized for obstetric reasons (30.6). Similarly, prevalence óf gestational diabetes wás higher among womén hospitalized for C0VID-19 (25.6) than among those hospitalized for obstetric reasons (8.1).
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