COVID-19 associated with maternal deaths/morbidity

A large national cohort study found that maternal mortality or serious morbidity from obstetric complications is associated with the SARS-CoV-2 virus among pregnant and postpartum individuals, reported Torri D. Metz, MD, MS, and colleagues. Dr. Metz is from the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City.

In this retrospective study1 conducted from March 1 to December 31, 2020, at 17 centers in the US, the primary outcome was a composite of maternal death or serious morbidity related to hypertensive disorders of pregnancy, postpartum hemorrhage, or infection other than SARS-CoV-2. The secondary outcome was cesarean birth among the over 14,000 study patients (mean age, 29.7 years).

The authors found that 2,352 patients had a SARS-CoV-2 infection, and 11,752 did not have a positive SARS-CoV-2 test result.

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When compared with those without a positive SARS-CoV-2 test result, they found that the SARS-CoV-2 infection was associated significantly with the primary outcome (13.4% vs. 9.2%).

Five maternal deaths occurred that were all in the SARS-CoV-2 group. The virus was not associated significantly with births by cesarean section (34.7% vs 32.4%, respectively).

Moderate or severe COVID-19 infection was associated with the primary outcome, compared with those without a positive SARS-CoV-2 test result (26.1% vs 9.2%) and cesarean birth (45.4% vs. 32.4%).

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Mild or asymptomatic infection was not associated significantly with the primary outcome (9.2% vs 9.2%) or cesarean birth (31.2% vs 32.4%).

The study conclusion was that “Among pregnant and postpartum individuals at 17 US hospitals, SARS-CoV-2 infection was associated with an increased risk for a composite outcome of maternal mortality or serious morbidity from obstetric complications.”

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Reference

Metz TD, Clifton RG, Hughes BL, et al. for the National Institute of Child Health and Human Development Maternal-Fetal Medicine Units (MFMU) Network. Association of SARS-CoV-2 infection with serious maternal morbidity and mortality from obstetric complications. JAMA published online February 7, 2022. doi:10.1001/jama.2022.1190