R J Martinez-Portilla1,2,3, A Sotiriadis4, C Chatzakis4, J Torres-Torres1,2, S Espino Y Sosa1,2, K Sandoval-Mandujano1,2, D A Castro-Bernabe1,2, V Medina-Jimenez2,5, J C Monarrez-Martin2, F Figueras3, L C Poon6. 1. Clinical Research Division, National Institute of Perinatology "Isidro Espinosa de lo Reyes", Mexico City, Mexico. 2. Iberoamerican Research Network in Obstetrics, Gynecology and Translational Medicine. Mexico City, Mexico. 3. Fetal Medicine Research Center, BCNatal. Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Institut Clínic de Ginecologia, Obstetricia i Neonatologia, Universitat de Barcelona, Barcelona, Catalonia, Spain. 4. Second Department of Obstetrics and Gynaecology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece. 5. State center for timely prenatal screening (CETO), Leon Guanajuato, Mexico. 6. Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
Abstract
BACKGROUND: Limited, unmatched data reported low complication rates in pregnant women with COVID-19. This study compared COVID-19-related outcomes in pregnant women versus non-pregnant women after adjusting for potential risk factors for severe outcomes. METHODS: Data were obtained from the COVID-19 National Data Registry of Mexico, which is an ongoing prospective cohort of people of any age with clinically suspected SARS-CoV-2 infection and admitted to 475 monitoring hospitals. This study included pregnant and non-pregnant women of reproductive age (15-49 y) with COVID-19 confirmed by reverse transcription polymerase chain reaction. To adjust for underlying risk factors, propensity score matching was conducted for chronic obstructive pulmonary disease, asthma, smoking, hypertension, cardiovascular disease, obesity, diabetes, and age. The primary outcome was death. Secondary outcomes were pneumonia, intubation, and intensive care unit (ICU) admission. RESULTS: The initial sample comprised of 5183 pregnant and 175,908 non-pregnant COVID-19 patients. The crude (unmatched) rates of death, pneumonia, intubation, and ICU admission in pregnant and non-pregnant women were 1.5% vs. 1.5%, 9.9% vs. 6.5%, 8.1% vs. 9.9%, 13.0% vs. 6.9%, respectively. After propensity score matching (5183 pregnant- and 5183 non-pregnant matched women), pregnant women had higher odds of death (odds ratio [OR] 1·65, 95% CI 1·30-2.09), pneumonia (OR 1·99, 95% CI 1·81-2·19) and ICU admission (OR 2.25, 95% CI 1·86-2·71) than non-pregnant women, but similar odds of intubation (OR 0·93, 95% CI 0·70-1·25). CONCLUSIONS: After adjusting for background demographic and medical factors, pregnancy is a risk factor for death, intubation and ICU admission in SARS-CoV-2-infected women of reproductive age. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
BACKGROUND: Limited, unmatched data reported low complication rates in pregnant women with COVID-19. This study compared COVID-19-related outcomes in pregnant women versus non-pregnant women after adjusting for potential risk factors for severe outcomes. METHODS: Data were obtained from the COVID-19 National Data Registry of Mexico, which is an ongoing prospective cohort of people of any age with clinically suspected SARS-CoV-2 infection and admitted to 475 monitoring hospitals. This study included pregnant and non-pregnant women of reproductive age (15-49 y) with COVID-19 confirmed by reverse transcription polymerase chain reaction. To adjust for underlying risk factors, propensity score matching was conducted for chronic obstructive pulmonary disease, asthma, smoking, hypertension, cardiovascular disease, obesity, diabetes, and age. The primary outcome was death. Secondary outcomes were pneumonia, intubation, and intensive care unit (ICU) admission. RESULTS: The initial sample comprised of 5183 pregnant and 175,908 non-pregnant COVID-19patients. The crude (unmatched) rates of death, pneumonia, intubation, and ICU admission in pregnant and non-pregnant women were 1.5% vs. 1.5%, 9.9% vs. 6.5%, 8.1% vs. 9.9%, 13.0% vs. 6.9%, respectively. After propensity score matching (5183 pregnant- and 5183 non-pregnant matched women), pregnant women had higher odds of death (odds ratio [OR] 1·65, 95% CI 1·30-2.09), pneumonia (OR 1·99, 95% CI 1·81-2·19) and ICU admission (OR 2.25, 95% CI 1·86-2·71) than non-pregnant women, but similar odds of intubation (OR 0·93, 95% CI 0·70-1·25). CONCLUSIONS: After adjusting for background demographic and medical factors, pregnancy is a risk factor for death, intubation and ICU admission in SARS-CoV-2-infectedwomen of reproductive age. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
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