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Indicators of Cardiometabolic Function in Pregnancy and Long-Term Risk of COVID-19: Population-Based Cohort Study

Joel G Ray1,2, Eyal Cohen3, Emily Ana Butler4

  • 1Obstetrical Medicine, University of Toronto, Toronto, CAN.

Cureus
|March 27, 2023
PubMed

Insights

Metabolic dysfunction markers during pregnancy, such as higher body mass index (BMI) and glucose levels, predict severe COVID-19 risk later. These indicators identify women at increased risk for adverse outcomes post-pregnancy.

Area of Science:

  • Reproductive Health
  • Infectious Disease Epidemiology
  • Metabolic Health

Background:

  • Pregnancy elevates women's risk of severe COVID-19, particularly those with metabolic dysfunction.
  • The association between common pregnancy-assessed metabolic dysfunction markers and postpartum COVID-19 severity is not well understood.

Purpose of the Study:

  • To investigate if metabolic dysfunction indicators measured during pregnancy predict the risk of severe COVID-19 after childbirth.
  • To evaluate the relationship between body mass index (BMI), glucose challenge test results, and gestational age at delivery with subsequent COVID-19 outcomes.

Main Methods:

  • A population-based cohort study in Ontario included 417,713 women with hospital births between April 2007 and March 2018.
  • Key exposures included higher body mass index (BMI), elevated glucose challenge test concentrations, and earlier gestational age at delivery.
  • Severe COVID-19 illness or death from March 2020 to December 2021 was the primary outcome.

Main Results:

  • Increased BMI, higher glucose levels, and earlier delivery gestational age were associated with a higher adjusted hazard ratio (aHR) for COVID-19 illness.
  • The aHR for severe COVID-19 increased significantly with the number of risk factors present (one factor: 1.60, two factors: 3.34, three factors: 4.52).

Conclusions:

  • The quantity and severity of standard metabolic indicators assessed during pregnancy are predictive of future severe COVID-19 risk.
  • These findings highlight the importance of monitoring metabolic health during pregnancy for long-term health surveillance.
Abstract

Keywords:
body mass indexcovid-19hyperglycemiametabolic syndromeobstetricspregnancyprematuritysars-cov-2

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