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Intrapartum and 30-Day Postpartum Complications in Patients With Antenatal COVID-19 Infection: A Retrospective Cohort
Sriya Donthi1, Jacqueline Kloos1, Kelly S Gibson2
1Case Western Reserve University School of Medicine, Cleveland, Ohio 44106, USA.
Insights
Pregnant individuals with antenatal COVID-19 faced higher risks of postpartum complications, including hemorrhage, hypertension, and cardiovascular issues. This finding highlights the importance of monitoring maternal health during and after pregnancy for those infected with COVID-19.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Public Health
Background:
- Antenatal COVID-19 infection in pregnant individuals may impact intrapartum and postpartum health.
- Understanding these risks is crucial for maternal healthcare and outcomes.
Purpose of the Study:
- To compare intrapartum and postpartum outcomes between pregnant patients with and without antenatal COVID-19 infection.
- To identify specific obstetric, cardiovascular, neurovascular, and respiratory complications associated with antenatal COVID-19.
Main Methods:
- Retrospective cohort study using deidentified electronic health record (EHR) data from over 80 healthcare organizations.
- Analysis of individuals admitted for delivery between January 2020 and May 2023, comparing those with and without COVID-19 diagnoses.
- Outcomes assessed included obstetric, cardiovascular, neurovascular, and respiratory complications within 30 days postpartum.
Main Results:
- 7% of 369,923 birthing parents had an antenatal COVID-19 diagnosis.
- Antenatal COVID-19 was associated with increased risks of postpartum hemorrhage, gestational hypertension, preeclampsia, eclampsia, and preterm labor.
- Significant increases in risks for cerebral infarction, cardiomyopathy, heart failure, sepsis, deep vein thrombosis (DVT), and pulmonary embolism were observed.
Conclusions:
- Individuals with antenatal COVID-19 experienced a higher likelihood of intrapartum and postpartum complications.
- Findings underscore the need for enhanced risk stratification and screening for prenatal care providers.
- This data can inform clinical practice and improve maternal care for pregnant individuals with COVID-19.
Abstract:
Objective: The study was aimed at comparing intrapartum and postpartum outcomes between pregnant patients with and without antenatal COVID-19 infection using aggregated, deidentified electronic health record (EHR) data. Design and Setting: This retrospective cohort study included data from over 80 health care organizations within the TriNetX Analytics Research Network. Population: Individuals admitted for delivery from Jan 2020 to May 2023 were studied. Methods: We studied individuals with ICD-10 codes for delivery, COVID-19 diagnosis, and primary outcomes. We compared the incidence of adverse intrapartum and 30-day postpartum outcomes in those with and without antenatal COVID-19. Main Outcome Measures: The main outcomes compared were obstetric, cardiovascular, neurovascular, and respiratory outcomes within 30 days postpartum. Results: Twenty-six thousand nine hundred seventy-four of 369,923 (7%) birthing parents with a delivery encounter had an antenatal COVID-19 diagnosis. Compared to matched controls, having COVID-19 was associated with an increased risk of postpartum hemorrhage (RR-1.24 (CI-1.16-1.33)), gestational hypertension (RR-1.27 (CI-1.27-1.34)), preeclampsia (RR-1.25 (CI-1.18-1.32)), eclampsia (RR-1.66 (CI-1.29-2.32)), preterm labor (RR-1.21 (CI-1.21-1.34)), cerebral infarction (RR-1.74 (CI-1.04-2.90)), cardiomyopathy (RR-2.08 (CI-1.30-3.32)), heart failure (RR-1.55 (CI-1.04-2.31)), sepsis (RR-2.21 (CI-1.54-3.19)), DVT (RR-2.32 (CI-1.45-3.71)), and pulmonary embolism (RR-2.68 (CI-1.74-2.90)). Conclusion: Individuals with antenatal COVID-19 were more likely to have intrapartum and postpartum obstetric, cardiovascular, neurovascular, and respiratory complications. This data will inform risk stratification and screening for prenatal care providers.
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