Maternal outcomes and risk factors for COVID-19 severity among pregnant women
Authors: Vouga Manon , Favre Guillaume , Martinez-Perez Oscar , Pomar Leo , Acebal Laura Forcen , Abascal-Saiz Alejandra , Hernandez Maria Rosa Vila , Hcini Najeh , Lambert Véronique , Carles Gabriel , Sichitiu Joanna , Salomon Laurent , Stirnemann Julien , Ville Yves , de Tejada Begoña Martinez , Goncé Anna , Hawkins-Villarreal Ameth , Castillo Karen , Solsona Eduard Gratacos , Trigo Lucas , Cleary Brian , Geary Michael , Bartels Helena , Al-Kharouf Feras , Malone Fergal , Higgins Mary , Keating Niamh , Knowles Susan , Poncelet Christophe , Ribeiro-do-Valle Carolina Carvalho , Surita Fernanda , Dantas-Silva Amanda , Borrelli Carolina , Luz Adriana Gomes , Fuenzalida Javiera , Carvajal Jorge , Canales Manuel Guerra , Hernandez Olivia , Grechukhina Olga , Ko Albert I. , Reddy Uma , Figueiredo Rita , Moucho Marina , Pinto Pedro Viana , De Luca Carmen , De Santis Marco , de Campos Diogo Ayres , Martins Inês , Garabedian Charles , Subtil Damien , Bohrer Betania , Da Rocha Oppermann Maria Lucia , Wender Maria Celeste Osorio , Schuler-Faccini Lavinia , Sanseverino Maria Teresa Vieira , Giugliani Camila , Friedrich Luciana , Scherer Mariana Horn , Mottet Nicolas , Ducarme Guillaume , Pelerin Helene , Moreau Chloe , Breton Bénédicte , Quibel Thibaud , Rozenberg Patrick , Giannoni Eric , Granado Cristina , Monod Cécile , Mueller Doris , Hoesli Irene , Bassler Dirk , Heldstab Sandra , Kölble Nicole Ochsenbein , Sentilhes Loïc , Charvet Melissa , Deprest Jan , Richter Jute , Van der Veeken Lennart , Eggel-Hort Béatrice , Plantefeve Gaetan , Derouich Mohamed , Calvache Albaro José Nieto , Lopez-Giron Maria Camila , Burgos-Luna Juan Manuel , Escobar-Vidarte Maria Fernanda , Hecher Kurt , Tallarek Ann-Christin , Hadar Eran , Haratz Karina Krajden , Amikam Uri , Malinger Gustavo , Maymon Ron , Yogev Yariv , Schäffer Leonhard , Toussaint Arnaud , Rossier Marie-Claude , De Sa Renato Augusto Moreira , Grawe Claudia , Aebi-Popp Karoline , Radan Anda-Petronela , Raio Luigi , Surbek Daniel , Böckenhoff Paul , Strizek Brigitte , Kaufmann Martin , Bloch Andrea , Boulvain Michel , Johann Silke , Heldstab Sandra Andrea , Bernasconi Monya Todesco , Grant Gaston , Feki Anis , Brochut Anne-Claude Muller , Giral Marylene , Sedille Lucie , Papadia Andrea , Brugger Romina Capoccia , Weber Brigitte , Fischer Tina , Kahlert Christian , Saines Karin Nielsen , Cambou Mary , Kanellos Panagiotis , Chen Xiang , Yin Mingzhu , Haessig Annina , Ackermann Sandrine , Baud David , Panchaud Alice 
Published: July 2021

Pregnant women may be at higher risk of severe complications associated with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which may lead to obstetrical complications. We performed a case control study comparing pregnant women with severe coronavirus disease 19 (cases) to pregnant women with a milder form (controls) enrolled in the COVI-Preg international registry cohort between March 24 and July 26, 2020. Risk factors for severity, obstetrical and immediate neonatal outcomes were assessed. A total of 926 pregnant women with a positive test for SARS-CoV-2 were included, among which 92 (9.9%) presented with severe COVID-19 disease. Risk factors for severe maternal outcomes were pulmonary comorbidities [aOR 4.3, 95% CI 1.9–9.5], hypertensive disorders [aOR 2.7, 95% CI 1.0–7.0] and diabetes [aOR2.2, 95% CI 1.1–4.5]. Pregnant women with severe maternal outcomes were at higher risk of caesarean section [70.7% (n = 53/75)], preterm delivery [62.7% (n = 32/51)] and newborns requiring admission to the neonatal intensive care unit [41.3% (n = 31/75)]. In this study, several risk factors for developing severe complications of SARS-CoV-2 infection among pregnant women were identified including pulmonary comorbidities, hypertensive disorders and diabetes. Obstetrical and neonatal outcomes appear to be influenced by the severity of maternal disease.