Perinatal Complications in Individuals in California With or Without SARS-CoV-2 Infection During Pregnancy

• DOI: 10.1001/jamainternmed.2022.0330
• Publication Date: 2022-03-21T15:36:25Z
• Authors: Assiamira Ferrara; Monique M. Hedderson; Yeyi Zhu; Lyndsay A. Avalos; Michael W. Kuznie...; Laura C. Myers; Amanda L. Ngo; Erica P. Gunderson; Jenna L. Ritchie; Charles P. Quesen...; Mara Greenberg
• Keywords: Adult; SARS-CoV-2; Infant, Newborn; Pregnancy Outcome; COVID-19; Venous Thromboembolism; 3. Good health; Cohort Studies; 03 medical and health sciences; 0302 clinical medicine; Pregnancy; Humans; Premature Birth; Female; Pregnancy Complications, Infectious

<h3>Importance</h3> Additional research from population-based studies is needed to inform the treatment of SARS-CoV-2 infection during pregnancy and provide health risk information pregnant individuals. <h3>Objective</h3> To assess perinatal complications associated with describe factors hospitalizations. <h3>Design, Setting, Participants</h3> This cohort study included 43 886 individuals longitudinal electronic record data preconception delivery who delivered at Kaiser Permanente Northern California between March 1, 2020, 16, 2021. Individuals diagnostic codes for COVID-19 that did not have a confirmatory polymerase chain reaction test were excluded. <h3>Exposures</h3> detected by (from 30 days before conception 7 after delivery) as time varying exposure. <h3>Main Outcomes Measures</h3> Severe maternal morbidity including 21 conditions (eg, acute myocardial infarction, renal failure, respiratory distress syndrome, sepsis) occurred any or delivery; preterm birth; hypertensive disorders; gestational diabetes; venous thromboembolism (VTE); stillbirth; cesarean newborn birth weight conditions. Standardized mean differences without calculated. Cox proportional hazards regression was used estimate hazard ratios (HRs) 95% CIs association hospitalization consider timing relative outcomes. <h3>Results</h3> In this (mean [SD] age, 30.7 [5.2] years), (1332 [3.0%]) more likely be younger, Hispanic, multiparous higher neighborhood deprivation index obesity chronic hypertension. After adjusting demographic characteristics, comorbidities, smoking status, had severe (HR, 2.45; CI, 1.91-3.13), (&lt;37 weeks; HR, 2.08; 1.75-2.47), VTE 3.08; 1.09-8.74) than SARS-CoV-2. also increased medically indicated 2.56; 2.06-3.19); spontaneous 1.61; 1.22-2.13); early 2.52; 1.49-4.24), moderate 2.18; 1.25-3.80), late 1.95; 1.61-2.37) birth. Among infection, 76 (5.7%) hospitalization; pregestational diabetes 7.03; 2.22-22.2) Asian Pacific Islander 2.33; 1.06-5.11) Black 3.14; 1.24-7.93) race ethnicity an hospitalization. <h3>Conclusions Relevance</h3> study, morbidity, birth, VTE. The findings clinicians patients about in support vaccination those planning conception.