A meta-analysis of 12 studies published in 2020 and 2021 involving 13,136 pregnant women residing in 12 countries was recently published in BMJ Global Health. The studies included women infected during all three trimesters of pregnancy. The relative risk of death for pregnant women with SARS-CoV-2 infection was 7.68-fold higher than for uninfected pregnant women. The relative risk for ICU admission was 3.81-fold higher and the risk for receiving mechanical ventilation was 15.23-fold higher.
SARS-CoV-2 infected pregnant women had a 23-fold increased risk of developing pneumonia and a 5-fold higher risk for thromboembolic disease.
In addition, babies born to women with COVID19 were1.71-fold more likely to be born prematurely and 1.86-fold more likely to be admitted to a neonatal ICU after birth. SARS-CoV-2 infection during pregnancy did not appear to increase the risk of stillbirth at or beyond 28 weeks' gestation.
This was the largest study to date to demonstrate that pre-Omicron SARS-CoV-2 infection at any time during pregnancy increased the risk of maternal death, severe maternal illness, and adverse outcomes in newborns. The authors stressed the need for global efforts to prevent COVID19 during pregnancy through vaccination and nonpharmaceutical interventions.
Reference
Smith ER, Oakley E, Grandner GW Perinatal COVID PMA Study Collaborators, et al. Adverse maternal, fetal, and newborn outcomes among pregnant women with SARS-CoV-2 infection: an individual participant data meta-analysis. BMJ Global Health 2023;8:e009495.