The following is a summary of “Outcomes and associations of severe COVID-19 in pregnancy; results from the CANCOVID-preg population surveillance study,” published in the FEBRUARY 2023 issue of Obstetrics and Gynecology by Atkinson A, et al.
There were encouraging initial reports on SARS-CoV-2 in pregnancy at the pandemic’s beginning. Pregnancy has been acknowledged as a risk factor for severe disease as numbers have grown internationally. There needed to be more cohort-level data available to guide the care of these instances. For a study, researchers sought to analyze the incidence and outcomes of severe cases of SARS-CoV-2 in pregnancy in Canada, including pre-and post-vaccination time points.
The Canadian Surveillance of COVID-19 in Pregnancy program was used to identify pregnancies affected by SARS-CoV-2 from March 2020 to October 2021. The focus was on severe cases requiring intensive care unit (ICU) or critical care unit (CCU) admission. ICU/CCU admission incidence in pregnant women with SARS-CoV-2 was compared to non-pregnant females with SARS-CoV-2.
Of 6,012 SARS-CoV-2-affected pregnancies, 121 (2%) required ICU admission. Pregnant women with SARS-CoV-2 had a 5.5 times higher risk of ICU/CCU admission than age-matched controls (RR 5.5, 95% CI 4.5-6.5). The median length of ICU admission was 4 days (IQR: 4-11), and 8.3% of cases required invasive mechanical ventilation. A few cases required extracorporeal membrane oxygenation or resulted in maternal death (<6). Increasing age was the main risk factor for ICU admission, with a ∼10% relative increase in risk per year of age. No severe cases of SARS-CoV-2 in pregnancy occurred in females who completed a two-dose vaccination against COVID-19.
Pregnancy is a vulnerable time for SARS-CoV-2 infection and carries a higher risk of severe disease, with increasing age being the leading risk factor for ICU admission. Vaccination and preventative measures are crucial in pregnancy to avoid infection and severe outcomes.