COVID-19 and maternal outcomes

What are the risks of COVID-19 related, and pregnancy-related complications in pregnant/postpartum women with COVID?

Are pregnant/postpartum women with COVID-19 more likely to have severe disease, and are they at increased risk of pregnancy complications than those without COVID?

Maternal outcomes in pregnant and postpartum women with COVID-19

Version 3: updated 5 August 2020

  • 4% of pregnant and recently pregnant women diagnosed with COVID-19 were admitted to the intensive care unit, 3% needed invasive ventilation.
  • 17% delivered preterm before 37 weeks, 6% had spontaneous preterm birth, 5% had preterm premature rupture of membranes, and 65% were delivered by caesarean section.
  • Some women were still pregnant at the end of the study period and outcomes were not known

The proportion of pregnant and recently pregnant women with COVID-19 needing admission to the intensive care may potentially be higher than the corresponding rates in non-pregnant reproductive aged women with COVID-19. The estimates for caesarean section and preterm birth are likely to be influenced by iatrogenic indications. 

(v3.0 last search update on 26th June 2020; findings may change as new evidence emerges)

Disclaimer: The findings have not yet been peer reviewed and the sources cited should be checked. Any views expressed are those of the authors and not necessarily those of their institutions and organisations.

Previous versions

Structured research question (PICO)

COVID-19 and risk of maternal complications
Population Pregnant/postpartum/postabortal women
Exposure Suspected/confirmed COVID-19
Comparator - Pregnant without COVID, Non-pregnant and reproductive aged (women, all)
Outcomes COVID-related main outcomes: all-cause mortality, COVID-specific mortality, pneumonia, respiratory failure, ARDS (Acute Respiratory Distress Syndrome), Time from illness onset to outcome (death, recovery)

Secondary outcomes: Need of respiratory support (invasive ventilation, non-invasive ventilation, oxygenation), admission to ICU (Intensive Care Unit), ICU length of stay, sepsis, cardiac failure, coagulopathy, acute cardiac injury, acute kidney injury, acute hepatic failure, cytokine storm syndrome, central nervous system manifestations, secondary infection, duration of viral shedding

Pregnancy-related main outcomes:
Miscarriage (spontaneous), induced abortion, preterm delivery (<37w, 36w); spontaneous preterm delivery, induced preterm birth), preterm rupture of membranes, preterm-premature rupture of membranes, prelabour rupture of membranes, death;

Secondary outcomes:
Mode of delivery, onset of labour (spontaneous, induced), chorioamnionitis, wound infection, pregnancy-induced hypertension, gestational diabetes, antepartum haemorrhage, postpartum haemorrhage
Study design Observational studies

Findings

Full details to be published shortly. Currently undergoing peer review.