Characteristics and Outcomes Associated With COVID-19 Infection in Pregnancy

INTRODUCTION: Data on COVID-19 in pregnancy are skewed toward infection at time of labor and delivery, and few studies have controlled for confounding variables. We aimed to explore the sociodemographic and health risk factors for COVID-19 at any point in pregnancy and its impact on maternal outcomes in a diverse cohort during the first year of the pandemic. METHODS: We conducted a retrospective cohort study using data abstracted from the electronic medical record within Kaiser Permanente Mid-Atlantic States, an integrated health care system, from March 15, 2020, to March 15, 2021. We included women at least 15 years old and pregnant during that timeframe, comparing those who tested positive for COVID-19 to those who did not. We used multivariable logistic regression to identify risk factors for COVID-19 infection during pregnancy. We then used propensity score matching to create a comparison group to explore associations between infection and key outcomes. RESULTS: Among 18,285 pregnant members, 1,036 (5.7%) tested positive for COVID-19 during pregnancy, with 26%, 31%, and 43%, respectively, diagnosed in each trimester of pregnancy. Patients with COVID-19 were more likely to be young, Latina, obese, and multiparous; being White or Asian was protective ( P <.001). Patients with COVID-19 during pregnancy were more likely to be hospitalized apart from delivery ( P =.029). There were no significant differences in fetal demise, cesarean delivery, preterm delivery, gestational diabetes, hypertensive disorders of pregnancy, venous thromboembolism, postpartum readmission, or maternal death between groups. CONCLUSION: Our study was consistent with previously identified disparities in COVID-19 infection. Outcome data were surprisingly reassuring.