Maternal and Neonatal Morbidity and Mortality & COVID

May 24, 2021

At the start of the COVID-19 pandemic, a team of researchers began to work on closing the knowledge gap related to the association of COVID-19 and subsequent outcomes in pregnant birthing persons, in comparison to non-infected pregnant individuals. The INTERCOVID Multinational Cohort Study, published by JAMA Pediatrics in April 2021, revealed that pregnant birthing persons who were positive for COVID-19 were at higher risk for the following: pre-eclampsia/eclampsia; severe infections; intensive care unit admission; maternal mortality; medically indicated preterm birth; and severe perinatal morbidity and mortality index. It was also noted that asymptomatic pregnant birthing persons with COVID-19 remained at a higher risk for maternal morbidity and preeclampsia. Pregnant patients with the COVID-19 diagnosis and pre-pregnancy comorbidities, such as overweight, diabetes, hypertension and cardiac/respiratory diseases had the highest risk for morbidity and mortality, especially for preeclampsia and eclampsia.  

With the publication of these findings, research outcomes could shed some light on the final results of the Louisiana Perinatal Quality Collaborative’s first initiative, Reducing Maternal Morbidity Initiative (RMMI), related to severe maternal morbidity (SMM*) among hypertension. It may be too early to surmise, but findings such as this could suggest an impact of the COVID-19 pandemic on birthing person outcomes, such as SMM among hypertension. This data does support an association between a COVID-19 diagnosis in pregnant patients and higher rates of preeclampsia, eclampsia and/or HELLP syndrome, with a significantly greater risk in morbidity and mortality related to those patients with pre-pregnancy comorbidities.

* Severe Maternal Morbidity events are the unexpected outcomes of labor and delivery that result in significant short or long- term consequences to a woman’s health.

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