Pregnancy, COVID-19 and Risk of Intensive Care

Pregnancy, COVID-19 and Risk of Intensive Care
Latest CDC report shows elevated dangers, racial disparities.

The latest CDC data suggest that pregnant women with COVID-19 are at increased risk for both hospital and ICU admission, and for requiring mechanical ventilation.

About one third (31.5 percent) of pregnant women with COVID-19 were hospitalized versus just 5.8 percent of non-pregnant women. Among pregnant patients, 0.5 percent required mechanical ventilation compared to 0.3 percent of non-pregnant patients. ICU admission took place for 1.5 percent of pregnant women versus 0.9 percent of non-pregnant women.

Mortality rates were similar (0.2 percent) for pregnant and non-pregnant women. Sixteen COVID-related deaths were reported among pregnant women aged 15 to 44 years, and 208 such deaths were reported among non-pregnant women, as of June 16, 2020.

“We are still counseling pregnant women that they have a potential risk for severe illness. These women and their families need to take the same steps as everyone else, with social distancing, hand washing and masking,” said Jennifer Thompson, M.D., an assistant professor of obstetrics and gynecology at Vanderbilt University Medical Center.

Evolving Recommendations

The CDC data suggest particular caution may be warranted for non-white women, Thompson explains.

“This report showed that ICU admissions were more frequent among Asian, Hispanic and Black pregnant women compared to all pregnant women.”

“This report showed that ICU admissions were more frequent among Asian, Hispanic and Black pregnant women compared to all pregnant women,” Thompson said. “Heightened risks for these groups go along with what we are seeing among COVID-19 patients generally.”

There are significant limitations to the current CDC data that should qualify any conclusions drawn about unique risks among pregnant women, says Thompson. “The CDC report didn’t distinguish between hospital admissions that occurred for pregnancy-related reasons and ones that occurred because of COVID-19,” Thompson said. “Obviously, pregnant women are admitted for pregnancy-related concerns and for delivery, so those events increase the hospitalization rate.”

Research in Progress

Thompson is coordinating Vanderbilt’s participation in a U.S. registry called PRIORITY (for Pregnancy CoRonavIrus Outcomes RegIsTrY), which is also gathering data about pregnant women with COVID-19. Currently, 927 women are participating. To enroll or refer a patient, click here.

Additionally, Thompson says Vanderbilt is maintaining its own data registry to track pregnant patients who have tested positive and to study outcomes for them and their infants. Another registry, IRCEP (for the International Registry of Coronavirus Exposure in Pregnancy), is collecting data from dozens of centers worldwide.

“We don’t know much about COVID in the first trimester, or about women who recover during an ongoing pregnancy; we still have so much to learn.”

Much of the data gathered so far pertains to the third trimester. “We don’t know much about COVID in the first trimester, or about women who recover during an ongoing pregnancy,” Thompson said. “We still have so much to learn.”