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.

Reference: ajog.org/article/S0002-9378(22)00998-X/fulltext