Intrapartum and 30-Day Postpartum Complications in Patients With Antenatal COVID-19 Infection: A Retrospective Cohort Study.

Objective

The study was aimed at comparing intrapartum and postpartum outcomes between pregnant patients with and without antenatal COVID-19 infection using aggregated, deidentified electronic health record (EHR) data. Design and

Setting

This retrospective cohort study included data from over 80 health care organizations within the TriNetX Analytics Research Network. Population: Individuals admitted for delivery from Jan 2020 to May 2023 were studied.

Methods

We studied individuals with ICD-10 codes for delivery, COVID-19 diagnosis, and primary outcomes. We compared the incidence of adverse intrapartum and 30-day postpartum outcomes in those with and without antenatal COVID-19. Main Outcome Measures: The main outcomes compared were obstetric, cardiovascular, neurovascular, and respiratory outcomes within 30 days postpartum.

Results

Twenty-six thousand nine hundred seventy-four of 369,923 (7%) birthing parents with a delivery encounter had an antenatal COVID-19 diagnosis. Compared to matched controls, having COVID-19 was associated with an increased risk of postpartum hemorrhage (RR-1.24 (CI-1.16-1.33)), gestational hypertension (RR-1.27 (CI-1.27-1.34)), preeclampsia (RR-1.25 (CI-1.18-1.32)), eclampsia (RR-1.66 (CI-1.29-2.32)), preterm labor (RR-1.21 (CI-1.21-1.34)), cerebral infarction (RR-1.74 (CI-1.04-2.90)), cardiomyopathy (RR-2.08 (CI-1.30-3.32)), heart failure (RR-1.55 (CI-1.04-2.31)), sepsis (RR-2.21 (CI-1.54-3.19)), DVT (RR-2.32 (CI-1.45-3.71)), and pulmonary embolism (RR-2.68 (CI-1.74-2.90)).

Conclusion

Individuals with antenatal COVID-19 were more likely to have intrapartum and postpartum obstetric, cardiovascular, neurovascular, and respiratory complications. This data will inform risk stratification and screening for prenatal care providers.