Covid in Pregnancy: Studying racial disparities and adverse birth outcomes

Risk of early preeclampsia

In a second study based on data from the same large diverse population among all 14 hospitals, researchers found a strong relationship between COVID-19 and early preeclampsia.

Researchers analyzed 369 cases involving women who got COVID-19 during pregnancy or shortly after, comparing delivery outcomes with 1,090 women who didn’t experience an infection. Both groups delivered between March and October, 2020 on the same respective unit among hospitals within 30 days of each other.

COVID-19 pregnancies were associated with an increased risk of preeclampsia – with an even higher risk for people who were more symptomatic and with severe disease -even after adjusting for relevant comorbidities.

“We wanted to know if having COVID-19 predisposed pregnant people to other medical complications during pregnancy,” Townsel said. “We knew they were at higher risk of respiratory complications and ending up in the ICU but were there any other signals we needed to be looking for in these patients?

“We found that individuals with a COVID-19 infection not only had a higher risk of preeclampsia and high blood pressure but early preeclampsia. This complication makes preterm births more likely, which can negatively impact outcomes for both the baby and mom.”

Many patients who had COVID-19 tended to have the same placental dysfunction seen in pregnant patients with high blood pressure, she noted.

“This is really important to understand because once patients develop preeclampsia, there’s no remedy, and there’s a high risk of a preterm delivery and need for specialized neonatal care,” Townsel said.

“We need to do everything we can to prevent early preeclampsia. Reducing COVID-19 infection in pregnancy improves the likelihood that patients carry all the way to term, which we know is the healthiest outcome.”

Black COVID-19 patients also experienced preterm delivery from preeclampsia 1.9 times more often than COVID-19 patients of other races – a disparity that should be studied further, Townsel says.

In the summer of 2021, the Centers for Disease Control and Prevention issued an urgent health advisory to increase COVID-19 vaccination among people who are pregnant, recently pregnant or trying to become pregnant.

“We’ve made progress, but we could still be doing better with vaccination rates among the pregnant population,” Townsel said. “For patients who are pregnant, trying to conceive, undergoing fertility treatment or breastfeeding, COVID-19 vaccination is a critical step to prevent serious illness, deaths, and adverse pregnancy outcomes.”

Additional institutions include Wayne State University, Henry Ford Health System, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Beaumont Health, Spectrum Health Hospital System, St. Joseph Mercy, Hurley Medical Center/Michigan State University, St. John Hospital and Medical Center, Ascension and Oakland University.

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