Download PDF
Am J Perinatol 2022; 39(12): 1261-1268
DOI: 10.1055/a-1787-3673
SMFM Fellowship Series Article

Characteristics and Outcomes of Pregnant Women with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in New York City: A Matched Cohort Study

Rasha S. Khoury 
1   Department of Obstetrics & Gynecology and Women's Health, Montefiore Medical Center & Albert Einstein College of Medicine, Bronx, New York
,
Melissa Fazzari
2   Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York
,
Calvin Lambert
1   Department of Obstetrics & Gynecology and Women's Health, Montefiore Medical Center & Albert Einstein College of Medicine, Bronx, New York
,
Chelsea Debolt
3   Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai Health System & Icahn School of Medicine at Mount Sinai, New York, New York
,
Joanne Stone
3   Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai Health System & Icahn School of Medicine at Mount Sinai, New York, New York
,
Angela Bianco
3   Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai Health System & Icahn School of Medicine at Mount Sinai, New York, New York
,
Lisa Nathan
1   Department of Obstetrics & Gynecology and Women's Health, Montefiore Medical Center & Albert Einstein College of Medicine, Bronx, New York
,
Siobhan M. Dolan
3   Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai Health System & Icahn School of Medicine at Mount Sinai, New York, New York
,
Peter S. Bernstein
1   Department of Obstetrics & Gynecology and Women's Health, Montefiore Medical Center & Albert Einstein College of Medicine, Bronx, New York
› Author Affiliations Funding None.
› Further Information
    Permissions and Reprints

Abstract

Objective The aim of this study was to examine the association between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and preterm birth, cesarean birth, and composite severe maternal morbidity by studying women with and without SARS-CoV-2 infection at the time of delivery hospitalization from similar residential catchment areas in New York City.

Study Design This was a retrospective cohort study of pregnant women with laboratory-confirmed or laboratory-denied SARS-CoV-2 on nasopharyngeal swab under universal testing policies at the time of admission who gave birth between March 13 and May 15, 2020, at two New York City medical centers. Demographic and clinical data were collected and follow-up was completed on May 30, 2020. Groups were compared for the primary outcome and preterm birth, in adjusted (for age, race/ethnicity, nulliparity, body mass index) and unadjusted analyses.

Results Among this age-matched cohort, 164 women were positive and 247 were negative for SARS-CoV-2. Of the positive group, 52.4% were asymptomatic and 1.2% had critical coronavirus disease 2019 (COVID-19). The groups did not differ by race and ethnicity, body mass index, or acute or chronic comorbidities. Women with SARS-CoV-2 were more likely to be publicly insured. Preterm birth, cesarean birth, and severe maternal morbidity did not differ between groups. Babies born to women with SARS-CoV-2 were more likely to have complications of prematurity or low birth weight (7.7 vs. 2%, p = 0.01).

Conclusion Preterm and cesarean birth did not differ between women with and without SARS-CoV-2 across disease severity in adjusted and unadjusted analysis among this cohort during the pandemic peak in New York City.

Keywords

SARS-CoV-2 and pregnancy outcomes - viral infection - preterm birth - prematurity - cesarean delivery - social determinants of health

Supplementary Material



Publication History

Received: 16 January 2021

Accepted: 22 February 2022

Accepted Manuscript online:
03 March 2022

Article published online:
18 May 2022

© 2022. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Schwartz DA, Graham AL. Potential maternal and infant outcomes from (Wuhan) coronavirus 2019-nCoV infecting pregnant women: lessons from SARS, MERS, and other human coronavirus infections. Viruses 2020; 12 (02) 194
    CrossrefPubMedGoogle Scholar
  • 2 Shanes ED, Mithal LB, Otero S, Azad HA, Miller ES, Goldstein JA. Placental pathology in COVID-19. Am J Clin Pathol 2020; 154 (01) 23-32
    CrossrefPubMedGoogle Scholar
  • 3 Hosier H, Farhadian SF, Morotti RA. et al. SARS-CoV-2 infection of the placenta. J Clin Invest 2020; 130 (09) 4947-4953
    CrossrefPubMedGoogle Scholar
  • 4 Bikdeli B, Madhavan MV, Jimenez D. et al; Global COVID-19 Thrombosis Collaborative Group, Endorsed by the ISTH, NATF, ESVM, and the IUA, Supported by the ESC Working Group on Pulmonary Circulation and Right Ventricular Function. COVID-19 and thrombotic or thromboembolic disease: implications for prevention, antithrombotic therapy, and follow-up: JACC state-of-the-art review. J Am Coll Cardiol 2020; 75 (23) 2950-2973
    CrossrefPubMedGoogle Scholar
  • 5 Connors JM, Levy JH. COVID-19 and its implications for thrombosis and anticoagulation. Blood 2020; 135 (23) 2033-2040
    CrossrefPubMedGoogle Scholar
  • 6 Varga Z, Flammer AJ, Steiger P. et al. Endothelial cell infection and endotheliitis in COVID-19. Lancet 2020; 395 (10234): 1417-1418
    CrossrefPubMedGoogle Scholar
  • 7 Manchanda EC, Couillard C, Sivashanker K. Inequity in crisis standards of care. N Engl J Med 2020; 383 (04) e16
    CrossrefPubMedGoogle Scholar
  • 8 Sabasteanski N, Brooks J, Roy T. Racial disparities and COVID-19 - National Center for Disaster Preparedness. Accessed August 27, 2020 at: https://ncdp.columbia.edu/ncdp-perspectives/racial-disparities-and-covid-19/
    PubMedGoogle Scholar
  • 9 Emeruwa UN, Spiegelman J, Ona S. et al. Influence of race and ethnicity on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rates and clinical outcomes in pregnancy. Obstet Gynecol 2020; 136 (05) 1040-1043
    CrossrefPubMedGoogle Scholar
  • 10 Egede LE, Walker RJ. Structural racism, social risk factors, and covid-19 - a dangerous convergence for Black Americans. N Engl J Med 2020; 383 (12) e77
    CrossrefPubMedGoogle Scholar
  • 11 Howell EA. Reducing disparities in severe maternal morbidity and mortality. Clin Obstet Gynecol 2018; 61 (02) 387-399
    CrossrefPubMedGoogle Scholar
  • 12 Howell EA, Egorova NN, Janevic T. et al. Race and ethnicity, medical insurance, and within-hospital severe maternal morbidity disparities. Obstet Gynecol 2020; 135 (02) 285-293
    CrossrefPubMedGoogle Scholar
  • 13 Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)–a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009; 42 (02) 377-381
    Google Scholar
  • 14 Harris PA, Taylor R, Minor BL. et al; REDCap Consortium. The REDCap consortium: Building an international community of software platform partners. J Biomed Inform 2019; 95: 103208
    CrossrefPubMedGoogle Scholar
  • 15 Khoury R, Bernstein PS, Debolt C. et al. Characteristics and outcomes of 241 births to women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection at five New York City medical centers. Obstet Gynecol 2020; 136 (02) 273-282
    CrossrefPubMedGoogle Scholar
  • 16 Li W, Onyebeke C, Huynh M, Castro A, Falci L, Gurung S, Kennedy J, Maduro G, Sun Y, Van Wye G. Summary of Vital Statistics, 2017. New York, NY: New York City Department of Health and Mental Hygiene, Bureau of Vital Statistics; 2019
    Google Scholar
  • 17 Aylward B, Liang W, Dong X. et al. Report of the WHO-China joint mission on coronavirus disease 2019 (COVID-19). Accessed April 22, 2020 at: https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf
    PubMedGoogle Scholar
  • 18 Easter SR, Bateman BT, Sweeney VH. et al. A comorbidity-based screening tool to predict severe maternal morbidity at the time of delivery. Am J Obstet Gynecol 2019; 221 (03) 271.e1-271.e10
    CrossrefPubMedGoogle Scholar
  • 19 Kilpatrick SK, Ecker JL. American College of Obstetricians and Gynecologists and the Society for Maternal–Fetal Medicine. Severe maternal morbidity: screening and review. Am J Obstet Gynecol 2016; 215 (03) B17-B22
    CrossrefPubMedGoogle Scholar
  • 20 Adhikari S, Pantaleo NP, Feldman JM, Ogedegbe O, Thorpe L, Troxel AB. Assessment of community-level disparities in coronavirus disease 2019 (COVID-19) infections and deaths in large US metropolitan areas. Am J Obstet Gynecol 2020; 3 (07) e2016938
    PubMedGoogle Scholar