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Severe Maternal Morbidity and Mortality of Pregnant Patients With COVID-19 Infection
Severe Maternal Morbidity and Mortality of Pregnant Patients With COVID-19 Infection
Pregnant patients with COVID-19 infection at delivery were more likely to develop severe maternal morbidity compared with those without (46.4 vs 18.8 per 1000, adjusted odds ratio [aOR]: 2.60 [95% CI, 2.39-2.82]) (Table 2). Among the individual morbidity indicators, COVID-19 infection was associated with the following outcomes with all aORs greater than 2: increased risk of tracheostomy, respiratory distress syndrome, ventilation, acute myocardial infarction, sepsis, shock, cardiac arrest, and coagulopathy (Table 2). The mortality risk of pregnant patients with COVID-19 infection at delivery was approximately 14 times higher compared with those without (64.0 vs 4.3 per 100 000 deliveries; aOR, 13.91 [95% CI, 6.36-30.42] (Table 2). Failure-to-rescue risk following the development of severe maternal morbidity was also increased in pregnant patients with COVID-19 infection at delivery (1.5% vs 0.2%; aOR, 5.56 [95% CI, 2.51-12.30]). Among the pregnant patients with COVID-19 infection who died during the hospital admission, the median time-to-death was 16 days, but this was particularly short in the early period (median 6 days in April to June 2020). The COVID-19 case-fatality rate decreased over time from 232.9 to 79.1 per 100 000 deliveries (P for trend < .001).
fsnestel·jamanetwork.com·
Severe Maternal Morbidity and Mortality of Pregnant Patients With COVID-19 Infection