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Clinical Characteristics and Outcomes of Hospitalized Women Giving Birth With and Without COVID-19

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

Physiologic adaptations and changes in immune regulation may increase the risk of morbidity and mortality in pregnant women with respiratory infections.1,2 The effects of coronavirus disease 2019 (COVID-19) in pregnancy have not been fully delineated. We compared the clinical characteristics and outcomes of hospitalized women who gave birth with and without COVID-19.

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Article Information

Accepted for Publication: December 29, 2020.

Published Online: January 15, 2021. doi:10.1001/jamainternmed.2020.9241

Corresponding Author: Scott D. Solomon, MD, Division of Cardiovascular Medicine, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02115 (ssolomon@bwh.harvard.edu).

Author Contributions: Drs Jering and Solomon had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Jering, Cunningham, Claggett.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Jering, Solomon.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Jering, Claggett, Cunningham, Greene.

Obtained funding: Solomon.

Administrative, technical, or material support: Jering.

Supervision: Solomon.

Conflict of Interest Disclosures: Dr Jering reports being supported by a postdoctoral training grant from the National Heart, Lung, and Blood Institute (NHLBI) (T32HL007604). Dr Claggett reports receiving personal fees from Amgen, Boehringer Ingelheim, Corvia Medical, MyoKardia, and Novartis outside the submitted work. Dr Cunningham reports being supported by a postdoctoral training grant from NHLBI (T32HL094301). Dr Rosenthal reports being an employee of Premier Inc, which curates the Premier Healthcare Database used in this study. Dr Vardeny reports receiving research support from NHLBI, grant support from AstraZeneca and Bayer, and personal fees from the American Heart Association, Novartis, and Sanofi Pasteur outside the submitted work. Dr Solomon reports receiving grants from Actelion, Alnylam, Amgen, AstraZeneca, Bellerophon, Bayer, Bristol Myers Squibb, Celladon, Cytokinetics, Eidos, Gilead Sciences, GlaxoSmithKline, Ionis Pharmaceuticals, LoneStar Heart, Mesoblast, MyoKardia, NeuroTronik, NHLBI, Novartis, Novo Nordisk, Respicardia, Sanofi Pasteur, and Theracos, as well as personal fees from Abbott, Actelion, Akros, Alnylam Pharmaceuticals, Amgen, Arena, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Cardior Pharmaceuticals, Cardurion Pharmaceuticals, Corvia Medical, Cytokinetics, Daiichi Sankyo, Gilead Sciences, GlaxoSmithKline, Ironwood Pharmaceuticals, Eli Lilly, Merck, MyoKardia, Novartis, Roche, Takeda, Theracos, Quantum Genetics, Cardurion Pharmaceuticals, AOBiome, Janssen, Cardiac Dimensions, Sanofi Pasteur, Tenaya, DiNAQOR, Tremeau Pharmaceuticals, CellProthera, and Moderna outside the submitted work. No other disclosures were reported.

Additional Contributions: We thank Muthiah Vaduganathan, MD, MPH, and Ankeet Bhatt, MD, of Brigham and Women’s Hospital for their thoughtful contributions to the study design and revisions of this article. They were not compensated for their contributions.

Additional Information: Qualified researchers can apply for data access directly to Premier Inc.

References
1.
Chen  Y-H , Keller  J , Wang  I-T , Lin  C-C , Lin  H-C .  Pneumonia and pregnancy outcomes: a nationwide population-based study.   Am J Obstet Gynecol. 2012;207(4):288.e1-288.e7. doi:10.1016/j.ajog.2012.08.023PubMedGoogle ScholarCrossref
2.
Adhikari  EH , Moreno  W , Zofkie  AC ,  et al.  Pregnancy outcomes among women with and without severe acute respiratory syndrome coronavirus 2 infection.   JAMA Netw Open. 2020;3(11):e2029256. doi:10.1001/jamanetworkopen.2020.29256PubMedGoogle Scholar
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Rosenthal  N , Cao  Z , Gundrum  J , Sianis  J , Safo  S .  Risk factors associated with in-hospital mortality in a US national sample of patients with COVID-19.   JAMA Netw Open. 2020;3(12):e2029058. doi:10.1001/jamanetworkopen.2020.29058PubMedGoogle Scholar
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Vandenbroucke  JP , von Elm  E , Altman  DG ,  et al; STROBE initiative.  Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration.   Ann Intern Med. 2007;147(8):W163-94. doi:10.7326/0003-4819-147-8-200710160-00010-w1PubMedGoogle Scholar
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Zambrano  LD , Ellington  S , Strid  P ,  et al; CDC COVID-19 Response Pregnancy and Infant Linked Outcomes Team.  Update: characteristics of symptomatic women of reproductive age with laboratory-confirmed SARS-CoV-2 infection by pregnancy status—United States, January 22-October 3, 2020.   MMWR Morb Mortal Wkly Rep. 2020;69(44):1641-1647. doi:10.15585/mmwr.mm6944e3PubMedGoogle ScholarCrossref
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Knight  M , Bunch  K , Vousden  N ,  et al; UK Obstetric Surveillance System SARS-CoV-2 Infection in Pregnancy Collaborative Group.  Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: national population based cohort study.   BMJ. 2020;369:m2107. doi:10.1136/bmj.m2107PubMedGoogle ScholarCrossref
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