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Complications, death in pregnancy rose during COVID-19

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Rates of severe pregnancy-related complications and severe maternal illness and death rose significantly amid the COVID-19 pandemic, find two retrospective US studies published late last week in JAMA Network Open.Role of disrupted obstetric careIn the first study, a team led by a Beth Israel Deaconess Medical Center researcher evaluated pregnancy-related complications, birth outcomes, and length of stay of more than 1.6 million pregnant women who gave birth at 463 US hospitals in the 14 months leading up to the pandemic (Jan 1, 2019, to Feb 28, 2020) and in the first 14 months of the crisis (Mar 1, 2020, to Apr 31, 2021).The study included 849,544 patients in the prepandemic period and 805,324 during the pandemic.

Characteristics were similar in both groups, including age (35 years and older, 18.1% prepandemic, 18.4% pandemic), race (White, 53.7% vs 53.9%, respectively), and health insurance (Medicaid, 43.1% vs 43.0%).

Average gestational age at birth was 38.3 weeks during both periods.During the pandemic, consistent with US Census reports, live births fell 5.2%.

Maternal deaths during delivery rose from 5.17 to 8.69 per 100,000 pregnant women (odds ratio [OR], 1.75). Rates of fetal death and stillbirth stayed relatively stable, at about 0.9%, as did rates of preterm and term births (10.7% and 89.3%, respectively).

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