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COVID-19 in pregnancy tied to poor maternal outcomes, preterm birth, fetal death

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Two studies published yesterday describe the medical consequences of COVID-19 in pregnancy, one finding that the virus may double the risk of severe maternal outcomes and preterm birth, and the other showing that infection can lead to problems with the placenta that may cause fetal loss.Findings underscore importance of vaccinationIn the first study, published in JAMA Internal Medicine, Kaiser Permanente Northern California researchers analyzed the electronic medical records of 43,886 pregnant women who delivered from Mar 1, 2020, to Mar 16, 2021.

Average patient age was 30.7 years, 33.8% were White, 28.4% were Hispanic, 25.9% were Asian or Pacific Islander, 6.5% Black, 0.3% American Indian or Alaska Native, and 5% were multiracial or of another race.Among these women, 1,332 (3.0%) tested positive for COVID-19 from 30 days before conception to 7 days after delivery.

Infected women were more likely than their uninfected peers to be younger and Hispanic and to have had multiple babies, a higher neighborhood deprivation index, and obesity or chronic high blood pressure.Before universal COVID-19 testing of pregnant women admitted for delivery was implemented in the healthcare system in December 2020, the positivity rate was 1.3%, compared with 7.8% after.After adjustment for demographic characteristics, underlying medical conditions, and smoking status, infected women were at double to triple the risk for severe illness such as acute respiratory distress syndrome and sepsis (hazard ratio [HR], 2.45), birth at less than 37 weeks gestation (HR, 2.08), and venous thromboembolism (blood clots) (HR, 3.08).COVID-19 infection was also tied to an elevated risk of medically indicated preterm birth (eg, for a life-threatening maternal

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