Characteristics of Pregnant, Non-pregnant Women of Reproductive Age Diagnosed With COVID

The coronavirus (COVID-19) pandemic has resulted in 2,104,346 cases and 116,140 deaths in the United States. During pregnancy, women experience immunologic and physiologic changes that could increase their risk for more severe illness from respiratory infections like COVID-19. To date, data to assess the prevalence and severity of COVID-19 among pregnant U.S. women and determine whether signs and symptoms differ among pregnant and nonpregnant women are limited, according to a report by the CDC.

As a part of COVID-19 surveillance, the CDC received reports of 326,335 women of reproductive age (15–44 years) who had positive test results for SARS-CoV-2, the virus that causes COVID-19. Data on pregnancy status was available for 91,412 (28.0%) women with laboratory-confirmed infections; among these, 8,207 (9.0%) were pregnant.

Symptomatic pregnant and nonpregnant women with COVID-19 reported similar frequencies of cough (less than 50%) and shortness of breath (30%), but pregnant women less frequently reported headache, muscle aches, fever, chills, and diarrhea. Chronic lung disease, diabetes mellitus, and cardiovascular disease were more commonly reported among pregnant women than among nonpregnant women.

Among women with COVID-19, approximately one third (31.5%) of pregnant women were reported to have been hospitalized compared with 5.8% of nonpregnant women. After adjusting for age, presence of underlying medical conditions, and race/ethnicity, pregnant women were significantly more likely to be admitted to the intensive care unit (ICU) and receive mechanical ventilation.

Sixteen COVID-19–related deaths were reported among pregnant women aged 15–44 years, and 208 (0.2%) such deaths were reported among nonpregnant women.

These findings suggest that among women of reproductive age with COVID-19, pregnant women are more likely to be hospitalized and at increased risk for ICU admission and receipt of mechanical ventilation compared with nonpregnant women, but their risk for death is similar.

To reduce occurrence of severe illness from COVID-19, pregnant women should be counseled about the potential risk for severe illness from COVID-19, and measures to prevent infection with SARS-CoV-2 should be emphasized for pregnant women and their families.

According to The American College of Obstetricians and Gynecologists, or ACOG, if you are diagnosed with COVID-19 while pregnant, you should still follow the general advice from the CDC and your ob-gyn or other health care professional.

The current CDC advice for all people with COVID-19 includes the following:

• Stay home except to get medical care. Avoid public transportation.
• Speak with your health care team over the phone before going to their office. Get medical care right away if you feel worse or think it’s an emergency.
• Separate yourself from other people in your home.
• Wear a face mask when you are around other people and when you go to get medical care.

In situations of birth plan, talk with your ob-gyn or other health care professional about your birth plan and if it should be changed, according to the ACOG. In most cases, the timing and method of delivery (vaginal birth or cesarean birth) do not need to be changed. Women who are sick probably do not need a cesarean birth.

ACOG believes the safest place for you to give birth is a hospital, hospital-based birth center, or accredited freestanding birth center. Your hospital or birth center may be adjusting their policies. For example, there may be changes to the number of visitors allowed and how long you will stay in the hospital. Check with your hospital and ob-gyn or other healthcare professional about your birth plan and be sure to mention if you are planning to have a doula with you during childbirth. 

Overall, the analysis includes cases reported during January 22 to June 7 to the CDC with data updated as of June 17, 2020. Included cases were limited to laboratory-confirmed infections with SARS-CoV-2 among women aged 15–44 years from 50 states, the District of Columbia, and New York City.

Data collected included information on demographic characteristics, pregnancy status, underlying medical conditions, clinical signs and symptoms, and outcomes (including hospitalization, ICU admission, receipt of mechanical ventilation, and death).

Information on race and ethnicity were available for 80.4% of pregnant women and 70.6% of nonpregnant women. Among pregnant women, 46.2% were Hispanic, 23.0% were non-Hispanic white (white), 22.1% were non-Hispanic black (black), and 3.8% were non-Hispanic Asian compared with 38.1%, 29.4%, 25.4%, and 3.2%, respectively, among nonpregnant women.