Perinatal & Pediatric
COVID-19 Infection and Hypertensive Disorders of Pregnancy, 2020-2022 Angela Malek* Angela Malek Chun-Che Wen Kalyan Chundru Julio Mateus Hermes Florez Brian Neelon Jeffrey Korte Dulaney Wilson John Pearce Sarah Simpson Kelly Hunt
Introduction: COVID-19 infection increases the risk of pregnancy complications; however, its association with hypertensive disorders of pregnancy (HDP) and its subtypes, preeclampsia and eclampsia (PE and E), remains unclear. We aimed to investigate the association between COVID-19 infection pre- and during pregnancy with these hypertensive conditions in South Carolina (SC).
Methods: We evaluated SC livebirth data (2020-2022) from 145,033 deliveries among pregnant people aged 12-52 years: 80,927 non-Hispanic White (NHW); 43,797 non-Hispanic Black (NHB); 13,150 Hispanic; and 7,157 of other race/ethnic groups. Linked birth certificate and hospitalization/emergency department (ED) visit data was used to define HDP, and hospitalization/ED visit data defined HDP subtypes (PE and E). Logistic regression models with matched pairs and covariate adjustment were conducted.
Results: The overall rate of HDP was 18.5% (22.7% in those with COVID-19 pre-pregnancy, 20.3% with 1st/2nd trimester infection, 19.6% with 3rd trimester infection, and 18.0% without COVID-19). On the other hand, 9.2% experienced PE or E (11.5% with COVID-19 pre-pregnancy, 10.7% with 1st/2nd trimester infection, 10.0% with 3rd trimester infection, and 8.8% without COVID-19). The odds of HDP increased by 9% (95% CI: 1.02-1.16) in those with COVID-19 pre-pregnancy compared to those without COVID-19, after adjusting for demographic, lifestyle and clinical factors (Table). Similarly, PE and E increased in those who had COVID-19 pre-pregnancy (OR=1.12, 95% CI: 1.03-1.21). COVID-19 infection during pregnancy was not associated with HDP or PE/E.
Discussion: Our data demonstrated pre-pregnancy COVID-19 infection is a significant independent risk factor of hypertensive disease during pregnancy even after accounting for the contribution of traditional risk factors, highlighting the importance of preventive measures including vaccination for people of reproductive age.
