LATEBREAKER
Women’s Health
The Impact of Pre-Pregnancy Obesity on the Relationship between COVID-19 Infection and Preeclampsia and Eclampsia in South Carolina (2020-2022) Sarah E. Simpson* Sarah E. Simpson Angela Malek Chun-Che Wen Brian Neelon Dulaney A. Wilson Julio Mateus John Pearce Kalyan Chundru Erin Wilkie Jeffery E. Korte Hermes Florez Kelly J. Hunt
Introduction: COVID-19 has been associated with adverse maternal birth outcomes with some studies reporting an increased risk of preeclampsia (PE) and eclampsia (E). Moreover, while obesity has been associated with increased risk of severe COVID-19, it is unclear whether obesity modifies the association between COVID-19 and risk of PE and E during pregnancy. Therefore, we aim to assess the impact of pre-pregnancy obesity on the association between COVID-19 and PE/E in South Carolina from 2020-2022.
Methods: SC vital records and hospitalization/ED visit data were linked for women with liveborn singleton births to define PE and E; COVID-19 infection data was also linked. Adjusted logistic regression models assessed the interaction of COVID-19 infection by trimester and obesity in relationship to development of PE/E.
Results: In our cohort of pregnancies in South Carolina from 2020 through 2022, the prevalence of COVID-19 was 6.7% prior to pregnancy, 6.0% during the 1St/2nd trimester and 3.6% during the 3rd trimester with 83.6% of pregnancies unexposed to COVID-19. The prevalence of PE/E was 9.2%. Among the non-Obese, relative to those without a history of COVID-19, having COVID-19 pre-pregnancy (OR:1.21,95% CI=1.09 -1.34), during the 1st/2nd trimester (OR:1.24,95% CI:1.11-1.37) and during the 3rd trimester (OR:1.21, 95% CI: 1.06-1.39) was associated with an increased odds of PE/E. Among the obese, having COVID-19 pre-pregnancy (OR:1.09,95% CI: 0.99-1.20), during the 1st or 2nd trimester (OR:1.03,95% CI: 0.92-1.14) and the during 3rd trimester (OR:1.00, 95% CI:0.87-1.14) was not associated with a PE/E.
Conclusion: In non-obese women a history of COVID-19 prior to pregnancy and during pregnancy was associated with PE/E. In contrast, in obese women neither a history of COVID-19 prior to or during pregnancy was associated with increased risk of PE/E. Our results highlight the importance of preventive strategies (e.g. weight management and vaccines) for this population.
