Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status - United States, January 22-October 3, 2020

• Published in: MMWR. Morbidity and mortality weekly report 2020-11, Vol.69 (44), p.1641-1647
• Main Authors: Zambrano, Laura D, Ellington, Sascha, Strid, Penelope, Galang, Romeo R, Oduyebo, Titilope, Tong, Van T, Woodworth, Kate R, Nahabedian, 3rd, John F, Azziz-Baumgartner, Eduardo, Gilboa, Suzanne M, Meaney-Delman, Dana
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age; Asymptomatic; Betacoronavirus - isolation & purification; Clinical Laboratory Techniques; Coronavirus Infections - complications; Coronavirus Infections - diagnosis; Coronavirus Infections - epidemiology; Coronaviruses; COVID-19; COVID-19 Testing; Disease; Ethnicity; Female; Full Report; Health surveillance; Hispanic people; Humans; Illnesses; Infection; Infections; Laboratories; Medical laboratories; Oxygenation; Pacific Islander people; Pandemics; Patient admissions; Pneumonia, Viral - complications; Pneumonia, Viral - diagnosis; Pneumonia, Viral - epidemiology; Pregnancy; Pregnancy Complications, Infectious - diagnosis; Pregnancy Complications, Infectious - epidemiology; Pregnant women; Public health; Race; Risk Assessment; Risk communication; SARS-CoV-2; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Severity of Illness Index; Symptom Assessment; United States - epidemiology; Ventilation; Ventilators; Viral diseases; Womens health; Young Adult
• ISSN: 0149-2195; 1545-861X
• DOI: 10.15585/mmwr.mm6944e3

Studies suggest that pregnant women might be at increased risk for severe illness associated with coronavirus disease 2019 (COVID-19) (1,2). This report provides updated information about symptomatic women of reproductive age (15-44 years) with laboratory-confirmed infection with SARS-CoV-2, the virus that causes COVID-19. During January 22-October 3, CDC received reports through national COVID-19 case surveillance or through the National Notifiable Diseases Surveillance System (NNDSS) of 1,300,938 women aged 15-44 years with laboratory results indicative of acute infection with SARS-CoV-2. Data on pregnancy status were available for 461,825 (35.5%) women with laboratory-confirmed infection, 409,462 (88.7%) of whom were symptomatic. Among symptomatic women, 23,434 (5.7%) were reported to be pregnant. After adjusting for age, race/ethnicity, and underlying medical conditions, pregnant women were significantly more likely than were nonpregnant women to be admitted to an intensive care unit (ICU) (10.5 versus 3.9 per 1,000 cases; adjusted risk ratio [aRR] = 3.0; 95% confidence interval [CI] = 2.6-3.4), receive invasive ventilation (2.9 versus 1.1 per 1,000 cases; aRR = 2.9; 95% CI = 2.2-3.8), receive extracorporeal membrane oxygenation (ECMO) (0.7 versus 0.3 per 1,000 cases; aRR = 2.4; 95% CI = 1.5-4.0), and die (1.5 versus 1.2 per 1,000 cases; aRR = 1.7; 95% CI = 1.2-2.4). Stratifying these analyses by age and race/ethnicity highlighted disparities in risk by subgroup. Although the absolute risks for severe outcomes for women were low, pregnant women were at increased risk for severe COVID-19-associated illness. To reduce the risk for severe illness and death from COVID-19, pregnant women should be counseled about the importance of seeking prompt medical care if they have symptoms and measures to prevent SARS-CoV-2 infection should be strongly emphasized for pregnant women and their families during all medical encounters, including prenatal care visits. Understanding COVID-19-associated risks among pregnant women is important for prevention counseling and clinical care and treatment.