Obstetric anesthesia

Impact of Covid-19 on risk of severe maternal morbidity

Crit CarePublished Population-based cohort study

Main finding · Severe maternal morbidityResult — go to the resultRelative risk 2.02 95% CI 1.76–2.31

Authors' conclusion

Covid-19 infection during pregnancy increases risk of life-threatening maternal morbidity, including renal, embolic, and hemorrhagic complications.

Study context

Population
Pregnancies in Quebec, Canada, March 2020–March 2022
Participants
162,576 pregnancies
Exposure
Covid-19 infection vs no infection
Outcome
Severe maternal morbidity
Follow-up
During pregnancy up to 42 days postpartum
Methodological detailsadjusted log-binomial regression
  • Adjusted log-binomial regression

Main finding

As reported in the abstract

Relative risk

2.02

95% CI 1.76–2.31

Covid-19 infection vs No infection
RR 2.02 (95% CI 1.76–2.31)

Observational data: associations, not effects.

Further findings

Acute renal failure

Covid-19 infection vs no infection, RR
3.01 (1.79-5.06) (95% CI)
  • Adjusted log-binomial regression

Embolism, shock, sepsis and disseminated intravascular coagulation

Covid-19 infection vs no infection, RR
1.35 (0.95-1.93) (95% CI)
  • Adjusted log-binomial regression

Severe hemorrhage

Covid-19 infection vs no infection, RR
1.49 (1.09-2.04) (95% CI)
  • Adjusted log-binomial regression

Severe maternal morbidity by infection severity and period (subgroup)

Severe antepartum infection, RR
13.60 (10.72-17.26) (95% CI)
Severe peripartum infection, RR
20.93 (17.11-25.60) (95% CI)
Mild antepartum infection, RR
3.43 (2.42-4.86) (95% CI)

Severe maternal morbidity by circulating variant (subgroup)

Risk around 3 times greater during wildtype, alpha and delta circulation
Risk only 1.2 times greater during omicron

Original publication

Impact of Covid-19 on risk of severe maternal morbidity. Crit Care. Published 5 September 2023. doi:10.1186/s13054-023-04584-6

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