Two MMWR Updates: Pregnant Women and COVID-19

CDC recently released two Morbidity and Mortality Weekly Reports (MMWRs) about pregnant women and COVID-19. Findings from two new CDC studies underscore the importance of counseling pregnant women about their risk for severe COVID-19 illness and the potential risk for preterm birth. 

The first study, "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," found that pregnant women with COVID-19 are at increased risk for severe illness, compared with non-pregnant women with COVID-19. Markers for severe illness included admission to an intensive care unit, receipt of invasive ventilation, receipt of extracorporeal membrane oxygenation (or ECMO, an advanced life support technique used for patients with life-threatening heart and/or lung problems), and death. Although the absolute risks of severe illness are low overall, pregnant women are at increased risk compared with nonpregnant women with COVID-19, and risk of severe outcomes were highest among women in the oldest age group (ages 35 – 44). Hispanic or Black women were found to be disproportionately affected by COVID-19 during pregnancy. Further, pregnant Hispanic women were more likely to die compared to nonpregnant women relative to other subgroups, and non-Hispanic Black women were disproportionately represented in the total number of deaths among women with COVID-19, regardless of pregnancy status.

The second study, "Birth and Infant Outcomes Following Laboratory-Confirmed SARS-CoV-2 Infection in Pregnancy—SET-NET, 16 Jurisdictions, March 29–October 14, 2020," found that pregnant women with COVID-19 may be at increased risk of having a preterm infant (born before 37 weeks), which may lead to serious health problems for the infant. Infants born to mothers with COVID-19 during pregnancy were rarely found to have positive COVID-19 test results, and those who did have a positive test result were primarily born to mothers who had COVID-19 within one week of delivery. Pregnant women and their families should continue to follow key mitigation measures to reduce their risk of becoming ill with COVID-19.

Healthcare providers should counsel pregnant people to:

• Continue to follow key prevention measures to reduce their risk of becoming ill, including limiting unnecessary interactions with persons who might have been exposed to or are infected with COVID-19 as much as possible, wearing a mask in public and when around others, avoiding activities where social distance is difficult to maintain, and washing their hands. 
• Continue to attend healthcare appointments during and after pregnancy. 
• Obtain all recommended vaccines. 
• Know the symptoms of COVID-19 illness. 
• Get emergency care immediately if they need it.

Below are some additional resources for more information about pregnancy and COVID-19:

• Considerations for Inpatient Obstetric Healthcare Settings
• Pregnancy, Breastfeeding, and Caring for Newborns
• Evaluation and Management Considerations for Neonates At Risk for COVID-19
• Care for Breastfeeding Women

Read more MMWR reports on COVID-19 here.