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Coronavirus Disease 2019 (COVID-19) in Pregnancy and the Risk of Hypertensive Disorders of Pregnancy: A Retrospective Cohort Study
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  • Michael Baracy,
  • Fareeza Afzal,
  • Susanna Szpunar,
  • MaKenzie Tremp,
  • Karlee Grace,
  • Marina Liovas,
  • Muhammad Aslam
Michael Baracy

Corresponding Author:michael.baracy@ascension.org

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Fareeza Afzal
Ascension St John Hospital
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Susanna Szpunar
Ascension St John Hospital
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MaKenzie Tremp
Ascension Providence Hospital Southfield Campus
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Karlee Grace
Ascension Macomb-Oakland Hospital
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Marina Liovas
St. Georges University
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Muhammad Aslam
Ascension St John Hospital
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Abstract

Objective: To evaluate the association of COVID-19 status in pregnant women and hypertensive disorders of pregnancy. Design: Retrospective Cohort Study Setting: Multicenter study from a large metropolitan hospital system Population: Pregnant patients who tested positive for COVID-19 Methods: Patients who tested positive for COVID-19 during their pregnancy and delivered (index cases) were compared to the three subsequent deliveries of patients who tested negative (controls) at the same institution. We evaluated the impact of COVID-19 on the development of hypertensive disorders of pregnancy. We also evaluated the association of these disorders with maternal characteristics; demographics; prior pregnancy complications; current pregnancy complications; COVID-19 severity; laboratory values and inflammatory markers; and maternal and fetal outcomes. Univariable analysis was conducted with Student’s t-test, the chi-squared test and analysis of variance. Multivariable analyses were done using linear and logistic regression models. Main Outcome Measures: The incidence of hypertensive disorders of pregnancy in SARs-CoV-2 positive patients compared to SARs-CoV-2 negative patients. Results: Compared with pregnancies negative for SARs-CoV-2 infection, maternal SARs-CoV-2 infection was associated with an increased risk for hypertensive disorders of pregnancy (OR 3.68, 95% CI 1.67 -8.10). Overall rates of preeclampsia with severe features were significantly higher in patients with a COVID-19 diagnosis (18.6% vs 7.1%, p=0.006). An early SARS-CoV-2 infection (prior to 32 week’s gestation) conferred a higher risk of hypertensive disorders in pregnancy compared to SARs-CoV-2 infections diagnosed after 32 weeks’ gestation(OR=6.29, CI 1.64-24.07; p=0.007). Conclusion: COVID-19 is a risk factor for hypertensive disorders of pregnancy. Funding: None Conflicts of Interest: None