tetano
Editor, Senior Moderator
Pediatr Infect Dis J
. 2023 Jun 1.
doi: 10.1097/INF.0000000000003988. Online ahead of print. Outcomes in Pregnant Adolescent Patients Infected With SARS-CoV-2
Anh Quynh Nguyen[SUP] 1 [/SUP], Ellen Murrin[SUP] 1 [/SUP], Sebastian Nasrallah[SUP] 1 [/SUP], Laura Hitchings[SUP] 2 [/SUP], Jenny Q Wang[SUP] 1 [/SUP], Michael B VanDillen[SUP] 3 [/SUP], Oluwafunmilayo Eletu[SUP] 4 [/SUP], G Larry Maxwell[SUP] 1 [/SUP], Luis M Gomez[SUP] 1 [/SUP]
Affiliations
Background: Pregnant patients with coronavirus disease 2019 (COVID-19) are at risk for adverse pregnancy outcomes. Although clinical outcomes for pregnant adults have been reported, the impact of COVID-19 on adolescents is lacking. We sought to evaluate obstetric outcomes of pregnant adolescents infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and compare them with uninfected adolescent controls.
Methods: Retrospective cohort study of pregnant adolescents (14-19 years) who had a positive polymerase chain reaction test for SARS-CoV-2 from April 2020 to December 2020 at Inova Health System Hospitals. Controls included pregnant adolescents who tested negative. The primary outcome was a composite of preeclampsia, preterm delivery, cesarean delivery, fetal growth restriction and stillbirth. Secondary outcomes included maternal and neonatal morbidity.
Results: Forty-eight pregnant adolescents who tested positive for SARS-CoV-2 were compared with 394 controls. Infected adolescents were more likely to be Hispanic (91.67% vs. 12.18%; risk ratio [RR] 41.85 [95% CI: 15.43-113.5]) and uninsured (50% vs. 7.87%; RR 7.04 [95% CI: 4.31-11.49]. Nearly 80% of infected adolescents remained asymptomatic, whereas one-third of symptomatic adolescents progressed to severe or critical COVID-19. The primary composite outcome was more prevalent in infected adolescents compared with noninfected controls (41.67% vs. 25.38%; adjusted RR 2.65 [95% CI: 1.19-5.93]). Maternal morbidity was more prevalent in infected adolescents (6.25% vs. 0.76%; adjusted RR 9.53 [95% CI: 3.83-23.71]). Primary and secondary maternal outcomes were more prevalent in younger adolescents and those with higher severity of COVID-19. Maternal SARS-CoV-2 infection was not associated with neonatal morbidity.
Conclusions: Pregnant adolescents infected with SARS-CoV-2 are more likely to have adverse obstetric outcomes and maternal morbidity compared with noninfected pregnant adolescents.
. 2023 Jun 1.
doi: 10.1097/INF.0000000000003988. Online ahead of print. Outcomes in Pregnant Adolescent Patients Infected With SARS-CoV-2
Anh Quynh Nguyen[SUP] 1 [/SUP], Ellen Murrin[SUP] 1 [/SUP], Sebastian Nasrallah[SUP] 1 [/SUP], Laura Hitchings[SUP] 2 [/SUP], Jenny Q Wang[SUP] 1 [/SUP], Michael B VanDillen[SUP] 3 [/SUP], Oluwafunmilayo Eletu[SUP] 4 [/SUP], G Larry Maxwell[SUP] 1 [/SUP], Luis M Gomez[SUP] 1 [/SUP]
Affiliations
- PMID: 37260248
- DOI: 10.1097/INF.0000000000003988
Background: Pregnant patients with coronavirus disease 2019 (COVID-19) are at risk for adverse pregnancy outcomes. Although clinical outcomes for pregnant adults have been reported, the impact of COVID-19 on adolescents is lacking. We sought to evaluate obstetric outcomes of pregnant adolescents infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and compare them with uninfected adolescent controls.
Methods: Retrospective cohort study of pregnant adolescents (14-19 years) who had a positive polymerase chain reaction test for SARS-CoV-2 from April 2020 to December 2020 at Inova Health System Hospitals. Controls included pregnant adolescents who tested negative. The primary outcome was a composite of preeclampsia, preterm delivery, cesarean delivery, fetal growth restriction and stillbirth. Secondary outcomes included maternal and neonatal morbidity.
Results: Forty-eight pregnant adolescents who tested positive for SARS-CoV-2 were compared with 394 controls. Infected adolescents were more likely to be Hispanic (91.67% vs. 12.18%; risk ratio [RR] 41.85 [95% CI: 15.43-113.5]) and uninsured (50% vs. 7.87%; RR 7.04 [95% CI: 4.31-11.49]. Nearly 80% of infected adolescents remained asymptomatic, whereas one-third of symptomatic adolescents progressed to severe or critical COVID-19. The primary composite outcome was more prevalent in infected adolescents compared with noninfected controls (41.67% vs. 25.38%; adjusted RR 2.65 [95% CI: 1.19-5.93]). Maternal morbidity was more prevalent in infected adolescents (6.25% vs. 0.76%; adjusted RR 9.53 [95% CI: 3.83-23.71]). Primary and secondary maternal outcomes were more prevalent in younger adolescents and those with higher severity of COVID-19. Maternal SARS-CoV-2 infection was not associated with neonatal morbidity.
Conclusions: Pregnant adolescents infected with SARS-CoV-2 are more likely to have adverse obstetric outcomes and maternal morbidity compared with noninfected pregnant adolescents.