Preterm birth among pregnant persons with severe acute respiratory syndrome Coronavirus 2 infection

Objective We examined the relationship between trimester of SARS-CoV-2 infection, illness severity, and risk for preterm birth. Study design We analyzed data for 6336 pregnant persons with SARS-CoV-2 infection in 2020 in the United States. Risk ratios for preterm birth were calculated for illness severity, trimester of infection, and illness severity stratified by trimester of infection adjusted for age, selected underlying medical conditions, and pregnancy complications. Result Pregnant persons with critical COVID-19 or asymptomatic infection, compared to mild COVID-19, in the second or third trimester were at increased risk of preterm birth. Pregnant persons with moderate-to-severe COVID-19 did not show increased risk of preterm birth in any trimester. Conclusion Critical COVID-19 in the second or third trimester was associated with increased risk of preterm birth. This finding can be used to guide prevention strategies, including vaccination, and inform clinical practices for pregnant persons.

Automated summary

This study analyzed data for 6336 pregnant individuals with SARS-CoV-2 infection in the US in 2020, finding that pregnant individuals with critical COVID-19 or asymptomatic infection in the second or third trimester had an increased risk of preterm birth. Pregnant individuals with moderate-to-severe COVID-19 did not show an increased risk of preterm birth in any trimester.