(125) INTRAPARTUM AND 30-DAY POSTPARTUM COMPLICATIONS IN PREGNANCIES WITH ANTENATAL SARS-COV-2 INFECTION

Abstract

Abstract Introduction While COVID-19 has been associated with adverse pregnancy outcomes, data regarding intrapartum and postpartum maternal complications after antenatal COVID-19 infection is limited and variable. Objective This study compares the intrapartum and postpartum complication rates between pregnant patients with and without an antenatal COVID-19 diagnosis in a national dataset. Methods This is a retrospective cohort study of patients who gave birth between January 2020 and May 2023 utilizing the TriNetx Analytics Research Network, an aggregated electronic health record platform. Our data searches were performed on May 1, 2023. ICD-10 codes were used to identify the encounter for delivery (ICD-10 code O80-O82) and pregnant individuals with a COVID-19 diagnosis (ICD-10 code U70.1) during their gestational period. The control group was defined as those with one encounter for delivery between January 2020 and May 2023 and without a diagnosis of COVID-19 during the gestational period. Complications included obstetric, cardiovascular, neurovascular, and pulmonary outcomes diagnosed from the day of delivery to 30 days postpartum. The cohort was propensity matched by age, race, and ethnicity. The relative risk values and 95% confidence intervals for the outcomes were calculated and compared. Results Of the 368,923 patients who had an encounter for delivery between January 2020 and May 2023, 26,974 (7%) had an antenatal COVID-19 diagnosis. Compared to our matched control cohort, patients with antenatal COVID-19 were at an increased risk of postpartum hemorrhage (RR 1.24, 95% CI 1.16-1.33), gestational hypertension without significant proteinuria (1.27 [1.21-1.34]), pre-eclampsia (1.25 [1.18-1.32]), eclampsia (1.66 [1.29-2.23]), and preterm labor (1.21 [1.12-1.31]). Patients with antenatal COVID-19 infections were also at an increased risk of postpartum complications, including cerebral infarction (1.74 [1.04-2.90]), pulmonary embolism (2.68 [1.74-4.13]), acute embolism and thrombosis of deep veins of lower extremity (2.32 [1.45-3.71]), sepsis (2.21 [1.54-3.19]), heart failure (1.55 [1.04-2.31]), and cardiomyopathy (2.08 [1.30-3.32]). There was no elevated risk of HELLP syndrome (1.18 [0.96-1.44]), placental abruption (1.14 [0.94-1.37]), and myocardial infarction (1.4 [0.62-3.15]). Conclusions Pregnant individuals with antenatal COVID-19 diagnosis were more likely to have intrapartum and postpartum encounter diagnoses for obstetric, cardiovascular, neurovascular, and pulmonary complications. This data allows providers to identify antenatal COVID-19 infection as a risk factor and monitor patients for complications. Disclosure No.