Rate of Hypertensive Disorders of Pregnancy With Monoclonal Antibody Treatment for SARS-CoV-2 Infection [ID: 1376017

Abstract

INTRODUCTION: SARS-CoV-2 infection among pregnant patients been associated with elevated rates of hypertensive disorders of pregnancy (HDP). We have demonstrated that monoclonal antibodies did not result in significantly different rates of severe COVID-19 in pregnancy. We undertook this study to determine whether HDP was altered with monoclonal antibody (mAb) treatment for SARS-CoV-2. METHODS: Retrospective cohort study approved by the IRB of University of Pittsburgh of patients aged 12 or older with a pregnancy episode and positive SARS-CoV-2 test in the UPMC health system. Among 663 patients, 403 received mAb treatment and 260 did not receive mAb. Chart review was performed for diagnosis of gestational hypertension (gHTN), preeclampsia without severe features, severe preeclampsia/HELLP syndrome, and postpartum hypertensive disorder with no antepartum diagnosis (PPHTN). Student’s t test was used to compare groups, and P<.05 was considered significant. RESULTS: The majority of patients presented during the Omicron wave. In the mAb-treated group, 21.8% developed HDP, 13.2% gHTN, 2.5% nonsevere preeclampsia, 6.9% severe preeclampsia/HELLP, and 2.7% PPHTN. The group that received no mAb experienced rates that were not significantly different from the mAb treated: 17.3% HDP, 10.8% gHTN, 3.5% nonsevere preeclampsia, 2.3% severe preeclampsia/HELLP, and 1.9% PPHTN. CONCLUSION: The use of mAbs in pregnant patients infected with SARS-CoV-2 is not associated with a change in the rate of HDP with the Omicron variant. Patients treated with mAbs had a trend toward increased severe preeclampsia, although this was not statistically significant. An understanding of which populations benefit maximally from mAb treatment will assist in managing the most effective and efficient allocation of resources.