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Pregnant People Hospitalized for COVID May Fare Better Than Patients Who Aren't Pregnant

Pregnant woman on hospital bed wearing mask with monitoring belly band

Kemal Yildirim / Getty Images

Key Takeaways

  • While the risk and severity of COVID-19 in pregnant people has been a concern throughout the pandemic, new research suggests pregnant women hospitalized for COVID-19 don't have a higher chance of dying than people who are not pregnant.
  • Pregnant patients were more likely to survive COVID-19 infection regardless of being in the ICU or on a mechanical ventilator.
  • The study focused only pregnant patients with severe COVID-19 who required hospitalization. The results can't be extrapolated to every pregnant person infected with COVID-19.

Pregnant patients hospitalized with severe COVID-19 may not have a higher chance of dying than non-pregnant patients, according to recent findings published in Annals of Internal Medicine. The study results suggest that whether or not a pregnant person gets vaccinated, they’re likely to do well if they become hospitalized.

The Centers for Disease Control and Prevention (CDC) says that pregnant or recently pregnant people are at a higher risk of developing severe COVID-19 infection due to bodily changes they experience. So it was important for researchers to investigate mortality outcomes in this group to have a sense of how they would fare.

Anthony D. Harris, MD, MPH, of the University of Maryland School of Medicine and senior author of the study, tells Verywell the results were “unexpected” and conflict with CDC findings. But he says the reporting used by the CDC is not perfect, and their initial reports may have had problems with data collection.

"We wanted to explore if pregnant women were doing worse, [and] see whether it was true on a different data set,” Harris says.

Regardless of the finding, Harris says there were multiple benefits to challenging CDC’s initial reports. He says that if his team confirmed pregnant people were doing worse, it could serve as evidence necessary to develop public health opportunities to relay that message. And if they were not faring more poorly—as researchers found—the results may help decrease the anxiety many pregnant people are grappling with.

“They probably would do better than the current science has indicated,” Harris says.

Who Was Included in the Study?

The research team took their data from 1,062 medical records of pregnant patients and more than 9,815 non-pregnant patients between the ages of 15 to 45 who were hospitalized for COVID-19 infection and pneumonia from April to November 2020. The data was pulled from a healthcare database reflecting about 20% of U.S. hospitalizations.

Since pregnant patients are routinely screened for COVID-19, researchers added viral pneumonia as an indicator of severe infection.

Pregnant Patients had a Lower Mortality Risk Than Patients Who Were Not Pregnant

Researchers noted 0.8% pregnant patients passed away compared to 3.5% of nonpregnant patients hospitalized with COVID-19 or pneumonia.

Pregnant patients in the intensive care unit (ICU) also had a lower mortality rate than nonpregnant patients.

For pregnant people who needed a ventilator, the risk of death was lower, too. About 8.6% of ventilated pregnant patients died compared to 31.4% of patients who were not pregnant.

Pregnant patients who died ranged from 23 to 44 years old. Four of the nine pregnant people who died were Hispanic; three were Black.

Results do not Reflect Every Pregnant Person Sick With COVID-19

The study looked only at hospitalized or ICU-admitted pregnant patients with COVID-19 and pneumonia, meaning the results are not applicable to everyone who is pregnant.

"We don’t know if pregnant women who just happened to be positive [for COVID-19] also do as well or better than those routinely screened. You can only generalize things to the population in which it's studied,” Harris says. “It doesn't necessarily mean that pregnant people in the community who are COVID-positive but not sick enough to be hospitalized don’t do as well. We didn't study that group; the database we used only includes hospitalized patients.”

The hospitalized pregnant patients included in the study tended to be younger, healthier, and have health insurance. For the most part, the study didn't focus on pregnant people with obesity, diabetes, or another disease that would make their pregnancy high-risk.

What Happens Next?

Harris says his team is expanding their research and confirming their results with a larger population of pregnant patients.

“When you find the same result in multiple different subgroups, you have a lot more confidence that what you're finding is definitely true,” Harris says.

In a month, they will analyze another data set, again controlling for obesity and comorbidities. “Are we still going to see those [same] results? Because the pregnant women [in our study] were a little bit healthier than the nonpregnant women, and they had less of those comorbid conditions. So, the next step in our research will be to better statistically control for COVID-19 to find if this is still the case.”

There’s currently a lack of information explaining why hospitalized pregnant women may be having better health outcomes. Harris and his team will continue to explore this question and hope other scientists will look further into this as well. While more data is needed, he suggests the answer may have to do with the lack of cytokine storms—uncontrolled inflammation associated with COVID—observed in pregnant women during infection.

“Pregnant women innately are a little bit more immunosuppressed, and it's possible that could actually make their outcomes better," Harris says. "They may not have the [cytokine] storm reaction that leads to some of the worst outcomes we're seeing in patients.”

What This Means For You

Pregnant patients hospitalized with COVID may not have worse outcomes than patients who are not pregnant, but they are still considered a high-risk group for infection. If you are pregnant, getting vaccinated would help relieve any anxiety of dying from COVID-19 illness. Vaccinations can also confer benefits such as protective immunity for breastfed babies.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.

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  1. Pineles BL, Goodman KE, Pineles L, et al. In-hospital mortality in a cohort of hospitalized pregnant and nonpregnant patients with COVID-19Ann Intern Med. Published online May 11, 2021. doi:10.7326/M21-0974

  2. Centers for Disease Control and Prevention. Pregnant and recently pregnant people. Updated May 13, 2021.