Abstract
Objective The study aimed to compare the quantitative blood loss (QBL) and hemorrhage-related
outcomes of pregnant women with and without a coronavirus disease 2019 (COVID-19)
diagnosis.
Study Design This retrospective cohort study of all live deliveries at Boston Medical Center between
April 1, 2020 and July 22, 2020 compares the outcomes of pregnant women with a laboratory-confirmed
COVID-19 positive diagnosis and pregnant women without COVID-19. The primary outcomes
are QBL and obstetric hemorrhage. The secondary outcomes analyzed were a maternal
composite outcome that consisted of obstetric hemorrhage, telemetry-level (intermediate
care unit) or intensive care unit, transfusion, length of stay greater than 5 days,
or intraamniotic infection, and individual components of the maternal composite outcome.
Groups were compared using Student's t-test, Chi-squared tests, or Fisher's exact. Logistic regression was used to adjust
for confounding variables.
Results Of 813 women who delivered a live infant between April 1 and July 22, 2020, 53 women
were diagnosed with COVID-19 on admission to the hospital. Women with a COVID-19 diagnosis
at their time of delivery were significantly more likely to identify as a race other
than white (p = 0.01), to deliver preterm (p = 0.05), to be diagnosed with preeclampsia with severe features (p < 0.01), and to require general anesthesia (p < 0.01). Women diagnosed with COVID-19 did not have a significantly higher QBL (p = 0.64). COVID-19 positive pregnant patients had no increased adjusted odds of obstetric
hemorrhage (adjusted odds ratio [aOR]: 0.41, 95% confidence interval [CI]: 0.17–1.04)
and no increased adjusted odds of the maternal morbidity composite (aOR: 0.98, 95%
CI: 0.50–1.93) when compared with those without a diagnosis of COVID-19.
Conclusion Pregnant women with COVID-19 diagnosis do not have increased risk for obstetric hemorrhage,
increased QBL or risk of maternal morbidity compared with pregnant women without a
COVID-19 diagnosis. Further research is needed to describe the impact of a COVID-19
diagnosis on maternal hematologic physiology and pregnancy outcomes.
Key Points
-
Information about blood loss associated with peripartum COVID-19 is limited.
-
COVID-19 diagnosis is not associated with increase in obstetric hemorrhage.
-
COVID-19 diagnosis is not associated with increase in blood loss.
Keywords
quantitative blood loss - obstetric hemorrhage - SARS-CoV-2 - Pregnancy
