Obstetric Outcomes in Women with Rheumatic Disease and COVID-19 in the Context of Vaccination Status

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Abstract

Objective:
To describe obstetric outcomes based on COVID-19 vaccination status, in women with rheumatic and musculoskeletal diseases (RMDs) who developed COVID-19 during pregnancy.

Methods:
Data regarding pregnant women entered into the COVID-19 Global Rheumatology Alliance registry from 24 March 2020 to 25 February 2022 were analysed. Obstetric outcomes were stratified by number of COVID-19 vaccine doses received prior to COVID-19 infection in pregnancy. Descriptive differences between groups were tested using the chi -square or Fisher’s exact test.

Results:
There were 73 pregnancies in 73 women with RMD and COVID-19. Overall, 24.7% (18) of pregnancies were ongoing, while of the 55 completed pregnancies 90.9% (50) of pregnancies resulted in livebirths. At the time of COVID-19 diagnosis, 60.3% (n=44) of women were unvaccinated, 4.1% (n=3) had received one vaccine dose while 35.6% (n=26) had two or more doses. Although 83.6% (n=61) of women required no treatment for COVID-19, 20.5% (n=15) required hospital admission. COVID-19 resulted in delivery in 6.8% (n=3) of unvaccinated women and 3.8% (n=1) of fully vaccinated women. There was a greater number of preterm births (PTB) in unvaccinated women compared to fully vaccinated 29.5% (n=13) vs 18.2%(n=2).

Conclusion:
In this descriptive study, unvaccinated pregnant women with RMD and COVID-19 had a greater number of PTB compared with those fully vaccinated against COVID-19. Additionally, the need for COVID-19 pharmacological treatment was uncommon in pregnant women with RMD regardless of vaccination status. These results support active promotion of COVID-19 vaccination in women with RMD who are pregnant or planning a pregnancy.

Bibliographical metadata

Original languageEnglish
JournalRheumatology
Publication statusAccepted/In press - 7 Sep 2022