Obstetric Outcomes in Women with Rheumatic Disease and COVID-19 in the Context of Vaccination Status.
Maguire, Sinead; Al-Emadi, Samar; Alba, Paula; Aguiar, Mathia Cecilia; Lawati, Talal Al; Alle, Gelsomina; Bermas, Bonnie; Bhana, Suleman; Branimir, Anic; Bulina, Inita; Clowse, Megan; Cogo, Karina; Colunga, Iris; Cook, Claire; Cortez, Karen J; Dao, Kathryn; Gianfrancesco, Milena; Gore-Massey, Monique; Gossec, Laure; Grainger, Rebecca; Hausman, Jonathon; Hsu, Tiffany Y T; Hyrich, Kimme; Isnardi, Carolina; Kawano, Yumeko; Kilding, Rachael; Kusevich, Daria A; Lawson-Tovey, Saskia; Liew, Jean; McCarthy, Eoghan; Montgumery, Anna; Moyano, Sebastian; Nasir, Noreen; Padjen, Ivan; Papagoras, Charalampos; Patel, Naomi J; Pera, Mariana; Pisoni, Cecilia; Pons-Estel, Guillermo; Quiambao, Antonio L; Quintana, Rosana; Ruderman, Eric; Sattui, Sebastian; Savio, Veronica; Sciascia, Savino; Sencarova, Marieta; Morales, Rosa Serrano; Siddique, Faizah; Sirotich, Emily; Sparks, Jeffrey; Strangfeld, Anja; Sufka, Paul; Tanner, Helen; Tissera, Yohana; Wallace, Zachary; Werner, Marina L; Wise, Leanna; Worthing, Angus B; Zell, JoAnn; Zepa, Julija; Machado, Pedro M; Yazdany, Jinoos; Robinson, Philip; Conway, Richard
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 2020-25 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 with 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.
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