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Risk for Stillbirth Among Women With and Without COVID-19 at Delivery Hospitalization — United States, March 2020–September 2021
https://www.cdc.gov/mmwr/volumes/70/wr/mm7047e1.htm?s_cid=mm7047e1_x
Pregnant women are at increased risk for severe COVID-19–related illness
COVID-19 is associated with an increased risk for adverse pregnancy outcomes,
and maternal and neonatal complications
Stillbirth during March 2020–September 2021
N = 1,249,634 deliveries
Stillbirths were rare (8,154; 0.65%)
21,653 deliveries to women with COVID-19 at the delivery hospitalization
273 (1.26%)
1,227,981 deliveries without COVID-19
7,881 (0.64%)
Prepandemic stillbirth rate 0.59%
Results, March 2020–September 2021
Adjusted relative risk [aRR] = 1.90
March 2020–June 2021, pre-delta
aRR = 1.47
0.98% of COVID-19–affected deliveries resulted in stillbirth
July–September 2021, delta
aRR = 4.04
2.7% of COVID-19–affected deliveries resulted in stillbirth
Implications
Implementing evidence-based COVID-19 prevention strategies,
including vaccination before or during pregnancy,
is critical to reducing the impact of COVID-19 on stillbirths.
Stillbirths, defined as fetal deaths at ≥20 weeks’ gestation
53.7% of women were non-Hispanic White
50.6% had private insurance
15.4% had obesity
11.2% had diabetes
17.2% had a hypertensive disorder
1.8% had a multiple-gestation pregnancy
4.9% had smoking (tobacco) documented
Pathophysiology
Placental histopathologic abnormalities, suggesting placental hypoperfusion and inflammation,
might occur with maternal COVID-19 infection
Need for pre and post delta placental studies
Mississippi, Black and Hispanic women accounted for 12 of the 15 covid-associated deaths
(50% of infections)
Source