US Pharm. 2022;47(4):14.
The National Center for Health Statistics notes that of the 1.4 million reported cases of maternal COVID-19 during pregnancy (MCDP) in 2020–2021, just 3.7% were confirmed positive. Data on the impact of coronavirus 2019 (COVID-19) infection on expectant mothers and their newborns are limited. These data, although not representative of all U.S. births, are the only multistate birth certificate–based data currently available.
Maternal Age: Mothers aged 30 years and older more often tested positive than negative for COVID-19 infection. Positive cases outnumbered negative cases in mothers aged 30 to 34 years (29.9% vs. 26.8%), 35 to 39 years (16.4% vs. 13.6%), and 40 years and older (3.9% vs. 3.1%). There were fewer positive cases than negative cases in mothers aged 25 to 29 years (27.7% vs. 29.9%), 20 to 24 years (17.9% vs. 21.4%), and younger than 20 years (4.2% vs. 5.2%).
Maternal Education: Confirmed MCDP was lowest among mothers holding an associate degree (8.2%) and highest among those with a high school diploma or General Equivalency Diploma (GED; 30%). In those with a bachelor’s degree or higher, the rate of confirmed MCDP in non-Hispanic whites (37.2%) was more than double that of non-Hispanic blacks (15.6%) and more than triple that of Hispanics (10.2%). In mothers with a high school diploma or GED, the rate was higher in non-Hispanic blacks (40%) than in Hispanics (33.9%) and non-Hispanic whites (25.3%). In those with an associate degree, Hispanics (5.1%) had the lowest rate of infection, followed by non-Hispanic blacks (7.8%) and non-Hispanic whites (10.4%). In mothers with less than high school education, cases were higher in Hispanics (31.3%) than in non-Hispanic blacks (11.2%) and non-Hispanic whites (6.9%).
Neonatal Characteristics: The rate of preterm births (34-36 weeks) in cases of MCDP was 15% higher in mothers who tested positive (11.48%) than in those testing negative (9.98%). Non-Hispanic black mothers with MCDP (15.7%) had the highest number of preterm births, followed by Hispanics (11.06%) and non-Hispanic whites (10.24%). The rate of preterm births in mothers with confirmed COVID-19 was higher in non-Hispanic blacks (10.57%) than in Hispanics (8.27%) and non-Hispanic whites (7.6%). The incidence of low birthweight (<2,500 g) in neonates whose mother had confirmed MCDP (8.73%) was greater than in those whose mother did not (8.01%). The incidence of low birthweight in neonates of mothers with confirmed MCDP was considerably higher in non-Hispanic blacks (14.69%) than in Hispanics (7.71%) and non-Hispanic whites (7.33%). Ten percent of neonates whose mother had a positive COVID-19 test were admitted to the neonatal ICU.
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