Magnus MC, Oakley L, Gjessing HK, Stephansson O, Engjom HM, Macsali F, Juliusson PB, Andersen AN, Håberg SE
BJOG - (-) - [2021-10-17; online 2021-10-17]
To compare the risk of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and contact with specialist health-care services for coronavirus disease 2019 (COVID-19) between pregnant and non-pregnant women. All women ages 15 to 45 living in Norway on March 1st , 2020 (N=1,033,699). We linked information from the national birth, patient, communicable diseases, and education databases using unique national identifiers. We estimated hazard ratios (HR) among pregnant compared to non-pregnant women of having a positive test for SARS-CoV-2, a diagnosis of COVID-19 in specialist healthcare, or hospitalization with COVID-19 using Cox regression. Multivariable analyses adjusted for age, marital status, education, income, country of birth and underlying medical conditions. Pregnant women were not more likely to be tested for or to a have a positive SARS-CoV-2 test (adjusted HR, 0.99; 95% confidence interval [CI]: 0.92-1.07). Pregnant women had higher risk of hospitalization with COVID-19 (HR, 4.70; 95% CI: 3.51- 6.30), and any type of specialist care for COVID-19 (HR, 3.46; 95% CI: 2.89-4.14). Pregnant women born outside Scandinavia were less likely to be tested, and at higher risk of a positive test (HR, 2.37; 95% CI: 2.51-8.87). Compared to pregnant Scandinavian born women, pregnant women with minority background had a higher risk of hospitalization with COVID-19 (HR, 4.72; 95% CI: 2.51-8.87). Pregnant women were not more likely to be infected with SARS-CoV-2. Still, pregnant women with COVID-19, especially those born outside of Scandinavia, were more likely to be hospitalized.