Date: Sunday, November 13, 2022
Session Title: Reproductive Issues in Rheumatic Disorders Poster
Session Type: Poster Session B
Session Time: 9:00AM-10:30AM
Background/Purpose: 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: We extracted data on pregnant women who were entered into the COVID-19 Global Rheumatology Alliance (C19 GRA) registry from 24 March 2020 to 25 February 2022. Supplemental data collection was carried out via e-surveys sent to healthcare professionals who previously submitted data on pregnant patients to the C19 GRA registry. Obstetric outcomes were stratified by the number of COVID-19 vaccine doses received prior to COVID-19 infection in pregnancy. Partially or unvaccinated was defined as 0 to 1 dose of COVID-19 vaccine, while fully vaccinated was defined as 2 or more doses. None of the participants received the single dose Johnson & Johnson vaccine. Descriptive differences between groups were tested for statistical significance using the Chi-square or Fisher’s exact test.
Results: There were 73 pregnancies in 73 women (mean [SD] age of 32.3 [5.1] years) with RMD and COVID-19. Systemic lupus erythematosus was the most common RMD (23.3%, n=17), followed by rheumatoid arthritis (21.9%, n=16) (table 1). RMD was in remission at the time of COVID-19 diagnosis in 69.9% (51) of patients, with only 4.1% (3) reporting severe disease activity.
At the time of data extraction, 24.7% (18) of pregnancies were ongoing, while of the 55 completed pregnancies 90.9% (50) of pregnancies resulted in livebirths. Overall, 1.4% (1) of pregnancies resulted in miscarriage, 1.4% (1) in termination for maternal health and 4.1% (3) in stillbirths. At the time of COVID-19 diagnosis, 60.3% (44) of women were unvaccinated, 4.1% (3) had received one dose while 35.6% (26) had two or more doses (table 2). Although 20.5% (15) required hospital admission, only 16.4% (12) of women required COVID-19 specific pharmacological treatment.
COVID-19 precipitated delivery in 6.8% (3) of unvaccinated women and 3.8%(1) of fully vaccinated women. Of the completed pregnancies there was a greater number of preterm births (PTB) in unvaccinated women compared to fully vaccinated women (29.5% vs 18.2%) (table 3). Low birthweight (LBW) was the most frequent neonatal complication recorded in 24% (12/50) of pregnancies resulting in live births, followed by small for gestational age (SGA) in 14% (7/50).
Conclusion: This multinational analysis of obstetric outcomes in women with RMDs and COVID-19 using data from the C19-GRA registry is unique in the inclusion of vaccination data. In this descriptive study, unvaccinated pregnant women with RMD and COVID-19 had a higher frequency of PTB compared to 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 of women with RMD who are pregnant or planning a pregnancy.
To cite this abstract in AMA style:Maguire S, Al emadi S, Alba P, Aguiar M, Al Lawati T, Alle G, Bermas B, Bhana S, Anic B, Bulina I, Clowse M, Cogo A, Colunga I, Cook C, CORTEZ K, Dao K, Gianfrancesco M, Gore-Massy M, Gossec L, Grainger R, Hausmann J, Hsu T, Hyrich K, Isnardi C, Kawano Y, Kilding R, Kusevich D, Lawson-Tovey S, Liew J, McCarthy E, Montgomery A, Moyano S, Nasir N, PADJEN I, Papagoras C, Patel N, PERA M, Pisoni C, Pons-Estel G, Quiambao A, Quintana R, Ruderman E, Sattui S, Savio V, Sciascia S, Sencarova M, Serrano-Morales R, Siddique F, Sirotich E, Sparks J, Strangfeld A, Sufka P, Tanner H, Tissera Y, Wallace Z, Werner M, Wise L, Worthing A, Zell J, Zepa J, Machado P, Yazdany J, Robinson P, Conway R. Obstetric Outcomes in Women with Rheumatic Disease and COVID-19 in the Context of Vaccination Status: Data from the COVID-19 Global Rheumatology Alliance Registry [abstract]. Arthritis Rheumatol. 2022; 74 (suppl 9). https://acrabstracts.org/abstract/obstetric-outcomes-in-women-with-rheumatic-disease-and-covid-19-in-the-context-of-vaccination-status-data-from-the-covid-19-global-rheumatology-alliance-registry/. Accessed March 27, 2023.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/obstetric-outcomes-in-women-with-rheumatic-disease-and-covid-19-in-the-context-of-vaccination-status-data-from-the-covid-19-global-rheumatology-alliance-registry/