COVID-19 in Pregnancy Raises Hypertension Risk - EMJ

COVID-19 in Pregnancy Raises Hypertension Risk


STUDY finds that COVID-19 infection during pregnancy increases the risk of hypertensive disorders, but does not appear to affect placental pathology.New research presented at the ACOG Annual Clinical & Scientific Meeting indicates that pregnant women who contract COVID-19 are at significantly higher risk of developing hypertensive disorders. But, in contrast, the study found no connection between COVID-19 infection and abnormalities in placental histology, which was initially suspected to be behind the increased risk. 

The retrospective cohort study conducted at Ascension St.John Hospital in Detroit, involved 647 women, of which 177 tested positive for COVID-19 during pregnancy and 470 who tested negative. The study compared placental samples from both groups to investigate potential associations between COVID-19 infection and placental pathology. 

Results showed that women who tested positive for COVID-19 during pregnancy had a higher likelihood of recreational drug use (6.8% vs. 2.9%) and were more likely to be Black compared to those who tested negative (57.1% vs. 36.7%). Additionally, among the COVI-19 positive group, 28.6% of women were diagnosed with hypertensive disorders of pregnancy, compared to 15.1% in the negative group. Which represents a 72.4% higher risk for hypertensive disorders in COVID-19 positive women. 

However, the results showed no significant differences in placental pathology between COVID-19 positive and negative women. Additionally, women with placental infracts had a 2.5-fold likelihood of hypertensive disorders of pregnancy. 

The results show that the increased risk of hypertensive disorders in pregnant women with COVID-19 is not due to the placental infection and inflammation. Instead, the risk is likely related to systemic inflammation, cytokine storms, or the dysregulation of the renin-angiotensin-aldosterone system. These findings emphasize the importance of monitoring pregnant women with COVID-19 for hypertensive disorders and highlight the need for further research into the systemic effects of COVID-19 on pregnancy. 


Siblini T et al. Coronavirus disease 2019 and hypertensive disorders of pregnancy: Is the placenta the problem? Abstract K13. ACOG Annual Clinical & Scientific Meeting; 17-20 May, 2024. 

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