{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T17:57:56Z","timestamp":1784138276934,"version":"3.55.0"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2021,5,10]],"date-time":"2021-05-10T00:00:00Z","timestamp":1620604800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,2,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Pregnancy has been reported to be a risk factor for severe COVID-19. We evaluated the impact of pregnancy on severe COVID-19 and mortality in an electronic medical record (EMR) database that enabled exclusion of labor and delivery (L&amp;D) encounters.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In this retrospective cohort study, EMRs from 82 healthcare facilities in the Cerner COVID-19 Datamart were analyzed. The study comprised 38 106 individuals aged 18\u201345 years old with COVID-19 who had emergency department, urgent care, or inpatient encounters from December 2019 to September 2020. Subgroups were balanced through propensity score weights for age, race, smoking status, and number of comorbidities. The primary outcome was COVID-19\u2013related mortality; secondary outcomes were markers of severe COVID-19: intubations, mechanical ventilation, use of vasopressors, diagnosis of sepsis, and diagnosis of acute respiratory distress syndrome.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In comparing pregnant and nonpregnant women, no statistical differences were found for markers of severe COVID-19, after adjusting for age, smoking, race, and comorbidities. The adjusted odds of an inpatient encounter were higher for pregnant vs nonpregnant women (adjusted odds ratio [aOR], 13.2; 95% confidence interval [CI], 11.6\u201315.3; P &amp;lt; .001), but notably lower after excluding L&amp;D encounters (aOR, 2.3; 95% CI, 1.89\u20132.88; P &amp;lt; .001). In comparison to women without L&amp;D encounters, hospitalization was significantly more likely for men.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>We did not find an increased risk of severe COVID-19 or mortality in pregnancy. Hospitalization does not necessarily indicate severe COVID-19 in pregnancy, as half of pregnant patients with COVID-19 were admitted for L&amp;D encounters in this study.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciab441","type":"journal-article","created":{"date-parts":[[2021,5,12]],"date-time":"2021-05-12T11:30:07Z","timestamp":1620819007000},"page":"467-471","source":"Crossref","is-referenced-by-count":3,"title":["Coronavirus Disease 2019 (COVID-19) Disease Severity: Pregnant vs Nonpregnant Women at 82 Facilities"],"prefix":"10.1093","volume":"74","author":[{"given":"Albert L","family":"Hsu","sequence":"first","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Women\u2019s Health, University of Missouri\u2013Columbia School of Medicine, Columbia, Missouri, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrienne M","family":"Ohler","sequence":"additional","affiliation":[{"name":"Child Health Research Institute, Department of Child Health, University of Missouri\u2013Columbia School of Medicine, Columbia, Missouri, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Goldstein","sequence":"additional","affiliation":[{"name":"University of Missouri\u2013Columbia School of Medicine, Columbia, Missouri, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Truong","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Women\u2019s Health, University of Missouri\u2013Columbia School of Medicine, Columbia, Missouri, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia Y","family":"Tang","sequence":"additional","affiliation":[{"name":"University of Missouri\u2013Columbia School of Medicine, Columbia, Missouri, USA"},{"name":"MU Center for Influenza and Emerging Infectious Diseases, University of Missouri, Columbia, Missouri, USA"},{"name":"University of Missouri Institute for Data Science and Informatics, Columbia, Missouri, USA"},{"name":"Department of Molecular Microbiology and Immunology, School of Medicine, University of Missouri, Columbia, Missouri, USA"},{"name":"Bond Life Sciences Center, University of Missouri, Columbia, Missouri, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiu-Feng","family":"Wan","sequence":"additional","affiliation":[{"name":"MU Center for Influenza and Emerging Infectious Diseases, University of Missouri, Columbia, Missouri, USA"},{"name":"University of Missouri Institute for Data Science and Informatics, Columbia, Missouri, USA"},{"name":"Department of Molecular Microbiology and Immunology, School of Medicine, University of Missouri, Columbia, Missouri, USA"},{"name":"Bond Life Sciences Center, University of Missouri, Columbia, Missouri, USA"},{"name":"Department of Electrical Engineering and Computer Science, College of Engineering, University of Missouri, Columbia, Missouri, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane A","family":"McElroy","sequence":"additional","affiliation":[{"name":"University of Missouri Department of Family and Community Medicine, Columbia, Missouri, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,5,10]]},"reference":[{"key":"2022021117153558600_CIT0001"},{"key":"2022021117153558600_CIT0002","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.15585\/mmwr.mm6938e1","article-title":"Characteristics and maternal and birth outcomes of hospitalized pregnant women with laboratory-confirmed COVID-19\u2014COVID-NET, 13 states, March 1-August 22, 2020","volume":"69","author":"Delahoy","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2022021117153558600_CIT0003","doi-asserted-by":"crossref","first-page":"769","DOI":"10.15585\/mmwr.mm6925a1","article-title":"Characteristics of women of reproductive age with laboratory-confirmed SARS-CoV-2 infection by pregnancy status\u2014United States, January 22-June 7, 2020","volume":"69","author":"Ellington","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2022021117153558600_CIT0004","doi-asserted-by":"crossref","first-page":"1641","DOI":"10.15585\/mmwr.mm6944e3","article-title":"Update: characteristics of symptomatic women of reproductive age with laboratory-confirmed SARS-CoV-2 infection by pregnancy status\u2014United States, January 22-October 3, 2020","volume":"69","author":"Zambrano","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2022021117153558600_CIT0005","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1097\/AOG.0000000000004025","article-title":"Characteristics and outcomes of 241 births to women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection at five New York City medical centers","volume":"136","author":"Khoury","year":"2020","journal-title":"Obstet 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