Cardiovascular Complications of COVID-19 in Pregnancy Reviewed


THURSDAY, Aug. 11, 2022 — COVID-19 infection in pregnant women is associated with worse outcomes than in women who are not pregnant, according to a state-of-the-art review published online Aug. 10 in JACC: Advances.

Joan E. Briller, M.D., from the University of Illinois at Chicago, and colleagues address pregnancy-associated COVID-19 cardiovascular complications.

The researchers note that pregnant women with COVID-19 infection are more likely to have severe outcomes, including intensive care unit admission, mechanical ventilation, and death. Mechanisms for adverse outcomes in pregnant individuals may reflect more serious outcomes of viral infection in pregnancy, immune system changes, increased clotting risk, older age, and underlying comorbidities. COVID-19-associated cardiac complications, including myocardial injury, arrhythmias, and heart failure, may require change to management during pregnancy. Furthermore, unique pregnancy complications, including preeclampsia, peripartum cardiomyopathy, and spontaneous coronary dissections, need to be differentiated from COVID-19-associated complications. For patients with cardiac disease after COVID-19 infection, a multidisciplinary cardio-obstetrics team should be involved in preconception planning and pregnancy management.

“Recognition of cardiovascular complication is hampered by failure to include pregnant women in clinical trials despite calls for inclusion of pregnant populations,” Briller said in a statement. “Consequently, women may be undertreated or inadequately treated due to lack [of] studies addressing safety and efficacy of therapies during pregnancy or conversely be exposed to therapies where safety is not known.”

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