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The large-scale retrospective study, conducted under the guidance of researchers from Weill Cornell Medicine, University of Rochester Medical Center, University of Utah Health, and Louisiana Public Health Institute, analyzed electronic health records from roughly 72,151 pregnant women. That sum includes 29,975 from the PCORnet cohort and 42,176 from the N3C cohort across two major U.S. clinical research networks.
The investigators found that pregnant women had 14-30% lower risk of developing Long COVID compared to matched non-pregnant women (14% reduction in PCORnet and 30% reduction in N3C), with consistent results across different definitions of Long COVID.
While the overall risk was lower, the research identified several high-risk subgroups among pregnant women. “Though we observed that pregnant women have a significant risk of Long COVID, it was surprisingly lower than those who were not pregnant when they had SARS-CoV-2 infection,” said Dr. Chengxi Zang, an instructor in population health sciences at Weill Cornell Medicine, as noted in the Weill Cornell Medicine press release. “However, some subgroups seemed especially vulnerable.” For instance, Black pregnant women, those of advanced maternal age (35+), and those with obesity or other metabolic conditions showed elevated risk compared to other pregnant women.
The study also revealed nuances within the pregnant group. It noted that infections occurring in the first two trimesters were associated with higher Long COVID risk compared to the third trimester. This finding underscores the need for targeted prevention and treatment strategies for such vulnerable populations, as interest in COVID-19 as a therapeutic area has largely diminished in recent years.
The authors also suggest these trimester-specific findings, once better understood through further research, could inform patient counseling regarding Long COVID risk.
In the long run, the researchers’ findings could open new avenues for understanding the immunological mechanisms that might protect against persistent post-COVID inflammation. The researchers highlighted pregnancy’s unique immunological state as a possible protective factor. “Pregnancy reflects a period of physiologic immune tolerance to accommodate fetal development. Differences in regulatory T cells, cytokines, and other immune cells have been described during pregnancy and are thought to prevent maternal immune system rejection of the fetus,” the authors noted in the study. “We might hypothesize that the altered immune and inflammatory environment during the puerperium [postpartum period] likely contributes to the lower risk of Long COVID identified among the pregnant compared to the non-pregnant cohorts,” they wrote on page 7 of the paper. The team emphasized that “future dedicated pathophysiology and immune studies of Long COVID in pregnant individuals are warranted.”
Filed Under: Infectious Disease
