Long COVID After Acquisition of the Omicron Variant of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) During Pregnancy Compared With Outside of Pregnancy

Torri D. Metz, University of Utah Health, Salt Lake City, Utah; Massachusetts General Hospital, Boston, Massachusetts; George Washington University, Washington, DC; University of California, San Francisco, San Francisco, and Stanford University, Palo Alto, California; Duke University, Durham, University of North Carolina at Chapel Hill, Chapel Hill, and WakeMed Health and Hospitals, Raleigh, North Carolina; University of New Mexico, Albuquerque, New Mexico; RECOVER Patient, Caregiver, or Community Advocate Representative, NYU Grossman School of Medicine, Mount Sinai Medical Center, and Columbia University, New York, and New York Presbyterian Queens, Queens, New York; University of Illinois Chicago and Northwestern University, Chicago, and NorthShore University Health System, Evanston, Illinois; The Ohio State University, Columbus, The MetroHealth System, Case Western Reserve University, and Case Western Reserve University and University Hospitals of Cleveland, Cleveland, TriHealth Good Samaritan Hospital, Cincinnati, and Wright State University Boonshoft School of Medicine, Dayton, Ohio; University of Alabama at Birmingham, Birmingham, Alabama; University of Arizona, Phoenix, Arizona; West Virginia University, Morgantown, West Virginia; University of Colorado School of Medicine, Aurora, Colorado; Christiana Care Health System, Newark, Delaware; University of Texas at Houston, Houston, University of Texas Medical Branch at Galveston, Galveston, and University of Texas Health Sciences Center San Antonio, San Antonio, Texas; Emory University, Atlanta, Georgia; Medical College of Wisconsin, Milwaukee, Wisconsin; Saint Peter's University Hospital, New Brunswick, New Jersey; University of Pennsylvania, Philadelphia, and University of Pittsburgh, Pittsburgh, Pennsylvania; Yale School of Medicine, New Haven, Connecticut; and Brown University, Providence, Rhode Island.
Harrison T. Reeder
Rebecca G. Clifton
Valerie Flaherman
Leyna V. Aragon
Leah Castro Baucom
Carmen J. Beamon
Alexis Braverman
Jeanette Brown
Megan Carmilani
Tingyi Cao
Ann Chang
Maged M. Costantine
Jodie A. Dionne
Kelly S. Gibson
Rachel S. Gross
Estefania Guerreros
Mounira Habli
Rachel Hess
Leah Hillier
Sally Hodder
M Camille Hoffman
Matthew K. Hoffman
Weixing Huang
Brenna L. Hughes
Xiaolin Jia
Minal Kale
Stuart D. Katz
Victoria Laleau
Hector Mendez-Figueroa
Grace A. McComsey
Igho Ofotokun

Document Type

Journal Article

Publication Date

10-2-2025

Journal

Obstetrics and gynecology

DOI

10.1097/AOG.0000000000006067

Abstract

OBJECTIVE: To evaluate whether the risk of long COVID among individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during pregnancy differs from that of individuals who were not pregnant at time of virus acquisition. METHODS: We conducted a multicenter observational cohort study at 79 NIH RECOVER (Researching COVID to Enhance Recovery) sites. Individuals assigned female at birth aged 18-45 years with an index (first) SARS-CoV-2 infection on or after December 1, 2021, were included. The exposure was pregnancy (any gestational age) at the time of index SARS-CoV-2 infection. The primary outcome was long COVID 6 months after index infection, defined as RECOVER-Adult Long COVID Research Index score 11 or higher based on a detailed symptom survey. To account for confounding and differential selection between participants who were pregnant and not pregnant at infection, propensity score-matching methods were used to balance the groups on variables potentially associated with both pregnancy status and long COVID. RESULTS: Overall 2,423 participants were included; 580 (23.9%) were pregnant at index SARS-CoV-2 infection. The median age at infection was 33 years (interquartile range 28-38 years), and 2,131 of participants (90.0%) with known vaccination status were vaccinated. After propensity score matching, the adjusted long COVID prevalence estimates 6 months after index infection were 10.2% (95% CI, 6.2-14.3%) among those pregnant at infection and 10.6% (95% CI, 8.8-12.4%) among those not pregnant at infection. Pregnancy was not associated with a difference in adjusted risk of long COVID (adjusted risk ratio 0.96, 95% CI, 0.63-1.48). CONCLUSION: Acquisition of SARS-CoV-2 during pregnancy was not associated with a differential risk of long COVID at 6 months compared with similar-aged individuals who acquired SARS-CoV-2 outside of pregnancy.

Department

Epidemiology

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