Severe Acute Respiratory Syndrome-Coronavirus-2 Antibody Status at the Time of Delivery and the Risk of Preeclampsia.

Objective: Our objective was to evaluate the association between severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) serologic status in immunologically naive patients and the risk of preeclampsia at the time of delivery.

Study Design: We conducted a retrospective cohort study of pregnant patients admitted to our institution from August 1 to September 30, 2020. We recorded maternal medical and obstetric characteristics and SARS-CoV-2 serologic status. Our primary outcome was the incidence of preeclampsia. Antibody testing was performed, and patients were classified into seropositive groups: immunoglobulin (Ig)G + , IgM + , or both IgG+ and IgM + . Bivariate and multivariable analyses were performed.

Results: We included 275 patients that were negative for SARS-CoV-2 antibodies, and 165 that were positive. Seropositivity was not associated with higher rates of preeclampsia ( = 0.183) or with preeclampsia with severe features ( = 0.916) even after adjusting for maternal age >35, BMI ≥ 30, nulliparity, and previous history of preeclampsia, and type of serologic status. Previous preeclampsia had the greatest association with the development of preeclampsia (odds ratio [OR] = 13.40; 95% confidence interval [CI]: 4.98-36.09;  <  0.05) and with preeclampsia with severe features (OR = 5.46; 95% CI: 1.65-18.02;  < 0.05).

Conclusion: We found that in an obstetric population, there was no association between SARS-CoV-2 antibody status and the risk of preeclampsia.

Key Points: · Pregnant people with acute COVID-19 are at an increased risk of developing preeclampsia.. · Seroconversion during pregnancy was not associated with an increased risk of preeclampsia.. · Further study regarding the timing of infection and its association with preeclampsia is necessary..