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

View Publication on PubMed

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Published

October 2025

Journal

Obstetrics & Gynecology

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.

Authors

Torri D Metz, 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, Megumi J Okumura, Luis D Pacheco, Anna Palatnik, Kristy T S Palomares, Samuel Parry, Christian M Pettker, Beth A Plunkett, Athena Poppas, Patrick Ramsey, Uma M Reddy, Dwight J Rouse, George R Saade, Grecio J Sandoval, Frank Sciurba, Hyagriv N Simhan, Daniel W Skupski, Amber Sowles, John M Thorp, Alan T N Tita, Samantha Wiegand, Steven J Weiner, Lynn M Yee, Leora I Horwitz, Andrea S Foulkes, Vanessa L Jacoby, NIH RECOVER (Researching COVID to Enhance Recovery) Consortium

Keywords

Not available