Cardiovascular complications as a consequence of coronavirus infection in pregnant women

Background

SARS-CoV-2 has been linked to cardiovascular complications, including myocardial inflammation and injury in the general population. However, data regarding its incidence, risk factors, and long-term cardiac outcomes in the pregnant population remain scarce.

Objective

To evaluate whether COVID-19 infection during pregnancy is associated with an increased incidence of cardiac complications within one year from the start of pregnancy (last menstrual period [LMP]).

Methods

We retrospectively reviewed data of pregnant women between 2020 and 2025. The study group (pregnant women with a first COVID-19 infection) was matched 1:1 with a control group based on exact matching for age, year of first electronic health record (EHR), socioeconomic status, ethnicity, BMI category, LMP quarter, and number of fetuses.

Results

Out of 54,741 pregnant women identified, 5,879 were diagnosed with COVID-19 during pregnancy. Following filtering for the aforementioned variables and performing 1:1 exact matching, the final analytical dataset consisted of 4,068 patients in each group.

Baseline demographic and obstetric characteristics were comparable between the study group and the control group, with no statistically significant differences observed (including age, weight, hypertension, and diabetes). Regarding cardiac outcomes within one year from the last menstrual period, no significant differences were found between the groups in the incidence of diagnosed cardiac complications, including arrhythmias (atrial fibrillation or flutter), congestive heart failure, cardiomyopathy, myocarditis, or pulmonary embolism (Table). However, the COVID-19 group demonstrated a significantly higher rate of complaints regarding chest pain compared to the control group (19.0% vs. 17.3%, p=0.047). Notably, despite the increased frequency of subjective chest pain complaints, there was no associated increase in confirmed clinical cardiac events in this group.

Conclusions

Our study suggests that COVID-19 infection is not associated with an increased incidence of cardiac complications among pregnant women. Cardiac monitoring in this population should follow standard obstetric practice.Patient selection flowchartPATIENT CHARACHTERISTICS AND COMPLICATIONS