Long COVID May Increase Risk of Hypertensive Disorders in Pregnancy: Study
USA: A recent RECOVER cohort study found no significant association between Long COVID and preterm birth or other adverse outcomes, including cesarean delivery, NICU admission, or small-for-gestational-age birth.
However, a sensitivity analysis suggested that Long COVID may be associated with a higher risk of hypertensive disorders of pregnancy—39.0% vs 25.9% among those without Long COVID. Therefore, it was inferred that COVID does not appear to increase the risk of preterm birth, but its possible association with gestational hypertension and related disorders warrants further investigation and closer blood-pressure monitoring during pregnancy.
The study, published in Obstetrics & Gynecology by Torri D. Metz, University of Utah Health, Salt Lake City, Utah, and colleagues, evaluated whether maternal Long COVID before or during pregnancy was linked to unfavorable pregnancy outcomes.
Researchers used data from the RECOVER-Adult study, a multicenter prospective cohort that enrolled adults with and without previous SARS-CoV-2 infection between October 2021 and January 2024. For the current analysis, investigators included participants who had experienced COVID-19 and completed at least one symptom assessment before or during pregnancy.
Long COVID status was determined using the Long COVID Research Index (LCRI). Participants with scores of 11 or higher were categorized as likely having Long COVID, while those scoring 0–10 were considered Long COVID-indeterminate.
Among 603 participants included in the analysis, 118 (19.6%) were classified as likely having Long COVID. Those with likely Long COVID were more likely to report socioeconomic challenges, including difficulty paying expenses, food insecurity, and missing medical care because of cost. They also had higher prepregnancy body mass index than participants in the Long COVID-indeterminate group.
The investigators primarily assessed whether Long COVID was associated with delivery before 37 weeks of gestation. They also examined hypertensive disorders of pregnancy, cesarean delivery, neonatal intensive care unit admission, and small-for-gestational-age birth weight.
The study led to the following findings:
- Likely Long COVID was not significantly associated with preterm birth, with adjusted rates of 8.1% vs 9.6% in the Long COVID and Long COVID-indeterminate groups, respectively.
- No significant association was observed between likely Long COVID and cesarean delivery, NICU admission, or small-for-gestational-age birth.
- Sensitivity analysis showed no significant increase in preterm birth risk among participants with likely Long COVID.
- However, likely Long COVID was associated with a higher risk of hypertensive disorders of pregnancy, occurring in 39.0% vs 25.9% of participants without likely Long COVID.
- The potential link between Long COVID and hypertensive disorders of pregnancy requires further investigation.
The researchers noted that the findings do not establish that Long COVID causes hypertensive disorders during pregnancy. The observed association requires confirmation in further studies.
Overall, the study suggests that maternal Long COVID before or during pregnancy is not significantly linked to preterm birth or several other major adverse pregnancy outcomes. However, the potential relationship with hypertensive disorders highlights an area requiring additional research and may support careful blood-pressure surveillance during pregnancy.
Reference:
Metz, T. D., Sandoval, G. J., Allshouse, A. A., Anderson, K., Braverman, A., Coombs, K., Erdmann, N., Gerver, A., Hess, R., Pappas, L., Singh, U., Taylor, B. D., Veres, S., Bahtiyar, M. O., Beamon, C. J., Brown, J., Chang, A., Clifton, R. G., Costantine, M. M., … (2026). Pregnancy Outcomes in Individuals With Long COVIDObstetrics & Gynecology https://doi.org/10.1097/AOG.0000000000006410
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