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ALERT: Data Show Higher Preeclampsia/Eclampsia Risk Among Pregnant Patients with COVID-19

The Hospital Quality Institute’s (HQI) Sentinel Signal Detection System has alerted HQI to notify California member hospitals about significantly higher preeclampsia/eclampsia risk identified among pregnant patients with evidence of concurrent COVID‑19 infection during 2020-2021.

Specifically, the below figure shows extended periods from April 2020 to June 2021 during which the probability of preeclampsia/eclampsia diagnosis was as much as 15% higher among pregnant patients with COVID-19 infection compared to those without COVID-19 infection. Also noteworthy is the slow but complete diminishment of the elevated risk that triggered this alert by mid-2021 for unknown reasons.

The elevated preeclampsia risk HQI detected is not unique to California. For example 76%-77% higher preeclampsia risk was identified in 2021 AJOG and JAMA multinational prospective studies and 55% higher risk was noted in a 2021 AJOG English cohort study.

Although the excess risk has inexplicably waned, HQI encourages members to continue vigilantly screening for pregnancy complications in patients with COVID-19 infection, should conditions change.

Time Period                                                          COVID-19+ Risk Difference p value   Statistical Interpretation
Apr 2020 – Dec 2020 +3% < .05 Significant
Apr 2020 – June 2021 +1% < .05 Significant
Jan 2021 – June 2021 0% .10 Not significant
Note: The probability of preeclampsia/eclampsia in COVID-19 pregnant patients vs. that in non-COVID-19 pregnant patients was deemed to be significantly different at the 95% level if the p value was less than .05.

These alerts are made possible by timely hospital submissions of discharge data to the Hospital Quality Improvement Platform (HQIP) and safety reports to the Collaborative Healthcare Patient Safety Organization. Thank you for helping us provide timely, accurate alerts to you and other members. Continuing to share complete and timely data to power our sentinel signal detection system allows us to generate actionable alerts and continue to assist improving patient safety.

Questions or comments about this alert should be directed to Michelle Newsom (mnewsom@chpso.org) or Vivian Eusebio (veusebio@chpso.org) at HQI.