Pregnant women were nearly 3.5 times more likely than non-pregnant women to require respiratory support when hospitalized for COVID-19.
RT’s Three Key Takeaways:
- Higher Risk of Severe COVID-19 in Pregnancy – Hospitalized pregnant women with COVID-19 were nearly 3.5 times more likely than non-pregnant women to require respiratory support, reflecting both greater physiologic vulnerability and heightened clinical vigilance to protect mother and fetus.
- Significant Risks for Newborns – Outcomes for infants were concerning: nearly 70% of women who delivered during hospitalization gave birth preterm, and 44% of newborns required NICU admission, underscoring the downstream impact of maternal COVID-19 illness on neonatal health.
- Vaccination and Specialized Care Are Critical – Most pregnant patients needing mechanical ventilation were unvaccinated, reinforcing evidence that COVID-19 vaccination reduces severe maternal and fetal complications. The findings highlight the need for early involvement of high-risk obstetrics and cardio-obstetrics teams and clear vaccination messaging during pregnancy.
When hospitalized for COVID-19, pregnant women — and their eventual newborn children — have a higher risk of complications, according to a Michigan Medicine study published in BMC Pregnancy and Childbirth.
The research, conducted between early 2020 and late 2022, revealed that pregnant women were nearly 3.5 times more likely than non-pregnant women to require respiratory support when hospitalized for COVID-19.
One in five pregnant patients required non-mechanical respiratory support, such as a high-flow nasal cannula or continuous positive airway pressure (CPAP).
“What we observed wasn’t just a difference in disease severity but a difference in clinical vigilance,” said Salim Hayek, M.D., adjunct professor of internal medicine-cardiology at University of Michigan Medical School and chief transformation officer at the University of Texas Medical Branch.
“Care teams were more likely to provide respiratory support to pregnant patients, likely because the threshold for intervention is lower when you are fighting for two lives. It reflects the complex reality of treating a mother who is trying to oxygenate not just herself, but her fetus as well.”
During the study period, one in every eight hospitalized women of childbearing age was pregnant.
Nearly 70% of all patients who gave birth during their COVID-19 hospitalization delivered preterm, and 44% of babies delivered during the mother’s hospital stay were admitted to the neonatal intensive care unit (NICU).
The results further solidify the risk COVID-19 poses for pregnant patients. Not only may they experience increased respiratory distress, but they also face greater rates of unique, cardiovascular pregnancy complications, such as preeclampsia, peripartum cardiomyopathy and spontaneous coronary dissections.
“These findings highlight the importance of close monitoring as pregnancy progresses when a patient is hospitalized for COVID-19, including the involvement of high-risk obstetrics providers early in their care,” said Melinda Davis, M.D., a co-director of the Cardio-Obstetrics Program at U-M Health Von Voigtlander Women’s Hospital who was not involved in the study.
“The health of the mother and baby are inextricably linked. You cannot care for a fetus without providing exceptional care for the mother.”
Most pregnant women who required mechanical ventilation were in their third trimester.
Seven of the eight pregnant women placed on a ventilator were unvaccinated against COVID-19.
The finding echoes previous studies that demonstrate the vaccine’s effectiveness at preventing major complications, which is reflected in a 2025 guidance from the American College of Obstetricians and Gynecologists on maternal immunization.
“We saw in the research and in practice that COVID-19 vaccination provided some protection against poor maternal and fetal outcomes,” said Elizabeth Langen, M.D. a co-director of the Cardio-Obstetrics Program and director of the Maternal-Fetal Medicine Fellowship who was not involved in the study.
“Clear messaging on the benefits of vaccination during pregnancy for viruses including both flu and COVID is essential.”
