LAUSR

The study by Mupanomunda et al 1 presents a thoughtful analysis of the association between severe maternal morbidities (SMM) and SARS-CoV-2 infection in a retrospective cohort spanning 4 time periods that represent dominant circulating SARS-COV-2 variants in the US. Specifically, 3129 patients with SARS-CoV-2 infection diagnosed during the delivery hospitalization were compared with a propensity-matched cohort of 12504 patients without infection at the delivery hospitalization. Mupanomunda et al 1 found that in all variant periods except for Omicron, there was a significantly higher rate of any SMM, with highest odds associated with Delta variant predominance (odds ratio [OR], 7.69 [95% CI, 5.19-11.54]). Compared with patients without evidence of SARS-CoV-2 at delivery, respiratory morbidity was increased across all variant periods among patients with SARS-CoV-2 at the delivery hospitalization. Secondary outcomes evaluated included an analysis of only nontransfusion-related SMM, which increased in association with the wild-type SARS-CoV-2 strain (OR, 2.16 [95% CI, 1.40-3.27]) and Alpha variant (OR, 1.96 [95% CI, 1.20-3.12]) and was significantly higher in association with the Delta variant period (OR, 4.65 [95% CI, 2.97-7.29]) but not with Omicron. SARS-COV-2 pregnancy outcomes. variants colleagues acute