1Division of Epidemiological Investigation Analysis, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
2Division of Infectious Disease Response, Gyeongnam Regional Center for Disease Control and Prevention, Korea Disease Control and Prevention Agency, Busan, Republic of Korea
© 2023 Korea Disease Control and Prevention Agency.
This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Ethics Approval
The collection of data in accordance with Article 76-2 of the infectious Disease Control and Prevention Act was approved by the Institutional Review Board of the KDCA (IRB No: 2022-11-10-PE-A).
Conflicts of Interest
The authors have no conflicts of interest to declare.
Funding
None.
Availability of Data
The datasets are not publicly available, but are available from the corresponding author upon reasonable request.
Authors’ Contributions
Conceptualization: all authors; Data curation: JJL; Formal analysis: JJL; Investigation: JJL; Methodology: SEL, YK, YJP; Project administration: YJP; Resources: JJL; Software: JJL; Supervision: YJP; Validation: SEL, YJP; Visualization: JJL; Writing–original draft: JJL; Writing–review & editing: all authors. All authors read and approved the final manuscript.
Characteristic | Total pregnant women (n=2,233) | Non-severe (n=2,160) | Severe (n=73) | p-value |
---|---|---|---|---|
Age group (y) | 0.01a) | |||
20–34 | 1,224 (54.8) | 1,195 (55.3) | 29 (39.7) | |
35–45 | 1,009 (45.2) | 965 (44.7) | 44 (60.3) | |
Ethnic group | 0.65a) | |||
Korean | 1,933 (86.6) | 1,868 (86.5) | 65 (89.0) | |
Foreign national | 300 (13.4) | 292 (13.5) | 8 (11.0) | |
Infection route | 0.40b) | |||
Domestic | 2,189 (98.0) | 2,116 (98.0) | 73 (100) | |
Abroad | 44 (2.0) | 44 (2.0) | 0 (0) | |
Period of variant predominance | 0.002a) | |||
Pre-Delta | 530 (23.7) | 524 (24.3) | 6 (8.2) | |
Delta | 1,703 (76.3) | 1,636 (75.7) | 67 (91.8) | |
Region | <0.05a) | |||
Seoul | 771 (34.5) | 745 (34.5) | 26 (35.6) | |
Busan | 79 (3.5) | 74 (3.4) | 5 (6.8) | |
Incheon | 135 (6.0) | 125 (5.8) | 10 (13.7) | |
Gyeonggi Province | 751 (33.6) | 729 (33.8) | 22 (30.1) | |
Other areas | 497 (22.3) | 487 (22.5) | 10 (13.7) | |
Underlying diseases | ||||
Diabetes mellitus | 26 (1.2) | 22 (1.0) | 4 (5.5) | 0.009b) |
Hypertension | 29 (1.3) | 29 (1.3) | 0 (0) | 1.00b) |
Hyperlipidemia | 51 (2.3) | 46 (2.1) | 5 (6.8) | 0.02b) |
Cardiovascular disease | 5 (0.2) | 5 (0.2) | 0 (0) | 1.00b) |
Cerebrovascular disease | 3 (0.1) | 3 (0.1) | 0 (0) | 1.00b) |
Malignancy | 20 (0.9) | 20 (0.9) | 0 (0) | 1.00b) |
COPD | 185 (8.3) | 182 (8.4) | 3 (4.1) | 0.28b) |
Renal disease | 2 (0.1) | 2 (0.1) | 0 (0) | 1.00b) |
Liver disease | 44 (2.0) | 41 (1.9) | 3 (4.1) | 0.17b) |
Tuberculosis | 14 (0.6) | 14 (0.6) | 0 (0) | 1.00b) |
Asthma | 83 (3.7) | 82 (3.8) | 1 (1.4) | 0.52b) |
Smoking | 0.41b) | |||
Yes | 49 (2.2) | 49 (2.3) | 0 (0) | |
No | 2,149 (96.2) | 2,076 (96.1) | 73 (100) | |
Unknown | 35 (1.6) | 35 (1.6) | 0 (0) | |
Trimester of SARS-CoV-2 infection | <0.001a) | |||
First (<14 wk) | 497 (22.3) | 496 (23.0) | 1 (1.4) | |
Second (14–27 wk) | 909 (40.7) | 885 (41.0) | 24 (32.9) | |
Third (≥28 wk) | 767 (34.3) | 720 (33.3) | 47 (64.4) | |
Unknown | 60 (2.7) | 59 (2.7) | 1 (1.4) | |
Vaccination status | 0.01b) | |||
Unvaccinated | 1,921 (86.0) | 1,849 (85.6) | 72 (98.6) | |
One dose | 101 (4.5) | 101 (4.7) | 0 (0) | |
Two doses | 158 (7.1) | 157 (7.3) | 1 (1.4) | |
Unknown | 53 (2.37) | 53 (2.5) | 0 (0) | |
Symptoms | 0.09a) | |||
Asymptomatic infection | 321 (14.4) | 316 (14.6) | 5 (6.8) | |
Symptomatic infection | 1,912 (85.6) | 1,844 (85.4) | 68 (93.2) | |
Mortality | 0.03b) | |||
Yes | 1 (0.04) | 0 (0) | 1 (1.4) | |
No | 2,232 (99.96) | 2,160 (100) | 72 (98.6) |
Characteristic |
Severe disease (n=73) |
||
---|---|---|---|
Crude OR (95% CI) | Adjusted OR (95% CI) | ||
Age group (y) | |||
20–34 | Ref. | Ref. | |
35–45 | 1.88 (1.17–3.05) | 2.00 (1.19–3.42) | |
Underlying diseases | |||
Diabetes mellitusa) | 5.63 (1.62–15.21) | 1.97 (0.32–9.36) | |
Hyperlipidemiab) | 3.38 (1.14–8.03) | 4.82 (1.04–17.66) | |
COPDc) | 0.47 (0.11–1.27) | 0.31 (0.04–1.19) | |
Liver diseased) | 2.21 (0.53–6.28) | 0.83(0.15–3.24) | |
Asthmae) | 0.35 (0.02–1.62) | 0.72 (0.03–9.35) | |
Trimester of SARS-CoV-2 infection | |||
First (<14 wk) | Ref. | Ref. | |
Second (14–27 wk) | 13.45 (2.83–240.85) | 11.28 (2.32–203.28) | |
Third (≥28 wk) | 32.38 (7.06–574.38) | 25.09 (5.30–449.29) | |
Period of variant predominance | |||
Pre-Delta (until week 30 of 2021) | Ref. | Ref. | |
Delta (weeks 31–53 of 2021) | 3.58 (1.68–9.28) | 3.37 (1.42–9.99) | |
Vaccination status | |||
Unvaccinated | Ref. | Ref. | |
One dose | NA | NA | |
Two doses | 0.16 (0.01–0.75) | 0.25 (0.01-1.23) | |
Symptoms | |||
Feverf) | 2.43 (1.50–4.00) | 2.78 (1.61–4.89) | |
Coughg) | 1.91 (1.19–3.13) | 1.24 (0.72–2.15) | |
Sputumh) | 1.93 (1.15–3.14) | 1.57 (0.86–2.79) | |
Sore throati) | 0.67 (0.40–1.10) | 0.59 (0.33–1.01) | |
Rhinorrheaj) | 1.33 (0.75–2.25) | 1.19 (0.64–2.13) | |
Myalgiak) | 0.53 (0.25–1.00) | 0.34 (0.15–0.69) | |
Dyspneal) | 2.71 (1.02–6.00) | 1.39 (0.47–3.55) | |
Headachem) | 0.77 (0.42–1.33) | 0.78 (0.40–1.46) |
OR, odds ratio; CI, confidence interval; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; COPD, chronic obstructive pulmonary disease; NA, not available.
Reference refers to the group that did not have
a)diabetes mellitus,
b)hyperlipidemia,
c)COPD,
d)liver disease, and
e)asthma.
f)fever,
g)cough,
h)sputum,
i)sore throat,
j)rhinorrhea,
k)myalgia,
l)dyspnea, and
m)headache.
Characteristic |
Severe disease (n=73) |
|
---|---|---|
n (%) | OR (95% CI)a) | |
Combinations of 3 factors | ||
Age, hyperlipidemia, trimester (n=2) | 1 (1.4) | 97.09 (3.69–2,564.1) |
Age, trimester, fever (n=49) | 2 (2.7) | 4.13 (0.63–15.95) |
Age, trimester, Delta (n=307) | 15 (20.5) | 4.99 (2.28–11.25) |
Trimester, Delta, fever (n=337) | 18 (24.7) | 5.48 (2.60–12.09) |
Combination of 4 factors | ||
Age, Delta, trimester, hyperlipidemia (n=10) | 1 (1.4) | 10.78 (0.56–65.24) |
Age, Delta, trimester, fever (n=275) | 23 (31.5) | 8.86 (4.35–19.12) |
Delta, trimester, hyperlipidemia, fever (n=7) | 2 (2.7) | 38.84 (5.18–203.48) |
SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; OR, odds ratio; CI, confidence interval; age, older than 35 years; Delta, infection during the Delta-predominant period; trimester, infection in the second or third trimester; hyperlipidemia, pregnant women with hyperlipidemia; fever, fever at diagnosis (≥38 °C); combinations of 2 (n=11), combination of 5 factors (n=0).
a)Reference refers to combinations of 2 factors (n=11).
Characteristic | Total pregnant women (n=2,233) | Non-severe (n=2,160) | Severe (n=73) | p-value |
---|---|---|---|---|
Age group (y) | 0.01 |
|||
20–34 | 1,224 (54.8) | 1,195 (55.3) | 29 (39.7) | |
35–45 | 1,009 (45.2) | 965 (44.7) | 44 (60.3) | |
Ethnic group | 0.65 |
|||
Korean | 1,933 (86.6) | 1,868 (86.5) | 65 (89.0) | |
Foreign national | 300 (13.4) | 292 (13.5) | 8 (11.0) | |
Infection route | 0.40 |
|||
Domestic | 2,189 (98.0) | 2,116 (98.0) | 73 (100) | |
Abroad | 44 (2.0) | 44 (2.0) | 0 (0) | |
Period of variant predominance | 0.002 |
|||
Pre-Delta | 530 (23.7) | 524 (24.3) | 6 (8.2) | |
Delta | 1,703 (76.3) | 1,636 (75.7) | 67 (91.8) | |
Region | <0.05 |
|||
Seoul | 771 (34.5) | 745 (34.5) | 26 (35.6) | |
Busan | 79 (3.5) | 74 (3.4) | 5 (6.8) | |
Incheon | 135 (6.0) | 125 (5.8) | 10 (13.7) | |
Gyeonggi Province | 751 (33.6) | 729 (33.8) | 22 (30.1) | |
Other areas | 497 (22.3) | 487 (22.5) | 10 (13.7) | |
Underlying diseases | ||||
Diabetes mellitus | 26 (1.2) | 22 (1.0) | 4 (5.5) | 0.009 |
Hypertension | 29 (1.3) | 29 (1.3) | 0 (0) | 1.00 |
Hyperlipidemia | 51 (2.3) | 46 (2.1) | 5 (6.8) | 0.02 |
Cardiovascular disease | 5 (0.2) | 5 (0.2) | 0 (0) | 1.00 |
Cerebrovascular disease | 3 (0.1) | 3 (0.1) | 0 (0) | 1.00 |
Malignancy | 20 (0.9) | 20 (0.9) | 0 (0) | 1.00 |
COPD | 185 (8.3) | 182 (8.4) | 3 (4.1) | 0.28 |
Renal disease | 2 (0.1) | 2 (0.1) | 0 (0) | 1.00 |
Liver disease | 44 (2.0) | 41 (1.9) | 3 (4.1) | 0.17 |
Tuberculosis | 14 (0.6) | 14 (0.6) | 0 (0) | 1.00 |
Asthma | 83 (3.7) | 82 (3.8) | 1 (1.4) | 0.52 |
Smoking | 0.41 |
|||
Yes | 49 (2.2) | 49 (2.3) | 0 (0) | |
No | 2,149 (96.2) | 2,076 (96.1) | 73 (100) | |
Unknown | 35 (1.6) | 35 (1.6) | 0 (0) | |
Trimester of SARS-CoV-2 infection | <0.001 |
|||
First (<14 wk) | 497 (22.3) | 496 (23.0) | 1 (1.4) | |
Second (14–27 wk) | 909 (40.7) | 885 (41.0) | 24 (32.9) | |
Third (≥28 wk) | 767 (34.3) | 720 (33.3) | 47 (64.4) | |
Unknown | 60 (2.7) | 59 (2.7) | 1 (1.4) | |
Vaccination status | 0.01 |
|||
Unvaccinated | 1,921 (86.0) | 1,849 (85.6) | 72 (98.6) | |
One dose | 101 (4.5) | 101 (4.7) | 0 (0) | |
Two doses | 158 (7.1) | 157 (7.3) | 1 (1.4) | |
Unknown | 53 (2.37) | 53 (2.5) | 0 (0) | |
Symptoms | 0.09 |
|||
Asymptomatic infection | 321 (14.4) | 316 (14.6) | 5 (6.8) | |
Symptomatic infection | 1,912 (85.6) | 1,844 (85.4) | 68 (93.2) | |
Mortality | 0.03 |
|||
Yes | 1 (0.04) | 0 (0) | 1 (1.4) | |
No | 2,232 (99.96) | 2,160 (100) | 72 (98.6) |
Characteristic | Severe disease (n=73) |
||
---|---|---|---|
Crude OR (95% CI) | Adjusted OR (95% CI) | ||
Age group (y) | |||
20–34 | Ref. | Ref. | |
35–45 | 1.88 (1.17–3.05) | 2.00 (1.19–3.42) | |
Underlying diseases | |||
Diabetes mellitus |
5.63 (1.62–15.21) | 1.97 (0.32–9.36) | |
Hyperlipidemia |
3.38 (1.14–8.03) | 4.82 (1.04–17.66) | |
COPD |
0.47 (0.11–1.27) | 0.31 (0.04–1.19) | |
Liver disease |
2.21 (0.53–6.28) | 0.83(0.15–3.24) | |
Asthma |
0.35 (0.02–1.62) | 0.72 (0.03–9.35) | |
Trimester of SARS-CoV-2 infection | |||
First (<14 wk) | Ref. | Ref. | |
Second (14–27 wk) | 13.45 (2.83–240.85) | 11.28 (2.32–203.28) | |
Third (≥28 wk) | 32.38 (7.06–574.38) | 25.09 (5.30–449.29) | |
Period of variant predominance | |||
Pre-Delta (until week 30 of 2021) | Ref. | Ref. | |
Delta (weeks 31–53 of 2021) | 3.58 (1.68–9.28) | 3.37 (1.42–9.99) | |
Vaccination status | |||
Unvaccinated | Ref. | Ref. | |
One dose | NA | NA | |
Two doses | 0.16 (0.01–0.75) | 0.25 (0.01-1.23) | |
Symptoms | |||
Fever |
2.43 (1.50–4.00) | 2.78 (1.61–4.89) | |
Cough |
1.91 (1.19–3.13) | 1.24 (0.72–2.15) | |
Sputum |
1.93 (1.15–3.14) | 1.57 (0.86–2.79) | |
Sore throat |
0.67 (0.40–1.10) | 0.59 (0.33–1.01) | |
Rhinorrhea |
1.33 (0.75–2.25) | 1.19 (0.64–2.13) | |
Myalgia |
0.53 (0.25–1.00) | 0.34 (0.15–0.69) | |
Dyspnea |
2.71 (1.02–6.00) | 1.39 (0.47–3.55) | |
Headache |
0.77 (0.42–1.33) | 0.78 (0.40–1.46) |
Characteristic | Severe disease (n=73) |
|
---|---|---|
n (%) | OR (95% CI) |
|
Combinations of 3 factors | ||
Age, hyperlipidemia, trimester (n=2) | 1 (1.4) | 97.09 (3.69–2,564.1) |
Age, trimester, fever (n=49) | 2 (2.7) | 4.13 (0.63–15.95) |
Age, trimester, Delta (n=307) | 15 (20.5) | 4.99 (2.28–11.25) |
Trimester, Delta, fever (n=337) | 18 (24.7) | 5.48 (2.60–12.09) |
Combination of 4 factors | ||
Age, Delta, trimester, hyperlipidemia (n=10) | 1 (1.4) | 10.78 (0.56–65.24) |
Age, Delta, trimester, fever (n=275) | 23 (31.5) | 8.86 (4.35–19.12) |
Delta, trimester, hyperlipidemia, fever (n=7) | 2 (2.7) | 38.84 (5.18–203.48) |
Data are presented as SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; COPD, chronic obstructive pulmonary disease.
OR, odds ratio; CI, confidence interval; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; COPD, chronic obstructive pulmonary disease; NA, not available. Reference refers to the group that did not have diabetes mellitus, hyperlipidemia, COPD, liver disease, and asthma. fever, cough, sputum, sore throat, rhinorrhea, myalgia, dyspnea, and headache.
SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; OR, odds ratio; CI, confidence interval; age, older than 35 years; Delta, infection during the Delta-predominant period; trimester, infection in the second or third trimester; hyperlipidemia, pregnant women with hyperlipidemia; fever, fever at diagnosis (≥38 °C); combinations of 2 ( Reference refers to combinations of 2 factors (