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Nearly 1 in 10 people who get COVID-19 while pregnant will develop long COVID, new study finds

Previous studies had shown pregnant women faced unique risks when infected by COVID-19, including that it would more likely lead to hospitalization or death.
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Nearly 1 in 10 women who get COVID-19 during pregnancy will develop long COVID, a new study shows.

The report, published Thursday in Obstetrics & Gynecology, adds evidence to research on the unique risks COVID-19 poses to pregnant women. For example, a woman's infection while pregnant is more likely to result in serious illness, which can increase pregnancy-related complications like preterm labor or stillbirth and carry an increased risk of hospitalization or death.

But this study — conducted as part of the National Institutes of Health RECOVER project, a nationwide collaboration to research long COVID — is among the first to look into the specific risks of a pregnant woman developing long COVID, its authors said.

Long COVID can include a wide array of symptoms that continue for at least three months after being infected by the virus but can last even years, emerging or persisting for different lengths of time, according to the Centers for Disease Control and Prevention.

Commonly reported symptoms include fatigue, brain fog, respiratory issues, digestive problems, joint or muscle pain and more. But the serious and sometimes confusing illness can still be hard to explain or manage, particularly as there's still no official test or treatment.

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To provide a fuller and more accurate picture of the condition for pregnant women, researchers enrolled more than 1,500 who had been infected with COVID-19 for the first time while pregnant and had reported long COVID symptoms for at least six months after.

They found 9.3% of those who were infected with the virus during pregnancy went on to experience long COVID symptoms, with the most common being fatigue, gastrointestinal issues and feeling exhausted by routine activities.

"It was surprising to me that the prevalence was that high. This is something that does continue to affect otherwise reasonably healthy and young populations," said Dr. Torri Metz, vice chair for research of obstetrics and gynecology at the University of Utah Health and co-leader of the nationwide study.

Earlier this year, the National Institutes of Health said 1 in 9 people in the U.S. who have ever had COVID-19 continue to experience long COVID symptoms. Dr. Metz says pregnant people are at a higher risk of severe symptoms during the infection, though they may be at "lower risk of long-term organ damage that can lead to persistent symptoms."

Factors that were linked to an increased risk of developing long COVID in the study included those with anxiety or depression prior to the infection, obesity and self-reported financial hardship, though the researchers said they couldn't determine if this was a cause or consequence of the symptoms.

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Metz said the study highlights the need for obstetricians to be vigilant of long COVID symptoms, as many overlap with those of pregnancy. The researchers even did a secondary analysis to ensure the reported long COVID symptoms weren't just related to pregnancy, which confirmed their initial findings.

By better understanding how the virus relates to the pregnant population, the researchers say targeted interventions could potentially be developed.

"We need to have this on our radar as we're seeing patients," Metz said. "It's something we really don't want to miss. And we want to get people referred to appropriate specialists who treat long COVID."

Over the next four years, the NIH says it's investing $515 million more into the RECOVER initiative, which will likely produce additional studies like this to better understand long COVID.