IDEAS home Printed from https://ideas.repec.org/a/nat/natcom/v16y2025i1d10.1038_s41467-025-57849-9.html
   My bibliography  Save this article

Long COVID after SARS-CoV-2 during pregnancy in the United States

Author

Listed:
  • Chengxi Zang

    (Weill Cornell Medicine)

  • Daniel Guth

    (University of Rochester Medical Center)

  • Ann M. Bruno

    (University of Utah Health)

  • Zhenxing Xu

    (Weill Cornell Medicine)

  • Haoyang Li

    (Weill Cornell Medicine)

  • Nariman Ammar

    (Illinois State University
    Ochsner Clinic Foundation)

  • Robert Chew

    (RTI International)

  • Nick Guthe

    (NYU Grossman School of Medicine
    or Community Advocate Representative)

  • Emily Hadley

    (RTI International)

  • Rainu Kaushal

    (Weill Cornell Medicine)

  • Tanzy Love

    (Rochester)

  • Brenda M. McGrath

    (OCHIN Inc.)

  • Rena C. Patel

    (The University of Alabama at Birmingham)

  • Elizabeth C. Seibert

    (or Community Advocate Representative
    Arts and Sciences)

  • Yalini Senathirajah

    (University of Pittsburgh)

  • Sharad Kumar Singh

    (University of Rochester Medical Center)

  • Fei Wang

    (Weill Cornell Medicine)

  • Mark G. Weiner

    (Weill Cornell Medicine)

  • Kenneth J. Wilkins

    (National Institutes of Health)

  • Yiye Zhang

    (Weill Cornell Medicine)

  • Torri D. Metz

    (University of Utah Health)

  • Elaine Hill

    (University of Rochester Medical Center)

  • Thomas W. Carton

    (Louisiana Public Health Institute)

Abstract

Pregnancy alters immune responses and clinical manifestations of COVID-19, but its impact on Long COVID remains uncertain. This study investigated Long COVID risk in individuals with SARS-CoV-2 infection during pregnancy compared to reproductive-age females infected outside of pregnancy. A retrospective analysis of two U.S. databases, the National Patient-Centered Clinical Research Network (PCORnet) and the National COVID Cohort Collaborative (N3C), identified 29,975 pregnant individuals (aged 18–50) with SARS-CoV-2 infection in pregnancy from PCORnet and 42,176 from N3C between March 2020 and June 2023. At 180 days after infection, estimated Long COVID risks for those infected during pregnancy were 16.47 per 100 persons (95% CI, 16.00–16.95) in PCORnet using the PCORnet computational phenotype (CP) model and 4.37 per 100 persons (95% CI, 4.18–4.57) in N3C using the N3C CP model. Compared to matched non-pregnant individuals, the adjusted hazard ratios for Long COVID were 0.86 (95% CI, 0.83–0.90) in PCORnet and 0.70 (95% CI, 0.66–0.74) in N3C. The observed risk factors for Long COVID included Black race/ethnicity, advanced maternal age, first- and second-trimester infection, obesity, and comorbid conditions. While the findings suggest a high incidence of Long COVID among pregnant individuals, their risk was lower than that of matched non-pregnant females.

Suggested Citation

  • Chengxi Zang & Daniel Guth & Ann M. Bruno & Zhenxing Xu & Haoyang Li & Nariman Ammar & Robert Chew & Nick Guthe & Emily Hadley & Rainu Kaushal & Tanzy Love & Brenda M. McGrath & Rena C. Patel & Elizab, 2025. "Long COVID after SARS-CoV-2 during pregnancy in the United States," Nature Communications, Nature, vol. 16(1), pages 1-14, December.
    • Handle: RePEc:nat:natcom:v:16:y:2025:i:1:d:10.1038_s41467-025-57849-9
    DOI: 10.1038/s41467-025-57849-9
    as

    Download full text from publisher

    File URL: https://www.nature.com/articles/s41467-025-57849-9
    File Function: Abstract
    Download Restriction: no
    File URL: https://libkey.io/10.1038/s41467-025-57849-9?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Ziyad Al-Aly & Yan Xie & Benjamin Bowe, 2021. "High-dimensional characterization of post-acute sequelae of COVID-19," Nature, Nature, vol. 594(7862), pages 259-264, June.
    2. Chengxi Zang & Hao Zhang & Jie Xu & Hansi Zhang & Sajjad Fouladvand & Shreyas Havaldar & Feixiong Cheng & Kun Chen & Yong Chen & Benjamin S. Glicksberg & Jin Chen & Jiang Bian & Fei Wang, 2023. "High-throughput target trial emulation for Alzheimer’s disease drug repurposing with real-world data," Nature Communications, Nature, vol. 14(1), pages 1-16, December.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Quanhe Yang & Anping Chang & Xin Tong & Sandra L Jackson & Robert K Merritt, 2024. "Long-term cardiovascular disease outcomes in non-hospitalized medicare beneficiaries diagnosed with COVID-19: Population-based matched cohort study," PLOS ONE, Public Library of Science, vol. 19(5), pages 1-25, May.
    2. Ainur T. Tauekelova & Zhanar Kalila & Akerke Bakhtiyar & Zarina Sautbayeva & Polina Len & Aliya Sailybayeva & Sadyk Khamitov & Nazira Kadroldinova & Natasha S. Barteneva & Makhabbat S. Bekbossynova, 2023. "Association of Lung Fibrotic Changes and Cardiological Dysfunction with Comorbidities in Long COVID-19 Cohort," IJERPH, MDPI, vol. 20(3), pages 1-18, January.
    3. Vanessa Bertuzzi & Michelle Semonella & Gianluca Castelnuovo & Gerhard Andersson & Giada Pietrabissa, 2022. "Synthesizing Stakeholders Perspectives on Online Psychological Interventions to Improve the Mental Health of the Italian Population during the COVID-19 Pandemic: An Online Survey Study," IJERPH, MDPI, vol. 19(12), pages 1-13, June.
    4. Bingyu Zhang & Deepika Thacker & Ting Zhou & Dazheng Zhang & Yuqing Lei & Jiajie Chen & Elizabeth A. Chrischilles & Dimitri A. Christakis & Soledad Fernandez & Vidu Garg & Susan Kim & Abu S. M. Mosa &, 2025. "Cardiovascular post-acute sequelae of SARS-CoV-2 in children and adolescents: cohort study using electronic health records," Nature Communications, Nature, vol. 16(1), pages 1-12, December.
    5. Michal Matuszewski & Yurii Reznikov & Michal Pruc & Frank W. Peacock & Alla Navolokina & Raúl Júarez-Vela & Lukasz Jankowski & Zubaid Rafique & Lukasz Szarpak, 2022. "Prognostic Performance of Cystatin C in COVID-19: A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 19(21), pages 1-10, November.
    6. Evan Xu & Yan Xie & Ziyad Al-Aly, 2023. "Long-term gastrointestinal outcomes of COVID-19," Nature Communications, Nature, vol. 14(1), pages 1-10, December.
    7. Chengxi Zang & Yongkang Zhang & Jie Xu & Jiang Bian & Dmitry Morozyuk & Edward J. Schenck & Dhruv Khullar & Anna S. Nordvig & Elizabeth A. Shenkman & Russell L. Rothman & Jason P. Block & Kristin Lyma, 2023. "Data-driven analysis to understand long COVID using electronic health records from the RECOVER initiative," Nature Communications, Nature, vol. 14(1), pages 1-14, December.
    8. Fu, Hongqiao & Cheng, Terence C. & Zhan, Jiajia & Xu, Duo & Yip, Winnie, 2024. "Dynamic effects of the COVID-19 pandemic on the demand for telemedicine services: Evidence from China," Journal of Economic Behavior & Organization, Elsevier, vol. 220(C), pages 531-557.
    9. Tianchu Lyu & Nicole Hair & Nicholas Yell & Zhenlong Li & Shan Qiao & Chen Liang & Xiaoming Li, 2021. "Temporal Geospatial Analysis of COVID-19 Pre-Infection Determinants of Risk in South Carolina," IJERPH, MDPI, vol. 18(18), pages 1-18, September.
    10. Yan Xie & Benjamin Bowe & Ziyad Al-Aly, 2021. "Burdens of post-acute sequelae of COVID-19 by severity of acute infection, demographics and health status," Nature Communications, Nature, vol. 12(1), pages 1-12, December.
    11. Carlos M. Pérez-Lara & Doris D. Lara-Malca & Luz A. Baltodano-Nontol & Jessica E. Vicuña-Villacorta & Liliana M. Haro-León & Julio A. Rodríguez-Azabache, 2024. "Advances in Studies on Psychological Symptoms in Patients Surviving Covid-19: A Bibliometric Analysis," Academic Journal of Interdisciplinary Studies, Richtmann Publishing Ltd, vol. 13, January.
    12. Wangzi Xu & Yu Cao & Lin Wu, 2023. "No Causal Effects Detected in COVID-19 and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Two Sample Mendelian Randomization Study," IJERPH, MDPI, vol. 20(3), pages 1-13, January.
    13. Alicja Mińko & Agnieszka Turoń-Skrzypińska & Aleksandra Rył & Natalia Tomska & Zuzanna Bereda & Iwona Rotter, 2022. "Searching for Factors Influencing the Severity of the Symptoms of Long COVID," IJERPH, MDPI, vol. 19(13), pages 1-11, June.
    14. Figueiredo, Bernardo & Sheahan, Jacob & Luo, Shiqi & Bird, Stephen & Wong Lit Wan, Dawn & Xenos, Sophia & Itsiopoulos, Catherine & Jessup, Rebecca & Zheng, Zhen, 2024. "Journey mapping long COVID: Agency and social support for long-hauling," Social Science & Medicine, Elsevier, vol. 340(C).
    15. Yunhe Wang & Binbin Su & Marta Alcalde-Herraiz & Nicola L. Barclay & Yaohua Tian & Chunxiao Li & Nicholas J. Wareham & Roger Paredes & Junqing Xie & Daniel Prieto-Alhambra, 2024. "Modifiable lifestyle factors and the risk of post-COVID-19 multisystem sequelae, hospitalization, and death," Nature Communications, Nature, vol. 15(1), pages 1-12, December.
    16. Igor Costa de Lima & Daniel Carvalho de Menezes & Juliana Hiromi Emin Uesugi & Cléa Nazaré Carneiro Bichara & Pedro Fernando da Costa Vasconcelos & Juarez Antônio Simões Quaresma & Luiz Fábio Magno Fa, 2023. "Liver Function in Patients with Long-Term Coronavirus Disease 2019 of up to 20 Months: A Cross-Sectional Study," IJERPH, MDPI, vol. 20(7), pages 1-11, March.
    17. Ivan Chun Hang Lam & Ran Zhang & Kenneth Keng Cheung Man & Carlos King Ho Wong & Celine Sze Ling Chui & Francisco Tsz Tsun Lai & Xue Li & Esther Wai Yin Chan & Chak Sing Lau & Ian Chi Kei Wong & Eric , 2024. "Persistence in risk and effect of COVID-19 vaccination on long-term health consequences after SARS-CoV-2 infection," Nature Communications, Nature, vol. 15(1), pages 1-15, December.
    18. André Santa Cruz & Ana Mendes-Frias & Marne Azarias-da-Silva & Sónia André & Ana Isabel Oliveira & Olga Pires & Marta Mendes & Bárbara Oliveira & Marta Braga & Joana Rita Lopes & Rui Domingues & Ricar, 2023. "Post-acute sequelae of COVID-19 is characterized by diminished peripheral CD8+β7 integrin+ T cells and anti-SARS-CoV-2 IgA response," Nature Communications, Nature, vol. 14(1), pages 1-14, December.
    19. Rúbens Prince dos Santos Alves & Julia Timis & Robyn Miller & Kristen Valentine & Paolla Beatriz Almeida Pinto & Andrew Gonzalez & Jose Angel Regla-Nava & Erin Maule & Michael N. Nguyen & Norazizah Sh, 2024. "Human coronavirus OC43-elicited CD4+ T cells protect against SARS-CoV-2 in HLA transgenic mice," Nature Communications, Nature, vol. 15(1), pages 1-20, December.
    20. Stelson, Elisabeth A. & Dash, Devanshi & McCorkell, Lisa & Wilson, Cali & Assaf, Gina & Re'em, Yochai & Wei, Hannah, 2023. "Return-to-work with long COVID: An Episodic Disability and Total Worker Health® analysis," Social Science & Medicine, Elsevier, vol. 338(C).

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:nat:natcom:v:16:y:2025:i:1:d:10.1038_s41467-025-57849-9. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.nature.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.