(1086) Risk Factors for Post-Acute Sequelae of SARS-CoV-2 Infection (PASC) Symptoms Among Postpartum Birthing People

Approximately 10% of people with SARS-CoV-2 will experience PASC, which has been characterized by symptoms such as malaise, fatigue, and cough, among others. PASC symptoms are particularly difficult for postpartum people as they navigate their own physical and emotional transition to new parenthood. We sought to evaluate risk factors for PASC in postpartum people.

Study Design:

This secondary analysis of a randomized trial of a digital health intervention to support new parents. The parent trial recruited birthing people after delivery, prior to hospital discharge. At the time of consent, birthing people were asked to answer additional questions surrounding prior SARS-CoV-2 infection, its timing, vaccination status, co-morbidities, and whether they were experiencing any of the 44 symptoms of PASC described within the NIH RECOVER cohort. Those who reported prior SARS-CoV-2 infection were included. A PASC score was calculated using previously published criteria and a cut-off of ≥ 12 used to define PASC. Multivariable models were used to identify risk factors for PASC.

Results:

Of the 284 postpartum people who met inclusion criteria, 137 (48.2%) reported prior SARS-CoV-2. A total of 27 (9.5%) met criteria for PASC. In multivariable models, non-Hispanic Black race was associated with having a lower PASC score whereas having a chronic medical condition was associated with a higher PASC score. For multivariable models with the outcome of PASC (i.e., PASC score ≥ 12), having a chronic medical condition was the only risk factor associated with PASC. Notably, SARS-CoV-2 infection during pregnancy (vs outside of pregnancy) was not associated with PASC. While point estimates for PASC score and PASC were lower for those vaccinated for SARS-CoV-2 compared to those unvaccinated, these estimates did not reach statistical significance.

Conclusion:

For postpartum birthing people with SARS-CoV-2, having a chronic medical condition is a risk factor for PASC symptoms postpartum. Recognizing the particular burden of PASC on new parents, these data amplify the importance of ongoing public health prevention efforts.