Report of the ISTH registry on pregnancy and COVID-19-associated coagulopathy (COV-PREG-COAG)

Background Concerns about COVID-19-associated coagulopathy (CAC) in pregnant individuals were raised in early pandemic. Methods An ISTH-sponsored COVID-19 coagulopathy in pregnancy (COV-PREG-COAG) international registry was developed to describe incidence of coagulopathy, VTE, and anticoagulation in this group. Results All pregnant patients with COVID-19 from participating centers were entered, providing 430 pregnancies for the first pandemic wave. Isolated abnormal coagulation parameters were seen in 20%; more often with moderate/severe disease than asymptomatic/mild disease (49% vs 15%; p < 0.0001). No one met the ISTH criteria for DIC, though 5/21 (24%) met the pregnancy DIC score. There was no difference in APH with asymptomatic/mild disease versus moderate/severe disease (3.4% vs 7.7%; p = 0.135). More individuals with moderate/severe disease experienced PPH (22.4% vs 9.3%; p = 0.006). There were no arterial thrombotic events. Only one COVID-associated VTE was reported. Conclusions Low rates of coagulopathy, bleeding, and thrombosis were observed among pregnant people in the first pandemic wave.