The Hospital Quality Institute’s (HQI) Sentinel Signal Detection System has alerted HQI to notify California member hospitals about significantly higher preeclampsia/eclampsia risk identified among pregnant patients with evidence of concurrent COVID‑19 infection during 2020-2021.
Specifically, the below figure shows extended periods from April 2020 to June 2021 during which the probability of preeclampsia/eclampsia diagnosis was as much as 15% higher among pregnant patients with COVID-19 infection compared to those without COVID-19 infection. Also noteworthy is the slow but complete diminishment of the elevated risk that triggered this alert by mid-2021 for unknown reasons.
The elevated preeclampsia risk HQI detected is not unique to California. For example 76%-77% higher preeclampsia risk was identified in 2021 AJOG and JAMA multinational prospective studies and 55% higher risk was noted in a 2021 AJOG English cohort study.
Although the excess risk has inexplicably waned, HQI encourages members to continue vigilantly screening for pregnancy complications in patients with COVID-19 infection, should conditions change.
| Time Period | COVID-19+ Risk Difference | p value | Statistical Interpretation |
|---|---|---|---|
| Apr 2020 – Dec 2020 | +3% | < .05 | Significant |
| Apr 2020 – June 2021 | +1% | < .05 | Significant |
| Jan 2021 – June 2021 | 0% | .10 | Not significant |
These alerts are made possible by timely hospital submissions of discharge data to the Hospital Quality Improvement Platform (HQIP) and safety reports to the Collaborative Healthcare Patient Safety Organization. Thank you for helping us provide timely, accurate alerts to you and other members. Continuing to share complete and timely data to power our sentinel signal detection system allows us to generate actionable alerts and continue to assist improving patient safety.
Questions or comments about this alert should be directed to Michelle Newsom (mnewsom@chpso.org) or Vivian Eusebio (veusebio@chpso.org) at HQI.