P25 Impact of COVID-19 on the Health-Related Quality-of-Life of Pregnant and Postpartum Persons

To assess the impact of COVID-19 on health-related quality-of-life (HRQoL) of those who were pregnant or recently pregnant during the pandemic. Individuals who were pregnant any time since January 2020, the beginning of the pandemic, were invited to participate in an online, national US survey (EuroQol grant: 260-2020RA). Respondents were asked to self-report their experiences with COVID-19, to complete the EQ-5D-5L, and other measurements of HRQoL. To estimate the association between COVID-19 infection with the EQ-5D-5L outcomes, we used median regression for the EQ-5D utility and EQ-VAS scores, and ordinal logistic regressions for the EQ-5D-5L health items. Post-stratification weights were used to ensure representation by age, race and US census region. Among pregnant or postpartum persons, the median EQ-5D-5L utility score was 0.87 and EQ-VAS was 0.80. The median EQ-5D-5L utility score increased by 0.0058 (95% CI 0.0026, 0.009) for each additional year of age of the respondent. We observed no change in EQ-5D-VAS utility measures by maternal age (ß= 0.00; 95% CI -0.09, 0.09). On average, comparing Black pregnant persons to White, EQ-5D-5L utility values were 0.44 points lower, and EQ-5D-VAS scores were 0.31 points lower. Although median EQ-5D-5L utility values were similar for those with and without a diagnosis of COVID-19 (0.87 and 0.88), utility values declined by 0.022 (95% CI -0.040, -0.010) for each unit increase in perceived COVID-19 severity. Similar results were observed for the EQ-5D-VAS scores. When we evaluated EQ-5D-5L items individually, respondents diagnosed with COVID-19 reported more problems related to anxiety/depression compared with those who did not (OR 2.43; 95% CI 1.35, 4.40). No other items were significantly associated with COVID-19. We observed lower HRQoL measures associated with severe COVID-19 infection during pregnancy. In particular, problems with anxiety and depression contributed most strongly to lowered HRQoL during pregnancy.