tetano
Editor, Senior Moderator
BMC Pregnancy Childbirth
. 2021 Apr 1;21(1):273.
doi: 10.1186/s12884-021-03742-4.
The association between SARS-CoV-2 infection and preterm delivery: a prospective study with a multivariable analysis
Oscar Martinez-Perez[SUP] 1 [/SUP], Pilar Prats Rodriguez[SUP] 2 [/SUP], Marta Muner Hernandez[SUP] 3 [/SUP], Maria Bego?a Encinas Pardilla[SUP] 4 [/SUP], Noelia Perez Perez[SUP] 5 [/SUP], Maria Rosa Vila Hernandez[SUP] 6 [/SUP], Ana Villalba Yarza[SUP] 7 [/SUP], Olga Nieto Velasco[SUP] 8 [/SUP], Pablo Guillermo Del Barrio Fernandez[SUP] 9 [/SUP], Laura Forcen Acebal[SUP] 10 [/SUP], Carmen Maria Orizales Lago[SUP] 11 [/SUP], Alicia Martinez Varea[SUP] 12 [/SUP], Bego?a Mu?oz Abellana[SUP] 13 [/SUP], Maria Suarez Arana[SUP] 14 [/SUP], Laura Fuentes Ricoy[SUP] 15 [/SUP], Clara Martinez Diago[SUP] 16 [/SUP], Maria Jesus Janeiro Freire[SUP] 17 [/SUP], Macarena Alf?rez Alvarez-Mallo[SUP] 18 [/SUP], Cristina Casanova Pedraz[SUP] 19 [/SUP], Onofre Alomar Mateu[SUP] 20 [/SUP], Cristina Lesmes Heredia[SUP] 21 [/SUP], Juan Carlos Wizner de Alva[SUP] 22 [/SUP], Rut Bernardo Vega[SUP] 23 [/SUP], Montserrat Macia Badia[SUP] 24 [/SUP], Cristina Alvarez Colomo[SUP] 25 [/SUP], Antonio Sanchez Mu?oz[SUP] 26 [/SUP], Laia Pratcorona Alicart[SUP] 27 [/SUP], Ruben Alonso Saiz[SUP] 28 [/SUP], Monica Lopez Rodriguez[SUP] 29 [/SUP], Maria Del Carmen Barbancho Lopez[SUP] 30 [/SUP], Marta Ruth Meca Casbas[SUP] 31 [/SUP], Oscar Vaquerizo Ruiz[SUP] 32 [/SUP], Eva Moran Antolin[SUP] 33 [/SUP], Maria Jose Nu?ez Valera[SUP] 34 [/SUP], Camino Fernandez Fernandez[SUP] 35 [/SUP], Albert Tubau Navarra[SUP] 36 [/SUP], Alejandra Maria Cano Garcia[SUP] 37 [/SUP], Carmen Baena Luque[SUP] 38 [/SUP], Susana Soldevilla Perez[SUP] 39 [/SUP], Irene Gastaca Abasolo[SUP] 40 [/SUP], Jose Adanez Garcia[SUP] 41 [/SUP], Maria Teulon Gonzalez[SUP] 42 [/SUP], Alberto Puertas Prieto[SUP] 43 [/SUP], Rosa Ostos Serna[SUP] 44 [/SUP], Maria Del Pilar Guadix Martin[SUP] 45 [/SUP], Monica Catalina Coello[SUP] 46 [/SUP], Elena Ferriols Perez[SUP] 47 [/SUP], Africa Ca?o Aguilar[SUP] 48 [/SUP], Maria Luisa De la Cruz Conty[SUP] 49 [/SUP], Jose Antonio Sainz Bueno[SUP] 50 [/SUP], Spanish Obstetric Emergency Group
Affiliations
Abstract
Background: To determine whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, the cause of COVID-19 disease) exposure in pregnancy, compared to non-exposure, is associated with infection-related obstetric morbidity.
Methods: We conducted a multicentre prospective study in pregnancy based on a universal antenatal screening program for SARS-CoV-2 infection. Throughout Spain 45 hospitals tested all women at admission on delivery ward using polymerase-chain-reaction (PCR) for COVID-19 since late March 2020. The cohort of positive mothers and the concurrent sample of negative mothers was followed up until 6-weeks post-partum. Multivariable logistic regression analysis, adjusting for known confounding variables, determined the adjusted odds ratio (aOR) with 95% confidence intervals (95% CI) of the association of SARS-CoV-2 infection and obstetric outcomes.
Main outcome measures: Preterm delivery (primary), premature rupture of membranes and neonatal intensive care unit admissions.
Results: Among 1009 screened pregnancies, 246 were SARS-CoV-2 positive. Compared to negative mothers (763 cases), SARS-CoV-2 infection increased the odds of preterm birth (34 vs 51, 13.8% vs 6.7%, aOR 2.12, 95% CI 1.32-3.36, p = 0.002); iatrogenic preterm delivery was more frequent in infected women (4.9% vs 1.3%, p = 0.001), while the occurrence of spontaneous preterm deliveries was statistically similar (6.1% vs 4.7%). An increased risk of premature rupture of membranes at term (39 vs 75, 15.8% vs 9.8%, aOR 1.70, 95% CI 1.11-2.57, p = 0.013) and neonatal intensive care unit admissions (23 vs 18, 9.3% vs 2.4%, aOR 4.62, 95% CI 2.43-8.94, p < 0.001) was also observed in positive mothers.
Conclusion: This prospective multicentre study demonstrated that pregnant women infected with SARS-CoV-2 have more infection-related obstetric morbidity. This hypothesis merits evaluation of a causal association in further research.
Keywords: COVID-19; Coronavirus; Intensive care units, neonatal; Pregnancy; Premature birth; Premature rupture of membranes; SARS-CoV-2.
. 2021 Apr 1;21(1):273.
doi: 10.1186/s12884-021-03742-4.
The association between SARS-CoV-2 infection and preterm delivery: a prospective study with a multivariable analysis
Oscar Martinez-Perez[SUP] 1 [/SUP], Pilar Prats Rodriguez[SUP] 2 [/SUP], Marta Muner Hernandez[SUP] 3 [/SUP], Maria Bego?a Encinas Pardilla[SUP] 4 [/SUP], Noelia Perez Perez[SUP] 5 [/SUP], Maria Rosa Vila Hernandez[SUP] 6 [/SUP], Ana Villalba Yarza[SUP] 7 [/SUP], Olga Nieto Velasco[SUP] 8 [/SUP], Pablo Guillermo Del Barrio Fernandez[SUP] 9 [/SUP], Laura Forcen Acebal[SUP] 10 [/SUP], Carmen Maria Orizales Lago[SUP] 11 [/SUP], Alicia Martinez Varea[SUP] 12 [/SUP], Bego?a Mu?oz Abellana[SUP] 13 [/SUP], Maria Suarez Arana[SUP] 14 [/SUP], Laura Fuentes Ricoy[SUP] 15 [/SUP], Clara Martinez Diago[SUP] 16 [/SUP], Maria Jesus Janeiro Freire[SUP] 17 [/SUP], Macarena Alf?rez Alvarez-Mallo[SUP] 18 [/SUP], Cristina Casanova Pedraz[SUP] 19 [/SUP], Onofre Alomar Mateu[SUP] 20 [/SUP], Cristina Lesmes Heredia[SUP] 21 [/SUP], Juan Carlos Wizner de Alva[SUP] 22 [/SUP], Rut Bernardo Vega[SUP] 23 [/SUP], Montserrat Macia Badia[SUP] 24 [/SUP], Cristina Alvarez Colomo[SUP] 25 [/SUP], Antonio Sanchez Mu?oz[SUP] 26 [/SUP], Laia Pratcorona Alicart[SUP] 27 [/SUP], Ruben Alonso Saiz[SUP] 28 [/SUP], Monica Lopez Rodriguez[SUP] 29 [/SUP], Maria Del Carmen Barbancho Lopez[SUP] 30 [/SUP], Marta Ruth Meca Casbas[SUP] 31 [/SUP], Oscar Vaquerizo Ruiz[SUP] 32 [/SUP], Eva Moran Antolin[SUP] 33 [/SUP], Maria Jose Nu?ez Valera[SUP] 34 [/SUP], Camino Fernandez Fernandez[SUP] 35 [/SUP], Albert Tubau Navarra[SUP] 36 [/SUP], Alejandra Maria Cano Garcia[SUP] 37 [/SUP], Carmen Baena Luque[SUP] 38 [/SUP], Susana Soldevilla Perez[SUP] 39 [/SUP], Irene Gastaca Abasolo[SUP] 40 [/SUP], Jose Adanez Garcia[SUP] 41 [/SUP], Maria Teulon Gonzalez[SUP] 42 [/SUP], Alberto Puertas Prieto[SUP] 43 [/SUP], Rosa Ostos Serna[SUP] 44 [/SUP], Maria Del Pilar Guadix Martin[SUP] 45 [/SUP], Monica Catalina Coello[SUP] 46 [/SUP], Elena Ferriols Perez[SUP] 47 [/SUP], Africa Ca?o Aguilar[SUP] 48 [/SUP], Maria Luisa De la Cruz Conty[SUP] 49 [/SUP], Jose Antonio Sainz Bueno[SUP] 50 [/SUP], Spanish Obstetric Emergency Group
Affiliations
- PMID: 33794829
- DOI: 10.1186/s12884-021-03742-4
Abstract
Background: To determine whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, the cause of COVID-19 disease) exposure in pregnancy, compared to non-exposure, is associated with infection-related obstetric morbidity.
Methods: We conducted a multicentre prospective study in pregnancy based on a universal antenatal screening program for SARS-CoV-2 infection. Throughout Spain 45 hospitals tested all women at admission on delivery ward using polymerase-chain-reaction (PCR) for COVID-19 since late March 2020. The cohort of positive mothers and the concurrent sample of negative mothers was followed up until 6-weeks post-partum. Multivariable logistic regression analysis, adjusting for known confounding variables, determined the adjusted odds ratio (aOR) with 95% confidence intervals (95% CI) of the association of SARS-CoV-2 infection and obstetric outcomes.
Main outcome measures: Preterm delivery (primary), premature rupture of membranes and neonatal intensive care unit admissions.
Results: Among 1009 screened pregnancies, 246 were SARS-CoV-2 positive. Compared to negative mothers (763 cases), SARS-CoV-2 infection increased the odds of preterm birth (34 vs 51, 13.8% vs 6.7%, aOR 2.12, 95% CI 1.32-3.36, p = 0.002); iatrogenic preterm delivery was more frequent in infected women (4.9% vs 1.3%, p = 0.001), while the occurrence of spontaneous preterm deliveries was statistically similar (6.1% vs 4.7%). An increased risk of premature rupture of membranes at term (39 vs 75, 15.8% vs 9.8%, aOR 1.70, 95% CI 1.11-2.57, p = 0.013) and neonatal intensive care unit admissions (23 vs 18, 9.3% vs 2.4%, aOR 4.62, 95% CI 2.43-8.94, p < 0.001) was also observed in positive mothers.
Conclusion: This prospective multicentre study demonstrated that pregnant women infected with SARS-CoV-2 have more infection-related obstetric morbidity. This hypothesis merits evaluation of a causal association in further research.
Keywords: COVID-19; Coronavirus; Intensive care units, neonatal; Pregnancy; Premature birth; Premature rupture of membranes; SARS-CoV-2.