tetano
Editor, Senior Moderator
PLoS One
. 2021 Aug 5;16(8):e0254875.
doi: 10.1371/journal.pone.0254875. eCollection 2021.
Preterm birth is not associated with asymptomatic/mild SARS-CoV-2 infection per se: Pre-pregnancy state is what matters
Stefano Cosma[SUP] 1 [/SUP], Andrea Roberto Carosso[SUP] 1 [/SUP], Jessica Cusato[SUP] 2 [/SUP], Fulvio Borella[SUP] 1 [/SUP], Marco Carosso[SUP] 1 [/SUP], Fiammetta Gervasoni[SUP] 1 [/SUP], Ilaria Stura[SUP] 3 [/SUP], Mario Preti[SUP] 1 [/SUP], Valeria Ghisetti[SUP] 4 [/SUP], Giovanni Di Perri[SUP] 5 [/SUP], Chiara Benedetto[SUP] 1 [/SUP]
Affiliations
Abstract
Evidence for the real impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on preterm birth is unclear, as available series report composite pregnancy outcomes and/or do not stratify patients according to disease severity. The purpose of the research was to determine the real impact of asymptomatic/mild SARS-CoV-2 infection on preterm birth not due to maternal respiratory failure. This case-control study involved women admitted to Sant Anna Hospital, Turin, for delivery between 20 September 2020 and 9 January 2021. The cumulative incidence of Coronavirus disease-19 was compared between preterm birth (case group, n = 102) and full-term delivery (control group, n = 127). Only women with spontaneous or medically-indicated preterm birth because of placental vascular malperfusion (pregnancy-related hypertension and its complications) were included. Current or past SARS-CoV-2 infection was determined by nasopharyngeal swab testing and detection of IgM/IgG antibodies in blood samples. A significant difference in the cumulative incidence of Coronavirus disease-19 between the case (21/102, 20.5%) and the control group (32/127, 25.1%) (P= 0.50) was not observed, although the case group was burdened by a higher prevalence of three known risk factors (body mass index > 24.9, asthma, chronic hypertension) for severe Coronavirus disease-19. Logistic regression analysis showed that asymptomatic/mild SARS-CoV-2 infection was not an independent predictor of spontaneous and medically-indicated preterm birth due to pregnancy-related hypertension and its complications (0.77; 95% confidence interval, 0.41-1.43). Pregnant patients without comorbidities need to be reassured that asymptomatic/mild SARS-CoV-2 infection does not increase the risk of preterm delivery. Preterm birth and severe Coronavirus disease-19 share common risk factors (i.e., body mass index > 24.9, asthma, chronic hypertension), which may explain the high rate of indicated preterm birth due to maternal conditions reported in the literature.
. 2021 Aug 5;16(8):e0254875.
doi: 10.1371/journal.pone.0254875. eCollection 2021.
Preterm birth is not associated with asymptomatic/mild SARS-CoV-2 infection per se: Pre-pregnancy state is what matters
Stefano Cosma[SUP] 1 [/SUP], Andrea Roberto Carosso[SUP] 1 [/SUP], Jessica Cusato[SUP] 2 [/SUP], Fulvio Borella[SUP] 1 [/SUP], Marco Carosso[SUP] 1 [/SUP], Fiammetta Gervasoni[SUP] 1 [/SUP], Ilaria Stura[SUP] 3 [/SUP], Mario Preti[SUP] 1 [/SUP], Valeria Ghisetti[SUP] 4 [/SUP], Giovanni Di Perri[SUP] 5 [/SUP], Chiara Benedetto[SUP] 1 [/SUP]
Affiliations
- PMID: 34351922
- DOI: 10.1371/journal.pone.0254875
Abstract
Evidence for the real impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on preterm birth is unclear, as available series report composite pregnancy outcomes and/or do not stratify patients according to disease severity. The purpose of the research was to determine the real impact of asymptomatic/mild SARS-CoV-2 infection on preterm birth not due to maternal respiratory failure. This case-control study involved women admitted to Sant Anna Hospital, Turin, for delivery between 20 September 2020 and 9 January 2021. The cumulative incidence of Coronavirus disease-19 was compared between preterm birth (case group, n = 102) and full-term delivery (control group, n = 127). Only women with spontaneous or medically-indicated preterm birth because of placental vascular malperfusion (pregnancy-related hypertension and its complications) were included. Current or past SARS-CoV-2 infection was determined by nasopharyngeal swab testing and detection of IgM/IgG antibodies in blood samples. A significant difference in the cumulative incidence of Coronavirus disease-19 between the case (21/102, 20.5%) and the control group (32/127, 25.1%) (P= 0.50) was not observed, although the case group was burdened by a higher prevalence of three known risk factors (body mass index > 24.9, asthma, chronic hypertension) for severe Coronavirus disease-19. Logistic regression analysis showed that asymptomatic/mild SARS-CoV-2 infection was not an independent predictor of spontaneous and medically-indicated preterm birth due to pregnancy-related hypertension and its complications (0.77; 95% confidence interval, 0.41-1.43). Pregnant patients without comorbidities need to be reassured that asymptomatic/mild SARS-CoV-2 infection does not increase the risk of preterm delivery. Preterm birth and severe Coronavirus disease-19 share common risk factors (i.e., body mass index > 24.9, asthma, chronic hypertension), which may explain the high rate of indicated preterm birth due to maternal conditions reported in the literature.