tetano
Editor, Senior Moderator
Am J Perinatol
. 2022 Jun 23.
doi: 10.1055/s-0042-1749666. Online ahead of print.
Association between SARS-CoV-2 Infection and Adverse Perinatal Outcomes in a Large Health Maintenance Organization
Darios Getahun[SUP] 1 2 [/SUP], Morgan R Peltier[SUP] 3 [/SUP], Lawrence D Lurvey[SUP] 4 [/SUP], Jiaxiao M Shi[SUP] 1 [/SUP], David Braun[SUP] 1 4 [/SUP], David A Sacks[SUP] 1 5 [/SUP], Anthony E Burgos[SUP] 6 7 [/SUP], Alex Fong[SUP] 8 [/SUP], Neha Trivedi[SUP] 9 [/SUP], Lyn Yasumura[SUP] 10 [/SUP], Kristi Reynolds[SUP] 1 2 [/SUP], Marielle Nguyen[SUP] 11 [/SUP], Marianna Volodarskiy[SUP] 12 [/SUP], Vicki Y Chiu[SUP] 1 [/SUP], Adrian H Lopez[SUP] 8 [/SUP], Michael J Fassett[SUP] 13 [/SUP]
Affiliations
Abstract
Objective: This study aimed to examine whether severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection during pregnancy is associated with increased odds of perinatal complications and viral transmission to the infant.
Study design: A retrospective cohort study of women who delivered at Kaiser Permanente Southern California hospitals (April 6, 2020-February 28, 2021) was performed using data extracted from electronic health records (EHRs). During this time polymerize chain reaction (PCR)-based tests for SARS-CoV-2 was universally offered to all pregnant women at labor and delivery admission, as well as earlier in the pregnancy, if they were displaying symptoms consistent with SARS-CoV-2 infection or a possible exposure to the virus. Adjusted odds ratio (aOR) was used to estimate the strength of associations between positive test results and adverse perinatal outcomes.
Results: Of 35,123 women with a singleton pregnancy, 2,203 (6%) tested positive for SARS-CoV-2 infection with 596 (27%) testing positive during the first or second trimester and 1,607 (73%) during the third trimester. Women testing positive were younger than those who tested negative (29.7 [5.4] vs. 31.1 [5.3] years; mean [standard deviation (SD)]; p < .001). The SARS-CoV-2 infection tended to increase the odds of an abnormal fetal heart rate pattern (aOR: 1.10; 95% confidence interval [CI]: 1.00, 1.21; p = 0.058), spontaneous preterm birth (aOR: 1.28; 95% CI: 1.03, 1.58; p = 0.024), congenital anomalies (aOR: 1.69; 95% CI: 1.15, 2.50; p = 0.008), and maternal intensive care unit admission at delivery (aOR: 7.44; 95% CI: 4.06, 13.62; p < 0.001) but not preeclampsia/eclampsia (aOR: 1.14; 95% CI: 0.98, 1.33; p = 0.080). Eighteen (0.8%) neonates of mothers who tested positive also had a positive SARS-CoV-2 test after 24 hours of birth, but all were asymptomatic during the neonatal period.
Conclusion: These findings suggest that prenatal SARS-CoV-2 infection increases the odds of some adverse perinatal outcomes. The likelihood of vertical transmission from the mother to the fetus was low (0.3%), suggesting that pregnancy complications resulting from SARS-CoV-2 infection pose more risk to the baby than transplacental viral transmission.
Key points: · SARS-CoV-2 infection is associated with increased odds of adverse perinatal outcomes.. · The odds of specific adverse outcomes were greater when a mother was infected earlier in pregnancy.. · The proportion of vertical transmission from mother to fetus was 0.3%.
. 2022 Jun 23.
doi: 10.1055/s-0042-1749666. Online ahead of print.
Association between SARS-CoV-2 Infection and Adverse Perinatal Outcomes in a Large Health Maintenance Organization
Darios Getahun[SUP] 1 2 [/SUP], Morgan R Peltier[SUP] 3 [/SUP], Lawrence D Lurvey[SUP] 4 [/SUP], Jiaxiao M Shi[SUP] 1 [/SUP], David Braun[SUP] 1 4 [/SUP], David A Sacks[SUP] 1 5 [/SUP], Anthony E Burgos[SUP] 6 7 [/SUP], Alex Fong[SUP] 8 [/SUP], Neha Trivedi[SUP] 9 [/SUP], Lyn Yasumura[SUP] 10 [/SUP], Kristi Reynolds[SUP] 1 2 [/SUP], Marielle Nguyen[SUP] 11 [/SUP], Marianna Volodarskiy[SUP] 12 [/SUP], Vicki Y Chiu[SUP] 1 [/SUP], Adrian H Lopez[SUP] 8 [/SUP], Michael J Fassett[SUP] 13 [/SUP]
Affiliations
- PMID: 35738286
- DOI: 10.1055/s-0042-1749666
Abstract
Objective: This study aimed to examine whether severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection during pregnancy is associated with increased odds of perinatal complications and viral transmission to the infant.
Study design: A retrospective cohort study of women who delivered at Kaiser Permanente Southern California hospitals (April 6, 2020-February 28, 2021) was performed using data extracted from electronic health records (EHRs). During this time polymerize chain reaction (PCR)-based tests for SARS-CoV-2 was universally offered to all pregnant women at labor and delivery admission, as well as earlier in the pregnancy, if they were displaying symptoms consistent with SARS-CoV-2 infection or a possible exposure to the virus. Adjusted odds ratio (aOR) was used to estimate the strength of associations between positive test results and adverse perinatal outcomes.
Results: Of 35,123 women with a singleton pregnancy, 2,203 (6%) tested positive for SARS-CoV-2 infection with 596 (27%) testing positive during the first or second trimester and 1,607 (73%) during the third trimester. Women testing positive were younger than those who tested negative (29.7 [5.4] vs. 31.1 [5.3] years; mean [standard deviation (SD)]; p < .001). The SARS-CoV-2 infection tended to increase the odds of an abnormal fetal heart rate pattern (aOR: 1.10; 95% confidence interval [CI]: 1.00, 1.21; p = 0.058), spontaneous preterm birth (aOR: 1.28; 95% CI: 1.03, 1.58; p = 0.024), congenital anomalies (aOR: 1.69; 95% CI: 1.15, 2.50; p = 0.008), and maternal intensive care unit admission at delivery (aOR: 7.44; 95% CI: 4.06, 13.62; p < 0.001) but not preeclampsia/eclampsia (aOR: 1.14; 95% CI: 0.98, 1.33; p = 0.080). Eighteen (0.8%) neonates of mothers who tested positive also had a positive SARS-CoV-2 test after 24 hours of birth, but all were asymptomatic during the neonatal period.
Conclusion: These findings suggest that prenatal SARS-CoV-2 infection increases the odds of some adverse perinatal outcomes. The likelihood of vertical transmission from the mother to the fetus was low (0.3%), suggesting that pregnancy complications resulting from SARS-CoV-2 infection pose more risk to the baby than transplacental viral transmission.
Key points: · SARS-CoV-2 infection is associated with increased odds of adverse perinatal outcomes.. · The odds of specific adverse outcomes were greater when a mother was infected earlier in pregnancy.. · The proportion of vertical transmission from mother to fetus was 0.3%.