tetano
Editor, Senior Moderator
Am J Perinatol
. 2024 May 10.
doi: 10.1055/s-0044-1786868. Online ahead of print. Prediction of COVID-19 Severity at Delivery after Asymptomatic or Mild COVID-19 during Pregnancy
Grecio J Sandoval[SUP] 1 [/SUP], Torri D Metz[SUP] 2 [/SUP], William A Grobman[SUP] 3 [/SUP], Tracy A Manuck[SUP] 4 [/SUP], Brenna L Hughes[SUP] 4 [/SUP], George R Saade[SUP] 5 [/SUP], Monica Longo[SUP] 6 [/SUP], Hyagriv N Simhan[SUP] 7 [/SUP], Dwight J Rouse[SUP] 8 [/SUP], Hector Mendez-Figueroa[SUP] 9 [/SUP], Cynthia Gyamfi-Bannerman[SUP] 10 [/SUP], Angela C Ranzini[SUP] 11 [/SUP], Maged M Costantine[SUP] 12 [/SUP], Harish M Sehdev[SUP] 13 [/SUP], Alan T N Tita[SUP] 14 [/SUP]; Eunice Kennedy Shriver National Institute of Child Health Human Development Maternal-Fetal Medicine Units Network, Bethesda, MD
Affiliations
Objective: This study aimed to develop a prediction model that estimates the probability that a pregnant person who has had asymptomatic or mild coronavirus disease 2019 (COVID-19) prior to delivery admission will progress in severity to moderate, severe, or critical COVID-19.
Study design: This was a secondary analysis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive patients who delivered from March through December 2020 at hospitals across the United States. Those eligible for this analysis presented for delivery with a current or previous asymptomatic or mild SARS-CoV-2 infection. The primary outcome was moderate, severe, or critical COVID-19 during the delivery admission through 42 days postpartum. The prediction model was developed and internally validated using stratified cross-validation with stepwise backward elimination, incorporating only variables that were known on the day of hospital admission.
Results: Of the 2,818 patients included, 26 (0.9%; 95% confidence interval [CI], 0.6-1.3%) developed moderate-severe-critical COVID-19 during the study period. Variables in the prediction model were gestational age at delivery admission (adjusted odds ratio [aOR], 1.15; 95% CI, 1.08-1.22 per 1-week decrease), a hypertensive disorder in a prior pregnancy (aOR 3.05; 95% CI, 1.25-7.46), and systolic blood pressure at admission (aOR, 1.04; 95% CI, 1.02-1.05 per mm Hg increase). This model yielded an area under the receiver operating characteristic curve of 0.82 (95% CI, 0.72-0.91).
Conclusion: Among individuals presenting for delivery who had asymptomatic-mild COVID-19, gestational age at delivery admission, a hypertensive disorder in a prior pregnancy, and systolic blood pressure at admission were predictive of delivering with moderate, severe, or critical COVID-19. This prediction model may be a useful tool to optimize resources for SARS-CoV-2-infected pregnant individuals admitted for delivery.
Key points: · Three factors were associated with delivery with more severe COVID-19.. · The developed model yielded an area under the receiver operating characteristic curve of 0.82 and model fit was good.. · The model may be useful tool for SARS-CoV-2 infected pregnancies admitted for delivery..
. 2024 May 10.
doi: 10.1055/s-0044-1786868. Online ahead of print. Prediction of COVID-19 Severity at Delivery after Asymptomatic or Mild COVID-19 during Pregnancy
Grecio J Sandoval[SUP] 1 [/SUP], Torri D Metz[SUP] 2 [/SUP], William A Grobman[SUP] 3 [/SUP], Tracy A Manuck[SUP] 4 [/SUP], Brenna L Hughes[SUP] 4 [/SUP], George R Saade[SUP] 5 [/SUP], Monica Longo[SUP] 6 [/SUP], Hyagriv N Simhan[SUP] 7 [/SUP], Dwight J Rouse[SUP] 8 [/SUP], Hector Mendez-Figueroa[SUP] 9 [/SUP], Cynthia Gyamfi-Bannerman[SUP] 10 [/SUP], Angela C Ranzini[SUP] 11 [/SUP], Maged M Costantine[SUP] 12 [/SUP], Harish M Sehdev[SUP] 13 [/SUP], Alan T N Tita[SUP] 14 [/SUP]; Eunice Kennedy Shriver National Institute of Child Health Human Development Maternal-Fetal Medicine Units Network, Bethesda, MD
Affiliations
- PMID: 38729164
- DOI: 10.1055/s-0044-1786868
Objective: This study aimed to develop a prediction model that estimates the probability that a pregnant person who has had asymptomatic or mild coronavirus disease 2019 (COVID-19) prior to delivery admission will progress in severity to moderate, severe, or critical COVID-19.
Study design: This was a secondary analysis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive patients who delivered from March through December 2020 at hospitals across the United States. Those eligible for this analysis presented for delivery with a current or previous asymptomatic or mild SARS-CoV-2 infection. The primary outcome was moderate, severe, or critical COVID-19 during the delivery admission through 42 days postpartum. The prediction model was developed and internally validated using stratified cross-validation with stepwise backward elimination, incorporating only variables that were known on the day of hospital admission.
Results: Of the 2,818 patients included, 26 (0.9%; 95% confidence interval [CI], 0.6-1.3%) developed moderate-severe-critical COVID-19 during the study period. Variables in the prediction model were gestational age at delivery admission (adjusted odds ratio [aOR], 1.15; 95% CI, 1.08-1.22 per 1-week decrease), a hypertensive disorder in a prior pregnancy (aOR 3.05; 95% CI, 1.25-7.46), and systolic blood pressure at admission (aOR, 1.04; 95% CI, 1.02-1.05 per mm Hg increase). This model yielded an area under the receiver operating characteristic curve of 0.82 (95% CI, 0.72-0.91).
Conclusion: Among individuals presenting for delivery who had asymptomatic-mild COVID-19, gestational age at delivery admission, a hypertensive disorder in a prior pregnancy, and systolic blood pressure at admission were predictive of delivering with moderate, severe, or critical COVID-19. This prediction model may be a useful tool to optimize resources for SARS-CoV-2-infected pregnant individuals admitted for delivery.
Key points: · Three factors were associated with delivery with more severe COVID-19.. · The developed model yielded an area under the receiver operating characteristic curve of 0.82 and model fit was good.. · The model may be useful tool for SARS-CoV-2 infected pregnancies admitted for delivery..