Subject: coronavirus
Subject: coronavirus disease 2019
Subject: infection
Subject: pregnancy
Subject: severe acute respiratory syndrome coronavirus 2
Year: 2021
Type: Article
Title: Maternal and perinatal outcomes in high compared to low risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection (phase 2): the World Association of Perinatal Medicine working group on coronavirus disease 2019
Author: D'Antonio, Francesco
Author: Sen, Cihat
Author: Mascio, Daniele Di
Author: Galindo, Alberto
Author: Villalain, Cecilia
Author: Herraiz, Ignacio
Author: Arisoy, Resul
Author: Ovayolu, Ali
Author: Eroğlu, Hasan
Author: Canales, Manuel Guerra
Author: Ladella, Subhashini
Author: Cojocaru, Liviu
Author: Turan, Ozhan
Author: Turan, Sifa
Author: Hadar, Eran
Author: Brzezinski-Sinai, Noa A.
Author: Dollinger, Sarah
Author: Uyaniklar, Ozlem
Author: Ocakouglu, Sakine Rahimli
Author: Atak, Zeliha
Author: Premru-Srsen, Tanja
Author: Kornhauser-Cerar, Lilijana
Author: Druškovič, Mirjam
Author: Ples, Liana
Author: Gündüz, Reyhan
Author: Ağaçayak, Elif
Author: Schvartzman, Javier Alfonso
Author: Malbran, Mercedes Negri
Author: Liberati, Marco
Author: Sebastiano, Francesca Di
Author: Oronzi, Ludovica
Author: Cerra, Chiara
Author: Buca, Danilo
Author: Cagnacci, Angelo
Author: Ramone, Arianna
Author: Barra, Fabio
Author: Carosso, Andrea
Author: Benedetto, Chiara
Author: Cosma, Stefano
Author: Pintiaux, Axelle
Author: Daelemans, Caroline
Author: Costa, Elena
Author: Özel, Ayşegül
Author: Muhçu, Murat
Author: Lopez, Jesús S Jimenez
Author: Alvarado, Clara
Author: Piqueras, Anna Luengo
Author: Oliva, Dolores Esteban
Author: Schera, Giovanni Battista Luca
Author: Volpe, Nicola
Author: Frusca, Tiziana
Author: Samardjiski, Igor
Author: Simeonova Krstevska, Slagjana
Author: Aleksioska Papestiev, Irena
Author: Hojman, Javier
Author: Turkcuoglu, Ilgin
Author: Cromi, Antonella
Author: Laganà, Antonio Simone
Author: Ghezzi, Fabio
Author: Sirico, Angelo
Author: Familiari, Alessandra
Author: Scambia, Giovanni
Author: Sukhikh, Zulfiya Khodjaeva Gennady T.
Author: Gorina, Ksenia A.
Author: de Sa, Renato Augusto Moreira
Author: Vaz, Mariana
Author: Feuerschuette, Otto Henrique May
Author: Gatta, Anna Nunzia Della
Author: Youssef, Aly
Author: Donna, Gaetana Di
Author: Martinez-Varea, Alicia
Author: Loscalzo, Gabriela
Author: Morales Roselló, José
Author: Stefanovic, Vedran
Author: Nupponen, Irmeli
Author: Nelskylä, Kaisa
Author: Ayala, Rodrigo
Author: Molpeceres, Rebeca Garrote
Author: Vázquez, Asunción Pino
Author: Sandri, Fabrizio
Author: Cataneo, Ilaria
Author: Lenzi, Marinella
Author: Haberal, Esra Tustas
Author: Huertas, Erasmo
Author: Sanchez, Amadeo
Author: Arango, Pedro
Author: Bermejo, Amanda
Author: Alcantara, María Monica Gonzalez
Author: Göynümer, Gökhan
Author: Okuyan, Erhan
Author: Madalina, Ciuhodaru
Author: Guisan, Ana Concheiro
Author: Schulte, Alejandra Martínez
Author: Esposito, Valentina
Author: De Robertis, Valentina
Author: Zdjelar, Snezana
Author: Lackovic, Milan
Author: Mihajlovic, Sladjana
Author: Jekova, Nelly
Author: Saccone, Gabriele
Author: Aslan, Mehmet Musa
Author: Dedda, Maria Carmela Di
Author: Chalid, Maisuri
Author: Canache, Jose Enrique Moros
Author: Daskalakis, George
Author: Antsaklis, Panos
Author: Vega, Enrique Criado
Author: Cueto, Elisa
Author: Taccaliti, Chiara
Author: Aykanat, Yeliz
Author: Özlem Genç, Şerife
Author: Froessler, Bernd
Author: Radulova, Petya Angelova
Author: Morano, Danila
Author: Bianchi, Beatrice
Author: Marino, Maria Giulia Lombana
Author: Meccariello, Gabriella
Author: Rohatgi, Bindu
Author: Schiattarella, Antonio
Author: Morlando, Maddalena
Author: Colacurci, Nicola
Author: Villasco, Andrea
Author: Biglia, Nicoletta
Author: Marques, Ana Luiza Santos
Author: Gatti, Alessandra
Author: Luvero, Daniela
Author: Angioli, Roberto
Author: Pittaro, Alejandro
Author: Lila, Albert
Author: Zlatohlávková, Blanka
Abstract: It has still to be ascertained whether severe acute respiratory syndrome coronavirus 2 infection in pregnancy is associated with worse maternal and fetal outcomes compared to low risk gestations. OBJECTIVE This study aimed to evaluate maternal and perinatal outcomes in high- and low-risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection. STUDY DESIGN This was a multinational retrospective cohort study involving women with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection from 76 centers from 25 countries in Europe, the United States, South America, Asia, and Australia from April 4, 2020, to October 28, 2020. The primary outcome was a composite measure of maternal mortality and morbidity, including admission to the intensive care unit, use of mechanical ventilation, or death. The secondary outcome was a composite measure of adverse perinatal outcome, including miscarriage, fetal loss, neonatal and perinatal death, and admission to the neonatal intensive care unit. All outcomes were assessed in high- and low-risk pregnancies. Pregnancies were considered high risk in case of either preexisting chronic medical conditions in pregnancy or obstetrical disorders occurring in pregnancy. The Fisher exact test and logistic regression analysis were used to analyze the data. RESULTS A total of 887 singleton pregnancies who tested positive for severe acute respiratory syndrome coronavirus 2 infection using reverse transcription-polymerase chain reaction of nasal and pharyngeal swab specimens were included in the study. The risk of composite adverse maternal outcomes was higher in high-risk pregnancies than in low-risk pregnancies (odds ratio, 1.52; 95% confidence interval, 1.03–2.24; P=.035). In addition, women carrying high-risk pregnancies were at higher risk of hospital admission (odds ratio, 1.48; 95% confidence interval, 1.07–2.04; P=.002), presence of severe respiratory symptoms (odds ratio, 2.13; 95% confidence interval, 0.41–3.21; P=.001), admission to the intensive care unit (odds ratio, 2.63; 95% confidence interval, 1.42–4.88), and invasive mechanical ventilation (odds ratio, 2.65; 95% confidence interval, 1.19–5.94; P=.002). When exploring perinatal outcomes, high-risk pregnancies were at high risk of adverse perinatal outcomes (odds ratio, 1.78; 95% confidence interval, 0.15–2.72; P=.009). However, such association was mainly because of the higher incidence of miscarriage in high-risk pregnancies compared with that in low-risk pregnancies (5.3% vs 1.6%, P=.008); furthermore, there was no difference in other explored outcomes between the 2 study groups. At logistic regression analysis, maternal age (odds ratio, 1.12; 95% confidence interval, 1.02–1.22; P=.023) and high-risk pregnancy (odds ratio, 4.21; 95% confidence interval, 3.90–5.11; P<.001) were independently associated with adverse maternal outcomes. CONCLUSION High-risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection were at higher risk of adverse maternal outcomes than low-risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection.
Publisher: Elsevier BV
Relation: American Journal of Obstetrics & Gynecology MFM
Identifier: oai:repository.ukim.mk:20.500.12188/28756
Identifier: http://hdl.handle.net/20.500.12188/28756Identifier: 10.1016/j.ajogmf.2021.100329
Identifier: https://api.elsevier.com/content/article/PII:S2589933321000240?httpAccept=text/xmlIdentifier: https://api.elsevier.com/content/article/PII:S2589933321000240?httpAccept=text/plainIdentifier: 3
Identifier: 4
Identifier: 100329
