The association between SARS-CoV-2 infection and preterm delivery: a prospective study with a multivariable analysis

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 b...

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Detalles Bibliográficos
Autores principales: Martinez-Perez, Oscar, Prats Rodriguez, Pilar, Muner Hernandez, Marta, Encinas Pardilla, Maria Begoña, Perez Perez, Noelia, Vila Hernandez, Maria Rosa, Villalba Yarza, Ana, Nieto Velasco, Olga, Del Barrio Fernandez, Pablo Guillermo, Forcen Acebal, Laura, Orizales Lago, Carmen Maria, Martinez Varea, Alicia, Muñoz Abellana, Begoña, Suarez Arana, Maria, Fuentes Ricoy, Laura, Martinez Diago, Clara, Janeiro Freire, Maria Jesus, Alférez Alvarez-Mallo, Macarena, Casanova Pedraz, Cristina, Alomar Mateu, Onofre, Lesmes Heredia, Cristina, Wizner de Alva, Juan Carlos, Bernardo Vega, Rut, Macia Badia, Montserrat, Alvarez Colomo, Cristina, Sanchez Muñoz, Antonio, Pratcorona Alicart, Laia, Alonso Saiz, Ruben, Lopez Rodriguez, Monica, del Carmen Barbancho Lopez, Maria, Meca Casbas, Marta Ruth, Vaquerizo Ruiz, Oscar, Moran Antolin, Eva, Nuñez Valera, Maria Jose, Fernandez Fernandez, Camino, Tubau Navarra, Albert, Cano Garcia, Alejandra Maria, Baena Luque, Carmen, Soldevilla Perez, Susana, Gastaca Abasolo, Irene, Adanez Garcia, Jose, Teulon Gonzalez, Maria, Puertas Prieto, Alberto, Ostos Serna, Rosa, del Pilar Guadix Martin, Maria, Catalina Coello, Monica, Ferriols Perez, Elena, Caño Aguilar, Africa, De la Cruz Conty, Maria Luisa, Sainz Bueno, Jose Antonio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Research Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8016158/
https://www.ncbi.nlm.nih.gov/pubmed/33794829
http://dx.doi.org/10.1186/s12884-021-03742-4
Descripción
Sumario: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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12884-021-03742-4.

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