• Oscar Martinez-Perez, Pilar Prats Rodriguez, Marta Muner Hernandez, Maria Begoña Encinas Pardilla, Noelia Perez Perez, Maria Rosa Vila Hernandez, Ana Villalba Yarza, Olga Nieto Velasco, Pablo Guillermo Del Barrio Fernandez, Laura Forcen Acebal, Carmen Maria Orizales Lago, Alicia Martinez Varea, Begoña Muñoz Abellana, Maria Suarez Arana, Laura Fuentes Ricoy, Clara Martinez Diago, Maria Jesus Janeiro Freire, Macarena Alférez Alvarez-Mallo, Cristina Casanova Pedraz, Onofre Alomar Mateu, Cristina Lesmes Heredia, Juan Carlos Wizner de Alva, Rut Bernardo Vega, Montserrat Macia Badia, Cristina Alvarez Colomo, Antonio Sanchez Muñoz, Laia Pratcorona Alicart, Ruben Alonso Saiz, Monica Lopez Rodriguez, Maria Del Carmen Barbancho Lopez, Marta Ruth Meca Casbas, Oscar Vaquerizo Ruiz, Eva Moran Antolin, Maria Jose Nuñez Valera, Camino Fernandez Fernandez, Albert Tubau Navarra, Alejandra Maria Cano Garcia, Carmen Baena Luque, Susana Soldevilla Perez, Irene Gastaca Abasolo, Jose Adanez Garcia, Maria Teulon Gonzalez, Alberto Puertas Prieto, Rosa Ostos Serna, Maria Del Pilar Guadix Martin, Monica Catalina Coello, Elena Ferriols Perez, Africa Caño Aguilar, Maria Luisa De la Cruz Conty, Jose Antonio Sainz Bueno, and Spanish Obstetric Emergency Group.
• Department Gynaecology and Obstetrics, Puerta de Hierro University Hospital of Majadahonda, Majadahonda, Madrid, Spain. Oscarmartinezgine@gmail.com.
• Bmc Pregnancy Childb. 2021 Apr 1; 21 (1): 273.

BackgroundTo 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.MethodsWe 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 MeasuresPreterm delivery (primary), premature rupture of membranes and neonatal intensive care unit admissions.ResultsAmong 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.ConclusionThis 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.

43 keywords...

hide…