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

Autor: Martinez-Perez O; Department Gynaecology and Obstetrics, Puerta de Hierro University Hospital of Majadahonda, Majadahonda, Madrid, Spain. Oscarmartinezgine@gmail.com., Prats Rodriguez P; Department Reproductive Medicine and Gynaecology, Obstetrics, Dexeus University Hospital, Barcelona, Catalunya, Spain., Muner Hernandez M; Department Gynaecology and Obstetrics, La Paz University Hospital. Madrid, Madrid, Spain., Encinas Pardilla MB; Department Gynaecology and Obstetrics, Puerta de Hierro University Hospital of Majadahonda, Majadahonda, Madrid, Spain., Perez Perez N; Department Gynaecology and Obstetrics, San Carlos University Hospital. Madrid, Madrid, Spain., Vila Hernandez MR; Department Gynaecology and Obstetrics, Santa Caterina Hospital, Girona, Catalunya, Spain., Villalba Yarza A; Department Gynaecology and Obstetrics, University Hospital of Salamanca, Salamanca, Castilla y León, Spain., Nieto Velasco O; Department Obstetrics and Gynaecology, Quironsalud Madrid University Hospital. Madrid, Madrid, Spain., Del Barrio Fernandez PG; Department Gynaecology and Obstetrics, Getafe University Hospital, Getafe, Madrid, Spain., Forcen Acebal L; Department Gynaecology and Obstetrics, Doce de Octubre University Hospital, Comunidad de Madrid, Madrid, Spain., Orizales Lago CM; Department Gynaecology and Obstetrics, Severo Ochoa University Hospital, Leganes, Madrid, Spain., Martinez Varea A; Department Gynaecology and Obstetrics, La Fe University and Polytechnic Hospital, Comunidad Valenciana, Valencia, Spain., Muñoz Abellana B; Department Obstetrics and Gynaecology, Sant Joan de Reus University Hospital, Reus, Catalunya, Spain., Suarez Arana M; Department Gynaecology and Obstetrics, Regional University Hospital of Malaga, Malaga, Andalucía, Spain., Fuentes Ricoy L; Department Obstetrics and Gynaecology, University Hospital of Ferrol, Ferrol, A Coruña, Spain., Martinez Diago C; Department Gynaecology and Obstetrics, Doctor Josep Trueta University Hospital of Girona, Girona, Catalunya, Spain., Janeiro Freire MJ; Department Obstetrics and Gynaecology, University Hospital Complex of A Coruña, A Coruña, Spain., Alférez Alvarez-Mallo M; Department Obstetrics and Gynaecology, HM Hospitals, Madrid, Spain., Casanova Pedraz C; Department Gynaecology and Obstetrics, University Hospital of Torrejon, Torrejon de Ardoz, Madrid, Spain., Alomar Mateu O; Department Obstetrics and Gynaecology, Regional Hospital of Inca, Inca, Illes Balears, Spain., Lesmes Heredia C; Department Obstetrics and Gynaecology, Parc Taulí Hospital, Barcelona, Catalunya, Spain., Wizner de Alva JC; Department Gynaecology and Obstetrics, San Pedro de Alcántara Hospital, Caceres, Extremadura, Spain., Bernardo Vega R; Department Gynaecology and Obstetrics, Rio Hortega University Hospital, Valladolid, Castilla y León, Spain., Macia Badia M; Department Gynaecology and Obstetrics, Arnau de Vilanova University Hospital, Lleida, Catalunya, Spain., Alvarez Colomo C; Department Gynaecology and Obstetrics, Valladolid University Hospital, Valladolid, Castilla y León, Spain., Sanchez Muñoz A; Department Gynaecology and Obstetrics, General University Hospital of Ciudad Real, Ciudad Real, Castilla-La Mancha, Spain., Pratcorona Alicart L; Department Obstetrics and Gynaecology, Germans Trias i Pujol University Hospital, Barcelona, Catalunya, Spain., Alonso Saiz R; Department Gynaecology and Obstetrics, University Hospital of Burgos, Burgos, Castilla y León, Spain., Lopez Rodriguez M; Department Obstetrics and Gynaecology, Joan XXIII University Hospital of Tarragona, Tarragona, Catalunya, Spain., Del Carmen Barbancho Lopez M; Department Gynaecology and Obstetrics, Infanta Sofia University Hospital, San Sebastian de los Reyes, Madrid, Spain., Meca Casbas MR; Department Obstetrics and Gynaecology, Poniente Hospital of Almería, El Ejido, Andalucía, Spain., Vaquerizo Ruiz O; Department Obstetrics and Gynaecology, University Hospital of Cabueñes, Gijon, Asturias, Spain., Moran Antolin E; Department Obstetrics and Gynaecology, Son Espases University Hospital, Palma de Mallorca, Illes Balears, Spain., Nuñez Valera MJ; Department Obstetrics and Gynaecology, Virgen de la Luz Hospital, Cuenca, Castilla-La Mancha, Spain., Fernandez Fernandez C; Department Gynaecology and Obstetrics, University Assistance Complex of Leon, Leon, Castilla y Leon, Spain., Tubau Navarra A; Department Obstetrics and Gynaecology, Son Llatzer University Hospital, Palma de Mallorca, Illes Balears, Spain., Cano Garcia AM; Department Gynaecology and Obstetrics, University Hospital of El Tajo, Aranjuez, Madrid, Spain., Baena Luque C; Department Gynaecology and Obstetrics, Infanta Margarita Hospital, Andalucía, Cabra, Spain., Soldevilla Perez S; Department Obstetrics and Gynaecology, University Hospital of Jerez de la Frontera, Jerez de la Frontera, Andalucía, Spain., Gastaca Abasolo I; Department Obstetrics and Gynaecology, Txagorritxu University Hospital of Araba, Vitoria-Gasteiz, País Vasco, Spain., Adanez Garcia J; Department Obstetrics and Gynaecology, Central University Hospital of Asturias, Oviedo, Asturias, Spain., Teulon Gonzalez M; Department Gynaecology and Obstetrics, University Hospital of Fuenlabrada, Fuenlabrada, Madrid, Spain., Puertas Prieto A; Department Obstetrics and Gynaecology, Virgen de las Nieves University Hospital, Granada, Andalucía, Spain., Ostos Serna R; Department Gynaecology and Obstetrics, Virgen de Valme University Hospital, Sevilla, Andalucía, Spain., Del Pilar Guadix Martin M; Department Obstetrics and Gynaecology, Virgen Macarena University Hospital, Sevilla, Andalucía, Spain., Catalina Coello M; Department Gynaecology and Obstetrics, Virgen de la Concha Hospital, Zamora, Castilla y León, Spain., Ferriols Perez E; Department Gynaecology and Obstetrics, Parc de Salut Mar University Hospital, Barcelona, Catalunya, Spain., Caño Aguilar A; Department Obstetrics and Gynaecology, San Cecilio University Hospital of Granada, Granada, Andalucía, Spain., De la Cruz Conty ML; Fundación de Investigación Biomédica, Puerta de Hierro University Hospital of Majadahonda, Majadahonda, Madrid, Spain., Sainz Bueno JA; Department Gynaecology and Obstetrics, University of Seville, G. Chacon (Viamed Santa Angela de la Cruz Hospital), Sevilla, Andalucia, Spain.
Jazyk: angličtina
Zdroj: BMC pregnancy and childbirth [BMC Pregnancy Childbirth] 2021 Apr 01; Vol. 21 (1), pp. 273. Date of Electronic Publication: 2021 Apr 01.
DOI: 10.1186/s12884-021-03742-4
Abstrakt: 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.
Databáze: MEDLINE
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