Association between SARS-CoV-2 Infection and Adverse Perinatal Outcomes in a Large Health Maintenance Organization.

Autor:	Getahun D; Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California.; Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California., Peltier MR; Department of Psychiatry, Jersey Shore University Medical Center, Neptune, New Jersey., Lurvey LD; Department of Obstetrics and Gynecology, Southern California Permanente Medical Group, Pasadena, California., Shi JM; Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California., Braun D; Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California.; Department of Obstetrics and Gynecology, Southern California Permanente Medical Group, Pasadena, California., Sacks DA; Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California.; Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California., Burgos AE; Department of Pediatrics, Kaiser Permanente Downey Medical Center, Downey, California.; Department of Clinical Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California., Fong A; Department of Obstetrics and Gynecology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California., Trivedi N; Department of Obstetrics and Gynecology, Kaiser Permanente San Diego Medical Center, San Diego, California., Yasumura L; Department of Obstetrics and Gynecology, Kaiser Permanente Baldwin Park Medical Center, Baldwin Park, California., Reynolds K; Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California.; Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California., Nguyen M; Department of Neonatal Medicine, Kaiser Permanente Orange County Medical Center, Anaheim, California., Volodarskiy M; Kaiser Foundation Hospitals, Pasadena, California., Chiu VY; Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California., Lopez AH; Department of Obstetrics and Gynecology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California., Fassett MJ; Department of Obstetrics and Gynecology, Kaiser Permanente West Los Angeles Medical Center, Los Angeles, California.
Jazyk:	angličtina
Zdroj:	American journal of perinatology [Am J Perinatol] 2024 Jan; Vol. 41 (2), pp. 199-207. Date of Electronic Publication: 2022 Jun 23.
DOI:	10.1055/s-0042-1749666
Abstrakt:	Objective: This study aimed to examine whether severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection during pregnancy is associated with increased odds of perinatal complications and viral transmission to the infant. Study Design: A retrospective cohort study of women who delivered at Kaiser Permanente Southern California hospitals (April 6, 2020-February 28, 2021) was performed using data extracted from electronic health records (EHRs). During this time polymerize chain reaction (PCR)-based tests for SARS-CoV-2 was universally offered to all pregnant women at labor and delivery admission, as well as earlier in the pregnancy, if they were displaying symptoms consistent with SARS-CoV-2 infection or a possible exposure to the virus. Adjusted odds ratio (aOR) was used to estimate the strength of associations between positive test results and adverse perinatal outcomes. Results: Of 35,123 women with a singleton pregnancy, 2,203 (6%) tested positive for SARS-CoV-2 infection with 596 (27%) testing positive during the first or second trimester and 1,607 (73%) during the third trimester. Women testing positive were younger than those who tested negative (29.7 [5.4] vs. 31.1 [5.3] years; mean [standard deviation (SD)]; p  < .001). The SARS-CoV-2 infection tended to increase the odds of an abnormal fetal heart rate pattern (aOR: 1.10; 95% confidence interval [CI]: 1.00, 1.21; p  = 0.058), spontaneous preterm birth (aOR: 1.28; 95% CI: 1.03, 1.58; p  = 0.024), congenital anomalies (aOR: 1.69; 95% CI: 1.15, 2.50; p  = 0.008), and maternal intensive care unit admission at delivery (aOR: 7.44; 95% CI: 4.06, 13.62; p  < 0.001) but not preeclampsia/eclampsia (aOR: 1.14; 95% CI: 0.98, 1.33; p  = 0.080). Eighteen (0.8%) neonates of mothers who tested positive also had a positive SARS-CoV-2 test after 24 hours of birth, but all were asymptomatic during the neonatal period. Conclusion: These findings suggest that prenatal SARS-CoV-2 infection increases the odds of some adverse perinatal outcomes. The likelihood of vertical transmission from the mother to the fetus was low (0.3%), suggesting that pregnancy complications resulting from SARS-CoV-2 infection pose more risk to the baby than transplacental viral transmission. Key Points: · SARS-CoV-2 infection is associated with increased odds of adverse perinatal outcomes.. · The odds of specific adverse outcomes were greater when a mother was infected earlier in pregnancy.. · The proportion of vertical transmission from mother to fetus was 0.3%. Competing Interests: None declared. (Thieme. All rights reserved.)
Databáze:	MEDLINE
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