COVID-19 is associated with early emergence of preeclampsia: results from a large regional collaborative.

Autor: Hasbini YG; Office of Women's Health, Wayne State University, Detroit, MI, USA., Sokol RJ; Department of Obstetrics and Gynecology and Department of Physiology, Wayne State University School of Medicine, Detroit, MI, USA.; Department of of Epidemiology and Biostatistics, Michigan State University College of Human Medicine, East Lansing, MI, USA., Green PM; Department of Obstetrics and Gynecology, St. Joseph Mercy Health System, Ann Arbor, MI, USA., Tarca AL; Department of Obstetrics and Gynecology and Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, MI, USA.; Department of Computer Science, Wayne State University, College of Engineering, Dearborn, MI, USA., Goyert G; Department of Obstetrics and Gynecology, Henry Ford Health System, Detroit, MI, USA., Ouweini HME; Office of Women's Health, Wayne State University, Detroit, MI, USA., Keerthy M; Department of Obstetrics and Gynecology, Henry Ford Health System, Detroit, MI, USA., Jones T; Department of Obstetrics and Gynecology, Corewell Health Dearborn, Dearborn, MI, USA., Thiel L; Department of Obstetrics and Gynecology, Corewell Heath West - Michigan State University, MI, USA., Youssef Y; Department of Obstetrics and Gynecology, Hurley Medical Center, Flint, MI, USA., Townsel C; University of Maryland, Department of Obstetrics, Gynecology and Reproductive Sciences, Baltimore, MD, USA., Vengalil S; Department of Obstetrics and Gynecology, Ascension St John Hospital, Detroit, USA., Paladino P; Department of Obstetrics and Gynecology, Ascension Macomb-Oakland Hospital Detroit, MI, USA., Wright A; Department of Obstetrics and Gynecology, St. Joseph Mercy Oakland, Trinity Health, MI, USA., Ayyash M; Department of Obstetrics and Gynecology, Henry Ford Health System, Detroit, MI, USA., Vadlamudi G; Department of Obstetrics and Gynecology, Henry Ford Health System, Detroit, MI, USA., Szymanska M; Department of Obstetrics and Gynecology, Corewell Health William Beaumont University Hospital, MI, USA., Sajja S; Department of Obstetrics and Gynecology, Corewell Health William Beaumont University Hospital, MI, USA., Crane G; Department of Obstetrics and Gynecology, Corewell Heath West - Michigan State University, MI, USA., Baracy M Jr; Department of Obstetrics and Gynecology, Ascension St John Hospital, Detroit, USA., Grace K; Department of Obstetrics and Gynecology, Ascension Macomb-Oakland Hospital Detroit, MI, USA., Houston K; University of Maryland, Department of Obstetrics, Gynecology and Reproductive Sciences, Baltimore, MD, USA., Norman J; Department of Obstetrics and Gynecology, St. Joseph Mercy Oakland, Trinity Health, MI, USA., Girdler K; Office of Women's Health, Wayne State University, Detroit, MI, USA., Gudicha DW; Department of Obstetrics and Gynecology, St. Joseph Mercy Health System, Ann Arbor, MI, USA., Bahado-Singh R; Department of Obstetrics and Gynecology, Corewell Health William Beaumont University Hospital, MI, USA., Hassan SS; Office of Women's Health, Wayne State University, Detroit, MI, USA.; Department of Obstetrics and Gynecology and Department of Physiology, Wayne State University School of Medicine, Detroit, MI, USA.
Jazyk: angličtina
Zdroj: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians [J Matern Fetal Neonatal Med] 2024 Dec; Vol. 37 (1), pp. 2345852. Date of Electronic Publication: 2024 May 26.
DOI: 10.1080/14767058.2024.2345852
Abstrakt: Objective: To investigate the relationship between preeclampsia and SARS-CoV-2 infection during pregnancy. Methods: This was a retrospective cohort study of pregnant women between March and October 2020. Pregnant patients admitted to 14 obstetrical centers in Michigan, USA formed the study population. Of the N  = 1458 participants, 369 had SARS-CoV-2 infection (cases). Controls were uninfected pregnancies that were delivered in the same obstetric unit within 30 days of the index case. Robust Poisson regression was used to estimate relative risk (RR) of preterm and term preeclampsia and preeclampsia involving placental lesions. The analysis included adjustment for relevant clinical and demographic risk factors. Results : SARS-CoV-2 infection during pregnancy increased the risk of preeclampsia [adjusted aRR = 1.69 (1.26-2.26)], preeclampsia involving placental lesions [aRR = 1.97(1.14-3.4)] and preterm preeclampsia 2.48(1.48-4.17). Although the highest rate of preeclampsia was observed in patients infected with SARS-CoV-2 who were symptomatic (18.4%), there was increased risk even in asymptomatic SARS-CoV-2 infected patients (14.2%) relative to non-infected controls (8.7%) ( p  < 0.05). This association with symptomatology was also noted with preterm preeclampsia for which the rate doubled from 2.7% in controls to 5.2% in asymptomatic cases and reached 11.8% among symptomatic cases ( p  < 0.05). The rate of preterm preeclampsia among cases of pregnant people self-identified as Black reached 10.1% and was almost double the rate of the reminder of the group of infected pregnancies (5.3%), although the rate among uninfected was almost the same (2.7%) for both Black and non-Black groups (interaction p  = 0.05). Conclusions: Infection with SARS-CoV-2 increases the risk of preeclampsia even in the absence of symptoms, although symptomatic persons are at even higher risk. Racial disparities in the development of preterm preeclampsia after SARS-CoV-2 infection may explain discrepancies in prematurity between different populations.
Databáze: MEDLINE