Severe Acute Respiratory Syndrome Coronavirus 2 Infection and Pregnancy in Sub-Saharan Africa: A 6-Country Retrospective Cohort Analysis.

Autor:	Nachega, Jean B, Sam-Agudu, Nadia A, Machekano, Rhoderick N, Rosenthal, Philip J, Schell, Sonja, Waard, Liesl de, Bekker, Adrie, Gachuno, Onesmus W, Kinuthia, John, Mwongeli, Nancy, Budhram, Samantha, Vannevel, Valerie, Somapillay, Priya, Prozesky, Hans W, Taljaard, Jantjie, Parker, Arifa, Agyare, Elizabeth, Opoku, Akwasi Baafuor, Makarfi, Aminatu Umar, Abdullahi, Asara M
Předmět:	HEALTH policy REVERSE transcriptase polymerase chain reaction COVID-19 CONFIDENCE intervals COVID-19 vaccines RETROSPECTIVE studies REGRESSION analysis CHILDBEARING age PREGNANT women SEVERITY of illness index HOSPITAL mortality HOSPITAL care DESCRIPTIVE statistics OXYGEN therapy MEDICAL practice LONGITUDINAL method PROPORTIONAL hazards models PREGNANCY
Zdroj:	Clinical Infectious Diseases; Dec2022, Vol. 75 Issue 11, p1950-1961, 12p
Abstrakt:	Background Few data are available on COVID-19 outcomes among pregnant women in sub-Saharan Africa (SSA), where high-risk comorbidities are prevalent. We investigated the impact of pregnancy on SARS-CoV-2 infection and of SARS-CoV-2 infection on pregnancy to generate evidence for health policy and clinical practice. Methods We conducted a 6-country retrospective cohort study among hospitalized women of childbearing age between 1 March 2020 and 31 March 2021. Exposures were (1) pregnancy and (2) a positive SARS-CoV-2 RT-PCR test. The primary outcome for both analyses was intensive care unit (ICU) admission. Secondary outcomes included supplemental oxygen requirement, mechanical ventilation, adverse birth outcomes, and in-hospital mortality. We used log-binomial regression to estimate the effect between pregnancy and SARS-CoV-2 infection. Factors associated with mortality were evaluated using competing-risk proportional subdistribution hazards models. Results Our analyses included 1315 hospitalized women: 510 pregnant women with SARS-CoV-2, 403 nonpregnant women with SARS-CoV-2, and 402 pregnant women without SARS-CoV-2 infection. Among women with SARS-CoV-2 infection, pregnancy was associated with increased risk for ICU admission (adjusted risk ratio [aRR]: 2.38; 95% CI: 1.42–4.01), oxygen supplementation (aRR: 1.86; 95% CI: 1.44–2.42), and hazard of in-hospital death (adjusted sub-hazard ratio [aSHR]: 2.00; 95% CI: 1.08–3.70). Among pregnant women, SARS-CoV-2 infection increased the risk of ICU admission (aRR: 2.0; 95% CI: 1.20–3.35), oxygen supplementation (aRR: 1.57; 95% CI: 1.17–2.11), and hazard of in-hospital death (aSHR: 5.03; 95% CI: 1.79–14.13). Conclusions Among hospitalized women in SSA, both SARS-CoV-2 infection and pregnancy independently increased risks of ICU admission, oxygen supplementation, and death. These data support international recommendations to prioritize COVID-19 vaccination among pregnant women. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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