Pregnant women may be at higher risk of severe complications associated with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which may lead to obstetrical complications. We performed a case control study comparing pregnant women with severe coronavirus disease 19 (cases) to pregnant women with a milder form (controls) enrolled in the COVI-Preg international registry cohort between March 24 and July 26, 2020. Risk factors for severity, obstetrical and immediate neonatal outcomes were assessed. A total of 926 pregnant women with a positive test for SARS-CoV-2 were included, among which 92 (9.9%) presented with severe COVID-19 disease. Risk factors for severe maternal outcomes were pulmonary comorbidities [aOR 4.3, 95% CI 1.9–9.5], hypertensive disorders [aOR 2.7, 95% CI 1.0–7.0] and diabetes [aOR2.2, 95% CI 1.1–4.5]. Pregnant women with severe maternal outcomes were at higher risk of caesarean section [70.7% (n = 53/75)], preterm delivery [62.7% (n = 32/51)] and newborns requiring admission to the neonatal intensive care unit [41.3% (n = 31/75)]. In this study, several risk factors for developing severe complications of SARS-CoV-2 infection among pregnant women were identified including pulmonary comorbidities, hypertensive disorders and diabetes. Obstetrical and neonatal outcomes appear to be influenced by the severity of maternal disease.
Pregnant women who are infected with SARS-CoV-2 are at an increased risk of adverse perinatal outcomes. With this study, we aimed to better understand the relationship between maternal infection and perinatal outcomes, especially preterm births, and the underlying medical and interventionist factors. This was a prospective observational study carried out in 78 centers (Spanish Obstetric Emergency Group) with a cohort of 1347 SARS-CoV-2 PCR-positive pregnant women registered consecutively between 26 February and 5 November 2020, and a concurrent sample of PCR-negative mothers. The patients’ information was collected from their medical records, and the association of SARS-CoV-2 and perinatal outcomes was evaluated by univariable and multivariate analyses. The data from 1347 SARS-CoV-2-positive pregnancies were compared with those from 1607 SARS-CoV-2-negative pregnancies. Differences were observed between both groups in premature rupture of membranes (15.5% vs. 11.1%, p < 0.001); venous thrombotic events (1.5% vs. 0.2%, p < 0.001); and severe pre-eclampsia incidence (40.6 vs. 15.6%, p = 0.001), which could have been overestimated in the infected cohort due to the shared analytical signs between this hypertensive disorder and COVID-19. In addition, more preterm deliveries were observed in infected patients (11.1% vs. 5.8%, p < 0.001) mainly due to an increase in iatrogenic preterm births. The prematurity in SARS-CoV-2-affected pregnancies results from a predisposition to end the pregnancy because of maternal disease (pneumonia and pre-eclampsia, with or without COVID-19 symptoms).
Objective To evaluate the influence of ABO and Rh blood groups on morbidity among SARS-CoV-2 infected pregnancies. Design Prospective observational study. Setting 78 centers of the Spanish Obstetric Emergency Group. Population Pregnant women with SARS-CoV-2 tested with polymerase-chain-reaction between 26-February and 5-November, 2020. A cohort of 1,278 SARS-CoV-2(+) pregnant women was analyzed and a concurrent comparison group of 1,453 SARS-COV-2(-) patients was established. Methods Data were collected from medical charts. SARS-COV-2(+) was compared with SARS-COV-2(-) for differences in distribution of blood groups. We performed multivariate analysis, controlling for maternal age and ethnicity, to evaluate association of ABO and Rh blood groups with maternal and perinatal outcomes in SARS-CoV-2(+) patients with adjusted odds ratios (aOR) and 95% confidence intervals (CI). Main outcomes measures Medical morbidity: Symptomatic COVID-19 and medical complications. Obstetric outcomes: caesarean delivery, preterm deliveries, preterm premature rupture of membranes (PPROM), hemorrhagic events, pre-eclampsia, maternal and neonatal mortality, stillbirth. Results Differences were noted between blood types and Rh for age and ethnicity comparing SARS-CoV-2(+) and SARS-CoV-2(-) groups (p<0.05). Among the SARS-CoV-2(+) cohort, the odds of symptomatic COVID-19 and obstetric hemorrhagic event were higher in Rh+ vs Rh- mothers (aOR 1.48, 95% CI 1.02-2.14, p=0.037, and aOR 8.72, 95% CI 1.20-63.57, p=0.033, respectively), and PPROM were higher among blood type A vs non-A mothers (aOR 2.06, 95% CI 1.01-4.18, p=0.046). Conclusions In SARS-CoV-2(+) pregnant women, Rh- status was associated with a lower risk of symptomatic COVID-19, while Rh+ and blood group A were associated with obstetric hemorrhage and PPROM, respectively. TWEETABLE ABSTRACT Among pregnant women with SARS-CoV-2, blood group A and Rh+ are associated with medical and obstetric morbidity.
Introduction. The study of placental lipid metabolism in uncomplicated pregnancies has not been 2 developed in the literature to date. Its importance lies in expanding the knowledge of placental function to 3 enable comparison with pathological pregnancies in future research. The aim of the present study was to 4 compare the lipid metabolic activity and storage of the maternal and fetal sides of the placenta in healthy 5 pregnancies. Moreover, we compare singleton vs. twin pregnancies to determine if placental metabolic 6 needs differ. 7Material and Methods. We analyzed placental explants from uncomplicated pregnancies, 20 from 8 singleton and 8 from bichorial-biamniotic twin pregnancies (n=28). Six cotyledon fragments were 9 collected from each placenta at different distances from the umbilical cord, three close to the chorionic 10 plate (hereinafter we will refer to them as "fetal side") and another three close to the anchoring villi into 11 the decidua basalis (referred to as "maternal side"). The samples were analyzed for quantitative assay 12 placental fatty acid oxidation (FAO) and esterification (FAE) activities and triglyceride levels. The 13 location of lipid storage in the chorionic villi was assessed by Oil red-O staining. 14Results. Placental fatty acid oxidation did not show differences when comparing the maternal and fetal 15 sides of the placenta or between single and twin pregnancies. When comparing placental sides, FAE was 16 increased two-fold in the maternal side compared to the fetal side of the placenta (P = 0.013). The 17 tendency for lipogenesis in the placenta was exemplified by the FAE/FAO ratio, which was a 37.1% 18 higher on the maternal side (P = 0.019). Despite this, triglyceride levels were five times higher in the fetal 19 side than in the maternal one (P = 0.024). When analyzing singleton vs. twins, FAE was superior in the 20 fetal side in multiple pregnancies (×2.6, P = 0.007) and the FAE/FAO ratio was significantly higher in 21 twins than in singleton pregnancies, on both sides of the placenta. Despite this finding, triglyceride levels 22 were similar in twin and singleton pregnancies. Comparing the placentas of twins in the same pregnancy, 23 there were no differences in lipid metabolism (FAO or FAE) or placental triglyceride levels between the 24 two co-twins. Using Oil red-O staining, lipid storage in chorionic villi was found to be located on the 25 syncytiotrophoblast cells and not in the connecting axis. 26Conclusion. The maternal side of the placenta is more active in the esterification of fatty acids, while the 27 storage of neutral lipids concentrates on the fetal side. Moreover, multiple gestations have increased 28 esterification without changes in the concentration of placental triglycerides, probably due to a higher 29 transfer to the fetal circulation in response to the greater energy demand from twin fetuses. 30
Objective To evaluate the perinatal and maternal outcomes of pregnancies in SARS-CoV-2 infected women, comparing spontaneous and In Vitro Fertilization (IVF) pregnancies (with either own or donor oocytes). Design Multicentre, prospective, observational study. Setting 78 centres participating in the Spanish COVID19 Registry. Patients 1,347 SARS-CoV-2 positive pregnant women registered consecutively between February 26 th and November 5 th , 2020. Interventions Patient´s information was collected from their medical records, and multivariable regression analyses were performed, controlling for maternal age and the clinical presentation of infection. Main outcome measures Obstetrics and neonatal outcomes, pregnancy comorbidities, intensive care unit admission, mechanical ventilation need and medical conditions. Results The IVF group was composed of 74 (5.5%) women whereas the spontaneous group included 1,275 (94.5%) women. Operative delivery rate was high in all patients, especially in the IVF group, where C-section became the most frequent method of delivery (55.4%, compared to 26.1% of spontaneous). The reason for C-section was induction failure in 56.1% of IVF patients. IVF women had more gestational hypertensive disorders [16.2% vs 4.5% among spontaneous, adjusted Odds Ratio (aOR) 5.31, 95% Confidence Interval (CI) 2.45-10.93) irrespective of oocyte origin. The higher rate of ICU admittance observed in the IVF group (8.1% vs 2.4% spontaneous) was attributed to pre-eclampsia (aOR 11.82, 95% CI 5.25-25.87), not to the type of conception, Conclusions High rate of operative delivery has been observed in SARS-CoV-2 infected women, especially in IVF pregnancies; method of conception does not affect foetal or maternal outcomes, except for pre-eclampsia.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.