Association Between Giving Birth During the Early Coronavirus Disease 2019 (COVID-19) Pandemic and Serious Maternal Morbidity

Metz, Torri D.; Clifton, Rebecca G.; Hughes, Brenna L.; Sandoval, Grecio; Grobman, William A.; Saade, George R.; Manuck, Tracy A.; Longo, Monica; Sowles, Amber; Clark, Kelly; Simhan, Hyagriv N.; Rouse, Dwight J.; Mendez‐Figueroa, Hector; Gyamfi-Bannerman, Cynthia; Bailit, Jennifer L.; Costantine, Maged M.; Sehdev, Harish M.; Tita, Alan; Macones, George A.

doi:10.1097/aog.0000000000004982

Cited by 5 publications

(4 citation statements)

References 17 publications

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“…1 [35.8-83.2] vs 60.2 [34.4-82.2]; aMD 1.50, 95% CI -0.28-3.29), ponderal index (2.6 g/cm 3 [2.4-2.8] in both groups; aMD 0.01, 95% CI 0.00,0.02), and small head circumference for livebirths [<10 th percentile (8.2 % vs 8.1%; aOR 1.03, 95% CI 0.89-1. 19), <3 rd percentile (3.5% vs 3.1%; aOR 1.16, 95% CI 0.93-1.44)] were similar between groups as well.…”

mentioning

confidence: 57%

“…Full details of the study were published previously. 18,19 Individuals in the cohort were divided into two groups: those who delivered prior to the pandemic (March-December 2019) and those who delivered during the pandemic (June-December 2020). Exposure to the pandemic was defined as being pregnant more than 3 months during the pandemic to ensure adequate exposure and time to affect daily habits.…”

Section: Methodsmentioning

confidence: 99%

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Gestational Weight Gain and Neonatal Biometry during the COVID-19 Pandemic: A Multicenter Observational Cohort

Abdelwahab,

Voest,

Metz

et al. 2024

Am J Perinatol

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Objective: To assess whether being pregnant and delivering during the COVID-19 pandemic was associated with changes in gestational weight gain (GWG) or frequency of small- (SGA) or large-for-gestational-age (LGA) neonates. Study Design: Secondary analysis of a multicenter observational cohort comparing pregnant people who delivered during the COVID-19 pandemic (June-December 2020) to people who delivered prior to the pandemic (March-December 2019). Those with multiple gestations, fetuses with major congenital anomalies, implausible GWG values, unavailable body mass index (BMI), or who were SARS-CoV-2 positive were excluded. The primary outcome was frequency of optimal recommended GWG based on pre-pregnancy BMI. Neonatal outcomes included birthweight, ponderal index, and frequency of SGA, LGA and small head circumference for livebirths. Multivariable regression analysis was used to assess associations between exposure to the pandemic and outcomes. Results: The 4,225 pregnant people exposed to the pandemic were older and more likely to have gestational diabetes compared with the 6,492 people who delivered prior to the COVID-19 pandemic. The frequency of appropriate GWG was 28.0% during the pandemic and 27.6% before the pandemic (aOR 1.02, 95% CI 0.93-1.11). Excessive GWG was more likely (aOR 1.08, 95% CI 1.001-1.17) and inadequate GWG was less likely during the pandemic (aOR 0.86, 95% CI 0.77-0.95). The frequency of SGA was 5.4% during the pandemic and 6.1% before the pandemic (aOR 0.90, 95% CI 0.76-1.06), and the frequency of LGA was 16.0% during the pandemic vs 15.0% before the pandemic (aOR 1.06, 95% CI 0.95-1.18). Other neonatal outcomes including birthweight percentile (62.1 vs 60.2), ponderal index (2.6 g/cm3 in both groups), and small head circumference for livebirths (8.2% vs 8.1%) were similar between groups as well. Conclusion: Being pregnant and delivering during the COVID-19 pandemic was associated with a higher likelihood of excessive GWG and a lower likelihood of inadequate GWG.

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mentioning

confidence: 57%

Section: Methodsmentioning

confidence: 99%

Gestational Weight Gain and Neonatal Biometry during the COVID-19 Pandemic: A Multicenter Observational Cohort

Abdelwahab,

Voest,

Metz

et al. 2024

Am J Perinatol

Self Cite

View full text Add to dashboard Cite

show abstract

“…A list of study sites can be obtained at https://recovercovid.org or in S1 Checklist . For participants recruited within the 26 individual hospital sites of the MFMU Network, recruitment occurs among individuals who were enrolled in the NICHD MFMU Gestational Research Assessments for COVID-19 (GRAVID) study [ 15 , 16 ], a previously established cohort of individuals with and without SARS-CoV-2 during pregnancy over the COVID-19 pandemic, and new prospective enrollments of individuals with and without SARS-CoV-2 in pregnancy to encompass all variants of SARS-CoV-2. Study procedures for participants recruited by NICHD MFMU Network sites will be completed through a combination of remote survey assessments and in-person study visits.…”

Section: Methodsmentioning

confidence: 99%

Researching COVID to enhance recovery (RECOVER) pregnancy study: Rationale, objectives and design

Metz,

Clifton,

Gallagher

et al. 2023

PLoS ONE

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Importance Pregnancy induces unique physiologic changes to the immune response and hormonal changes leading to plausible differences in the risk of developing post-acute sequelae of SARS-CoV-2 (PASC), or Long COVID. Exposure to SARS-CoV-2 during pregnancy may also have long-term ramifications for exposed offspring, and it is critical to evaluate the health outcomes of exposed children. The National Institutes of Health (NIH) Researching COVID to Enhance Recovery (RECOVER) Multi-site Observational Study of PASC aims to evaluate the long-term sequelae of SARS-CoV-2 infection in various populations. RECOVER-Pregnancy was designed specifically to address long-term outcomes in maternal-child dyads. Methods RECOVER-Pregnancy cohort is a combined prospective and retrospective cohort that proposes to enroll 2,300 individuals with a pregnancy during the COVID-19 pandemic and their offspring exposed and unexposed in utero, including single and multiple gestations. Enrollment will occur both in person at 27 sites through the Eunice Kennedy Shriver National Institutes of Health Maternal-Fetal Medicine Units Network and remotely through national recruitment by the study team at the University of California San Francisco (UCSF). Adults with and without SARS-CoV-2 infection during pregnancy are eligible for enrollment in the pregnancy cohort and will follow the protocol for RECOVER-Adult including validated screening tools, laboratory analyses and symptom questionnaires followed by more in-depth phenotyping of PASC on a subset of the overall cohort. Offspring exposed and unexposed in utero to SARS-CoV-2 maternal infection will undergo screening tests for neurodevelopment and other health outcomes at 12, 18, 24, 36 and 48 months of age. Blood specimens will be collected at 24 months of age for SARS-CoV-2 antibody testing, storage and anticipated later analyses proposed by RECOVER and other investigators. Discussion RECOVER-Pregnancy will address whether having SARS-CoV-2 during pregnancy modifies the risk factors, prevalence, and phenotype of PASC. The pregnancy cohort will also establish whether there are increased risks of adverse long-term outcomes among children exposed in utero. Clinical Trials.gov Identifier Clinical Trial Registration: http://www.clinicaltrials.gov. Unique identifier: NCT05172011.

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“…A list of study sites can be obtained at https://recovercovid.org or in Appendix 1. For participants recruited within the 26 individual hospital sites of the MFMU Network, recruitment occurs among individuals who were enrolled in the NICHD MFMU Gestational Research Assessments for COVID-19 (GRAVID) study 15,16 , a previously established cohort of individuals with and without SARS-CoV-2 during pregnancy over the COVID-19 pandemic, and new prospective enrollments of individuals with and without SARS-CoV-2 in pregnancy to encompass all variants of SARS-CoV-2. Study procedures for participants recruited by NICHD MFMU Network sites will be completed through a combination of remote survey assessments and in-person study visits.…”

Section: Study Design and Settingmentioning

confidence: 99%

Researching COVID to enhance recovery (RECOVER) pregnancy study: Rationale, objectives and design

Metz

Clifton

Gallagher

et al. 2023

Preprint

Self Cite

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Importance: Pregnancy induces unique physiologic changes to the immune response and hormonal changes leading to plausible differences in the risk of developing post-acute sequelae of SARS-CoV-2 (PASC), or Long COVID. Exposure to SARS-CoV-2 during pregnancy may also have long-term ramifications for exposed offspring, and it is critical to evaluate the health outcomes of exposed children. The National Institutes of Health (NIH) Researching COVID to Enhance Recovery (RECOVER) Multi-site Observational Study of PASC aims to evaluate the long-term sequelae of SARS-CoV-2 infection in various populations. RECOVER-Pregnancy was designed specifically to address long-term outcomes in maternal-child dyads. Methods: RECOVER-Pregnancy cohort is a combined prospective and retrospective cohort that proposes to enroll 2,300 individuals with a pregnancy during the COVID-19 pandemic and their offspring exposed and unexposed in utero, including single and multiple gestations. Enrollment will occur both in person at 27 sites through the Eunice Kennedy Shriver National Institutes of Health Maternal-Fetal Medicine Units Network and remotely through national recruitment by the study team at the University of California San Francisco (UCSF). Adults with and without SARS-CoV-2 infection during pregnancy are eligible for enrollment in the pregnancy cohort and will follow the protocol for RECOVER-Adult including validated screening tools, laboratory analyses and symptom questionnaires followed by more in-depth phenotyping of PASC on a subset of the overall cohort. Offspring exposed and unexposed in utero to SARS-CoV-2 maternal infection will undergo screening tests for neurodevelopment and other health outcomes at 12, 18, 24, 36 and 48 months of age. Blood specimens will be collected at 24 months of age for SARS-CoV-2 antibody testing, storage and anticipated later analyses proposed by RECOVER and other investigators. Discussion: RECOVER-Pregnancy will address whether having SARS-CoV-2 during pregnancy modifies the risk factors, prevalence, and phenotype of PASC. The pregnancy cohort will also establish whether there are increased risks of adverse long-term outcomes among children exposed in utero.

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Association Between Giving Birth During the Early Coronavirus Disease 2019 (COVID-19) Pandemic and Serious Maternal Morbidity

Abstract: Despite health care and societal modifications, giving birth during the early coronavirus disease 2019 (COVID-19) pandemic was not associated with increased risk of serious maternal morbidity from common obstetric complications.

Cited by 5 publications

References 17 publications

Gestational Weight Gain and Neonatal Biometry during the COVID-19 Pandemic: A Multicenter Observational Cohort

Gestational Weight Gain and Neonatal Biometry during the COVID-19 Pandemic: A Multicenter Observational Cohort

Researching COVID to enhance recovery (RECOVER) pregnancy study: Rationale, objectives and design

Researching COVID to enhance recovery (RECOVER) pregnancy study: Rationale, objectives and design

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