Maternal and neonatal outcomes of pregnancies with COVID-19 after medically assisted reproduction: results from the prospective COVID-19-Related Obstetrical and Neonatal Outcome Study

Ziert, Yvonne; Abou-Dakn, Michael; Backes, Clara; Banz‐Jansen, Constanze; Bock, Nina; Bohlmann, Michael K.; Engelbrecht, Charlotte; Gruber, Teresa Mia; Iannaccone, Antonella; Jegen, Magdalena; Keil, C; Kyvernitakis, Ioannis; Lang, Katharina; Lihs, Angela; Manz, Jula; Morfeld, C; Richter, Manuela; Seliger, G; Sourouni, Marina; Kaisenberg, Constantin S. von; Wegener, S; Pecks, Ulrich; Versen‐Höynck, Frauke von

doi:10.1016/j.ajog.2022.04.021

Cited by 15 publications

(14 citation statements)

References 36 publications

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“…The available data from the COVID‐19 pandemic show that SARS‐CoV‐2 infection by itself is not associated with an increased risk of early pregnancy loss or stillbirth 38–40 . A study from Germany 41 including 1485 women with SARS‐CoV‐2 infection found higher rates of preterm birth and NICU admission among women with medically assisted conception in the early pandemic compared with women with spontaneous conception; however, the elevated risks were due to non‐ART‐related risk factors, which is also consistent with our results.…”

Section: Discussionmentioning

confidence: 99%

Early coronavirus disease 2019 restrictive measures and changes in maternal characteristics, use of assisted reproductive technology, and stillbirth

Lisonkova

Bone

Muraca

et al. 2022

Paediatric Perinatal Epid

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Background The initial COVID‐19 pandemic response−related effects on conceptions following the use of assisted reproductive technologies (ART), and on changes in the maternal characteristics of women who conceived during the early vs. pre‐pandemic period, have been understudied. Objectives To examine the effects of ART clinic closures in the United States (US) in March 2020 on the frequency of ART‐conceived live births, multiple births and stillbirths; and to describe changes in the characteristics of women who conceived in the early pandemic period. Methods Population‐based cohort study including all births in the US from January 2015 to December 2020 (22,907,688 live births; 134,537 stillbirths). Interrupted time series (ITS) methodology was used to estimate rate ratios (RR) of expected versus observed rates in December 2020 (i.e., among births conceived mainly in March 2020). Demographic and clinical characteristics were compared between mothers who conceived in March 2020 versus March 2015–2019. Results Overall, 1.1% of live births and 1.7% of stillbirths were conceived by ART. ART‐conceived live births decreased by 57.0% in December 2020 (observed vs. expected RR 0.43, 95% confidence interval [CI] 0.40, 0.45), and these declines occurred in all subgroups of women. Multiple births also declined in December 2020. Stillbirth rates increased in December 2020 in ART‐conceived births (RR 2.55, 95% CI 1.63, 3.92) but remained unchanged in the non‐ART group. Maternal characteristics of women who conceived in the early pandemic versus pre‐pandemic period differed and included an increased prevalence of pre‐pregnancy obesity class 3 and chronic hypertension. Conclusions The early pandemic closure of ART clinics resulted in a substantial decline in ART‐conceived live births and multiple births in December 2020 and an increase in the proportion of stillbirths among ART‐conceived births. Women who conceived in the early pandemic period also had an increased prevalence of obesity and chronic hypertension.

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Section: Discussionmentioning

confidence: 99%

Early coronavirus disease 2019 restrictive measures and changes in maternal characteristics, use of assisted reproductive technology, and stillbirth

Lisonkova

Bone

Muraca

et al. 2022

Paediatric Perinatal Epid

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“…CRONOS is a multicentric prospective observational study established by the German Society of Perinatal Medicine in April 2020 to collect representative data on the effect of SARS-CoV-2 infection during pregnancy on maternal and neonatal outcomes in Germany. Parts of the study results have been published [16][17][18][19]. Ethics approval was obtained (University Hospital Schleswig-Holstein, Kiel, file-no.…”

Section: Methodsmentioning

confidence: 99%

Evolution of Fetal Growth in Symptomatic Sars-Cov-2 Pregnancies

Hachenberg,

Guenther,

Steinkasserer

et al. 2024

Z Geburtshilfe Neonatol

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Introduction SARS-CoV-2 is a viral disease with potentially devastating effects. Observational studies of pregnant women infected with SARS-CoV-2 report an increased risk for FGR. This study utilizes data from a prospective SARS-CoV-2 registry in pregnancy, investigating the progression of fetuses to fetal growth restriction (FGR) at birth following maternal SARS-CoV-2 and evaluating the hypothesis of whether the percentage of SGA at birth is increased after maternal SARS-CoV-2 taking into account the time interval between infection and birth. Materials & Methods CRONOS is a prospective German registry enrolling pregnant women with confirmed SARS-CoV-2 infection during their pregnancy. SARS-CoV-2 symptoms, pregnancy- and delivery-specific information were recorded. The data evaluated in this study range from March 2020 until August 2021. Women with SARS-CoV-2 were divided into three groups according to the time of infection/symptoms to delivery: Group I<2 weeks, Group II 2–4 weeks, and Group III>4 weeks. FGR was defined as estimated and/or birth weight<10% ile, appropriate for gestational age (AGA) was within 10 and 90%ile, and large for gestational age (LGA) was defined as fetal or neonatal weight>90%ile. Results Data for a total of 2,650 SARS-CoV-2-positive pregnant women were available. The analysis was restricted to symptomatic cases that delivered after 24+0 weeks of gestation. Excluding those cases with missing values for estimated fetal weight at time of infection and/or birth weight centile, 900 datasets remained for analyses. Group I consisted of 551 women, Group II of 112 women, and Group III of 237 women. The percentage of changes from AGA to FGR did not differ between groups. However, there was a significantly higher rate of large for gestational age (LGA) newborns at the time of birth compared to the time of SARS-CoV-2 infection in Group III (p=0.0024), respectively. Conclusion FGR rates did not differ between symptomatic COVID infections occurring within 2 weeks and>4 weeks before birth. On the contrary, it presented a significant increase in LGA pregnancies in Group III. However, in this study population, an increase in the percentage of LGA may be attributed to pandemic measures and a reduction in daily activity.

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“…Die Daten wurden über Vergleichs- und Suchalgorithmen auf Plausibilität der Einträge überprüft. Nach Exklusion von Doppelteinträgen, Patientinnen mit fehlender Angabe zum Gestationsalter bei Infektion und nichtverifizierten Testergebnissen konnten 2650 Datensätze für eine weitere Auswertung verwendet werden [ 5 , 12 , 14 ].…”

Section: Methodik Des Cronos-registersunclassified

“…So hat sich ein intensiv arbeitendes Netzwerk in Deutschland etabliert, das die Evidenz zum Umgang mit der Erkrankung in Schwangerschaft, Geburt und Wochenbett für die Betreuung unserer Patientinnen aufbereitet. Zahlreiche wissenschaftliche Arbeiten und nicht zuletzt die AWMF-Leitlinie 015/092 sind hieraus entstanden [ 1 , 5 , 7 , 9 , 12 , 14 ].…”

Section: Kommentarunclassified

COVID-19 in Schwangerschaft, Geburt und Wochenbett

Pecks

Agel²,

Doubek

et al. 2022

Gynäkologie

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COVID(„coronavirus disease“)-19 ist eine Infektionserkrankung, die zu schweren respiratorischen Symptomen führen kann. Schwangere haben ein erhöhtes Risiko für einen schweren Verlauf. Für eine gute Betreuung in der COVID-19-Pandemie wurde daher die AWMF(Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften)-Leitlinie 015/092 „SARS-CoV‑2 in Schwangerschaft, Geburt und Wochenbett“ erstellt. Die Leitliniengruppe nutzte zur Erstellung von evidenzbasierten Handlungsempfehlungen die Daten der „Covid-19 Related Obstetrics and Neonatal Outcome Study“ (CRONOS). CRONOS sammelt deutschlandweit Daten aus mehr als 130 angeschlossenen Geburtenkliniken. SARS-CoV-2(„severe acute respiratory syndrome coronavirus 2“)-positive Schwangere sind demnach häufig asymptomatisch. Bei 1 von 25 erkannten Infektionen kommt es jedoch zu einem schweren Verlauf mit intensivmedizinischer Behandlung. Bei 1 von 30 stationär wegen COVID-19 behandelten Frauen kommt es zu einer Thromboembolie. Eine Infektion des Neugeborenen einer peripartal infizierten Mutter wird gelegentlich (etwa 1 von 20 Kindern) nachgewiesen und bleibt in der Regel ohne Konsequenz im Kurzzeit-Outcome. Viele weitere Fragestellungen wurden mithilfe von CRONOS beantwortet. Das weiter aktiv rekrutierende Register wird zukünftig mit mehr als 6000 Fällen auch tiefere Informationen zu verschiedenen Virusvarianten und zum Impfen liefern. CRONOS steht vorbildlich für eine beispiellose Kooperation von Ärztinnen und Ärzten der Frauenheilkunde in der Pandemie.

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Maternal and neonatal outcomes of pregnancies with COVID-19 after medically assisted reproduction: results from the prospective COVID-19-Related Obstetrical and Neonatal Outcome Study

Cited by 15 publications

References 36 publications

Early coronavirus disease 2019 restrictive measures and changes in maternal characteristics, use of assisted reproductive technology, and stillbirth

Early coronavirus disease 2019 restrictive measures and changes in maternal characteristics, use of assisted reproductive technology, and stillbirth

Evolution of Fetal Growth in Symptomatic Sars-Cov-2 Pregnancies

COVID-19 in Schwangerschaft, Geburt und Wochenbett

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