Maternal and Obstetrical Outcomes in a Cohort of Pregnant Women Tested for SARS-CoV-2: Interim Results of the COVI-Preg International Registry

Vouga, Manon; Favre, Guillaume; Pérez, Oscar; Pomar, Léo; Acebal, Laura Forcén; Abascal, A.; Hernández, Marı́a Rosa; Hcini, Najeh; Lambert, Véronique; Carles, Gabriel; Sichitiu, Joanna; Salomon, Laurent; Stiremann, Julien; Ville, Y.; Tejada, Begoña Martínez de; Goncé, Anna; Hawkins-Villareal, Ameth; CA, Karen; Solsona, E.; Trigo, L.; Cleary, Brian; Geary, Michael; Bartels, H; Al-Kharouf, Feras; Malone, Fergal D.; Higgins, Mary; Keating, Niamh; Knowles, S; Poncelet, C.; Ribeiro‐do‐Valle, Carolina C.; Ribeiro-do-Valle, Fernanda; Surita, Garanhani; Dantas‐Silva, Amanda; Borrelli, Carolina; Luz, Adriana Gomes; Fuenzalida, Javiera; Canales, Manuel Guerra; Hernández, Olivia Allende; Grechukhina, Olga; Ko, Albert Icksang; Reddy, Uma M.; Figueiredo, Rita; Moucho, Marina; Pinto, Pedro Viana; Luca, Carmen De; Santis, Marco De; Ayres-de-Campos, Diogo; Garabédian, Charles; Subtil, D.; Bohrer, Betânia Barreto de Athayde; Oppermann, Maria; Celeste, María; Wender, Osorio; Schüler‐Faccini, Lavínia; Sanseverino, Maria Teresa Vieira; Giugliani, Camila; Friedrich, Luciana; Scherer, Mariana Horn; Mottet, Nicolas; Ducarme, Guillaume; Pelerin, Hélène; Moreau, Chloé; Breton, Bénédicte; Quibel, Thibaud; Rozenberg, Patrick; Mueller, D; Granado, Cristina; Hoesli, Irène; Monod, Cécile; Bassler, Dirk; Heldstab, Sandra A.; Kölble, N.; Sentilhes, Loïc; Charvet, Melissa; Deprest, Jan; Richter, Jute; Veeken, Lennart Van der; Eggel-Hort, Béatrice; Plantefève, Gaëtan; Derouich, Mohamed; Calvache, Albaro José Nieto; López-Girón, María Camila; Burgos‐Luna, Juan Manuel; Escobar-Vidarte, María Fernanda; Hecher, Kurt; Tallarek, Ann‐Christin; Hadar, Eran; Haratz, K.K.; Malinger, Gustavo; Maymon, Ron; Yogev, Yariv; Schäffer, Leonhard; Toussaint, Arnaud; Rossier, Marie‐Claude; de, Renato Augusto Moreira; Grawe, Claudia; Aebi‐Popp, Karoline; Radan, Anda‐Petronela; Raio, Luigi; Surbek, Daniel; Böckenhoff, Paul; Strizek, Brigitte; Kaufmann, Martin; Bloch, Andrea; Boulvain, Michel; Johann, Silke; Bernasconi, Monya Todesco; Grant, Gastón; Féki, Anis; Brochut, Anne‐Claude Muller; Giral, Marylene; Sedille, Lucie; Papadia, Andrea; Brugger, Romina Capoccia; Weber, Brigitte; Fischer, Tina; Kahlert, Christian R.; Saines, Karin Nielsen; Cambou, Mary Catherine; Kanellos, P.; Chen, Xiang; Yin, Mingzhu; Haessig, Annina; Baud, David; Panchaud, Alice

doi:10.2139/ssrn.3684424

Cited by 3 publications

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“…Women with symptomatic COVID-19 infection are at increased risk of caesarean birth and fetal distress during active labour [13,14]. The average caesarean section rate in Italian study (Donati et al [15]) was 33.7%; elective CS was performed in 15.4% of the cases; urgent/emergency CS due to maternal or fetal indications was performed in 15% and due to COVID-19 was performed in 3.3% of the cases.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 in pregnancy, management and outcomes among pregnant women and neonates — results from tertiary care center in Wroclaw

et al. 2022

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Objectives: A novel coronavirus -SARS-CoV-2 -outbreak has, for sure, been the greatest medical challenge in recent years. The maternal and neonatal consequences of the infection are still largely unknown. Material and methods:This prospective study aims to describe the perinatal care and outcomes of SARS-CoV-2 positive pregnant women and their newborn infants during the third wave of the pandemic, in a large tertiary university center in Wroclaw/Poland from 15 February to 1 May 2021. Results:The paper describes a group of 83 women with confirmed SARS-CoV-2 infection during delivery, as well as their newborn infants (n = 84). The course of COVID-19 disease in pregnant patients was mostly asymptomatic (54.2%) but 31% women manifested mild to moderate symptoms and 14% had severe infection. The median gestational age at the delivery was 39 weeks. On average, 16.7% of mothers were separated from their newborns at birth, 83.3% practiced skin-to-skin, and roomed in with their babies, and 84.5% of the infants received any mother's milk. Preterm infants were more often born by mothers with symptomatic course of COVID-19 infection. Need for neonatal treatment was only due to prematurity. Neonates with acquired infection (after 14 th day of life) had to be treated symptomatically with fever and loose stools, only 28.5% had symptoms of respiratory failure.Conclusions: Despite the confirmed SARS-CoV-2 infection, the majority of mother-infant dyads were in a good health condition. The data on perinatal care reported in the paper could be helpful contribution supporting childbirth physiology protection during the COVID-19 pandemic.

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Section: Discussionmentioning

confidence: 99%

COVID-19 in pregnancy, management and outcomes among pregnant women and neonates — results from tertiary care center in Wroclaw

et al. 2022

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“…Five studies report data from multiple geographical regions and country income groups (online supplemental 3). [19][20][21][22][23] Overall, 31.2% (72/231) of studies were from the USA, 10.0% (23/231) from China and 7.8% (18/231) from India. There were 14 studies, each from Spain and Turkey; 11 from Iran; 10 from France and Italy; 7 from Brazil; 6 from Chile, Mexico, Pakistan and Portugal; and less than 6 from 44 other countries (online supplemental 2).…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Global variations in the burden of SARS-CoV-2 infection and its outcomes in pregnant women by geographical region and country’s income status: a meta-analysis

et al. 2022

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IntroductionThe prevalence of COVID-19 and its impact varied between countries and regions. Pregnant women are at high risk of COVID-19 complications compared with non-pregnant women. The magnitude of variations, if any, in SARS-CoV-2 infection rates and its health outcomes among pregnant women by geographical regions and country’s income level is not known.MethodsWe performed a random-effects meta-analysis as part of the ongoing PregCOV-19 living systematic review (December 2019 to April 2021). We included cohort studies on pregnant women with COVID-19 reporting maternal (mortality, intensive care admission and preterm birth) and offspring (mortality, stillbirth, neonatal intensive care admission) outcomes and grouped them by World Bank geographical region and income level. We reported results as proportions with 95% confidence intervals (CI).ResultsWe included 311 studies (2 003 724 pregnant women, 57 countries). The rates of SARS-CoV-2 infection in pregnant women varied significantly by region (p<0.001) and income level (p<0.001), with the highest rates observed in Latin America and the Caribbean (19%, 95% CI 12% to 27%; 13 studies, 38 748 women) and lower-middle-income countries (13%, 95% CI 6% to 23%; 25 studies, 100 080 women). We found significant differences in maternal and offspring outcomes by region and income level. Lower-middle-income countries reported significantly higher rates of maternal mortality (0.68%, 95% CI 0.24% to 1.27%; 3 studies, 31 136 women), intensive care admission (4.53%, 95% CI 2.57% to 6.91%; 54 studies, 23 420 women) and stillbirths (1.09%, 95% CI 0.48% to 1.88%; 41 studies, 4724 women) than high-income countries. COVID-19 complications disproportionately affected South Asia, which had the highest maternal mortality rate (0.88%, 95% CI 0.16% to 1.95%; 17 studies, 2023 women); Latin America and the Caribbean had the highest stillbirth rates (1.97%, 95% CI 0.9% to 3.33%; 10 studies, 1750 women).ConclusionThe rates of SARS-CoV-2 infection in pregnant women vary globally, and its health outcomes mirror the COVID-19 burden and global maternal and offspring inequalities.PROSPERO registration numberCRD42020178076.

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SARS-CoV-2 and the role of vertical transmission from infected pregnant women to their fetuses: systematic review.

Plüddemann

Spencer

Heneghan

et al. 2021

Preprint

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Background Vertical transmission of SARS-CoV-2 has been reported but does not appear to be common. This study aims to systematically review the evidence for vertical transmission of SARS-CoV-2. Methods This review is part of an Open Evidence Review on the transmission dynamics of SARS-CoV-2 and the role of intrauterine mother to fetus transmission. Literature searches were performed in the WHO Covid-19 Database, LitCovid, medRxiv, and Google Scholar for SARS-CoV-2 using keywords and associated synonyms, search date up to 20 December 2020, no language restrictions. Results We included 106 studies assessing vertical transmission of SARS-CoV-2 from pregnant women to their neonates: these studies comprised 40 reviews (21 fulfilled systematic review methodology, including risk of bias assessment of included studies) and 66 primary studies including 32 case reports (of up to two cases) and 34 prospective and retrospective cohort studies, prospective and retrospective case series, observational studies (including asymptomatic screening), database studies and a quality improvement project. Almost all were conducted in a hospital setting. The 32 case reports were considered to be at high risk of bias, due to the study design; across the 34 remaining primary studies, risk of bias was low to moderate. Sixteen case reports examined vertical transmission, which was not related to maternal symptomatology. For the cohort and case series studies, the percentage of positive neonates ranged from 0% to 22% across the studies. Twenty studies reported no positive vertical transmission. Three studies that reported the highest positivity rates of 11%, 15% and 22% had specifically selected neonates with a positive test (within up to 35 days) within the study population and were therefore more selective populations. Across the cohort and case series studies there were 65/2391 (2.7%) neonates born to mothers with a diagnosis of COVID-19 tested positive for SARS-CoV-2 within 24 hours of birth. No evidence correlated maternal symptomatology to vertical transmission. Mode of delivery did not correlate with rates of vertical transmission. Of 25 studies, 7 identified SARS-CoV-2 in placental tissue; some of these did not demonstrate vertical transmission to the neonate. No study reported the results of viral culture to detect SARS-CoV-2. Conclusions The results of these studies indicate that vertical transmission is possible, but is not frequent, and factors that influence when vertical transmission occurs are unknown. Further studies using standardised methods to establish viral infection are needed to establish vertical transmission rates and to assess clinical and other conditions affecting transmission.

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Maternal and Obstetrical Outcomes in a Cohort of Pregnant Women Tested for SARS-CoV-2: Interim Results of the COVI-Preg International Registry

Cited by 3 publications

References 0 publications

COVID-19 in pregnancy, management and outcomes among pregnant women and neonates — results from tertiary care center in Wroclaw

COVID-19 in pregnancy, management and outcomes among pregnant women and neonates — results from tertiary care center in Wroclaw

Global variations in the burden of SARS-CoV-2 infection and its outcomes in pregnant women by geographical region and country’s income status: a meta-analysis

SARS-CoV-2 and the role of vertical transmission from infected pregnant women to their fetuses: systematic review.

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