SARS-CoV-2 infection in pregnancy during the first wave of COVID-19 in the Netherlands: a prospective nationwide population-based cohort study

Klungsøyr

et al. 2021

Preprint

Introduction Population-based studies about the consequences of SARS-CoV-2 infection (COVID-19) in pregnancy are few and have limited generalizability to the Nordic population and health care systems. Material and method This study examines pregnant women with COVID-19 in the five Nordic countries. Pregnant women were included if they were admitted to hospital between March 1 and June 30, 2020 and had a positive SARS-CoV-2 PCR test 14 days or fewer prior to the admission. Cause of admission was classified as either obstetric or COVID-19 related. Results In the study areas, 214 pregnant women with a positive test were admitted to hospital, of which 56 women needed hospital care due to COVID-19. The rate of admission due to COVID-19 was 0.4 per 1000 deliveries in Denmark, Finland, and Norway and 3.8 per 1000 deliveries in the Swedish regions. Women hospitalized because of COVID-19 were more frequently obese (P < 0.001) and had migrant background (P < 0.001) compared to the total population of women who delivered in 2018. Twelve women (21.4%) needed intensive care. Preterm delivery (n=12, 25%, P < 0.001) and cesarean delivery (n=21, 43,8%, P < 0.001) were more frequent in women with COVID-19 compared to the women who delivered in 2018. No maternal deaths, stillbirths or neonatal deaths were reported. Conclusion The risk of admission due to severe COVID-19 disease in pregnancy was low in the Nordic countries. A fifth of the women required intensive care and we observed higher rates of preterm and cesarean deliveries. National public health policies appear to have had an impact on the rates of admission due to severe COVID-19 disease in pregnancy. Nordic collaboration is important in collecting robust data and assessing rare outcomes.

Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 85%

Section: Characteristics Of Women Admitted For Any Reason Are Shown Insupporting

confidence: 86%

Section: Discussionmentioning

confidence: 69%

Section: Characteristics Of Women Admitted For Any Reason Are Shown Inmentioning

confidence: 67%

See 3 more Smart Citations

COVID-19 in pregnancy – characteristics and outcomes of pregnant women admitted to hospital because of SARS-CoV-2 infection in the Nordic countries

Engjom

Klungsøyr

et al. 2021

Preprint

COVID-19 in Pregnancy: Characteristics and Outcomes of Pregnant Women Admitted to Hospital Because of SARS-CoV-2 Infection in the Nordic Countries

Engjom

Obstetric Anesthesia Digest

Klungsøyr

et al. 2022

SARS-CoV-2 infection in pregnancy in Denmark – characteristics and outcomes after confirmed infection in pregnancy: a nationwide, prospective, population-based cohort study

Krebs

Petersen

et al. 2021

Preprint

Introduction Assessing the risk factors for and consequences of infection with SARS-CoV-2 during pregnancy is essential to guide clinical guidelines and care. Previous studies on the influence of SARS-CoV-2 infection in pregnancy have been among hospitalised patients, which may have exaggerated risk estimates of severe outcomes because all cases of SARS-CoV-2 infection in the pregnant population were not included. The objectives of this study were to identify risk factors for and outcomes after SARS-CoV-2 infection in pregnancy independent of severity of infection in a universally tested population, and to identify risk factors for and outcomes after severe infection requiring hospital admission. Material and Methods This was a prospective population-based cohort study in Denmark using data from the Danish National Patient Register and Danish Microbiology Database and prospectively registered data from medical records. We included all pregnancies between March 1 and October 31, 2020 and compared women with a positive SARS-CoV-2 test during pregnancy to non-infected pregnant women. Cases of SARS-CoV-2 infection in pregnancy were both identified prospectively and through register linkage to secure that all cases were identified and that cases were pregnant during infection. Main outcome measures were pregnancy, delivery, maternal, and neonatal outcomes. Severe infection was defined as hospital admission due to COVID-19. Results Among 82 682 pregnancies, 418 women had SARS-CoV-2 infection during pregnancy, corresponding to an incidence of 5.1 per 1000 pregnancies, 23 (5.5%) of which required hospital admission due to COVID-19. Risk factors for infection were asthma (OR 2.19 [1.41-3.41]) and being foreign born (OR 2.12 [1.70-2.64]). Risk factors for hospital admission due to COVID-19 included obesity (OR 2.74 [1.00-7.51]), smoking (OR 4.69 [1.58-13.90]), infection after gestational age (GA) 22 weeks (GA 22-27 weeks: OR 3.77 [1.16-12.29]; GA 28-36 weeks: OR 4.76 [1.60-14.12]) and having asthma (OR 4.53 [1.39-14.79]). We found no difference in any obstetric or neonatal outcomes. Conclusions Only 1 in 20 women with SARS-CoV-2 infection during pregnancy require admission to hospital due to COVID-19. And severe outcomes of SARS-CoV-2 infection in pregnancy are rare.