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Martinez-Perez, Oscar; Prats Rodriguez, Pilar; Muner Hernandez, Marta; Encinas Pardilla, Maria Begoña; Perez Perez, Noelia; Vila Hernandez, Maria Rosa; Villalba Yarza, Ana; Nieto Velasco, Olga; Del Barrio Fernandez, Pablo Guillermo; Forcen Acebal, Laura; Orizales Lago, Carmen Maria; Martinez Varea, Alicia; Muñoz Abellana, Begoña; Suarez Arana, Maria; Fuentes Ricoy, Laura; Martinez Diago, Clara; Janeiro Freire, Maria Jesus; Alférez Alvarez-Mallo, Macarena; Casanova Pedraz, Cristina; Alomar Mateu, Onofre; Lesmes Heredia, Cristina; Wizner de Alva, Juan Carlos; Bernardo Vega, Rut; Macia Badia, Montserrat; Alvarez Colomo, Cristina; Sanchez Muñoz, Antonio; Pratcorona Alicart, Laia; Alonso Saiz, Ruben; Lopez Rodriguez, Monica; Del Carmen Barbancho Lopez, Maria; Meca Casbas, Marta Ruth; Vaquerizo Ruiz, Oscar; Moran Antolin, Eva; Nuñez Valera, Maria Jose; Fernandez Fernandez, Camino; Tubau Navarra, Albert; Cano Garcia, Alejandra Maria; Baena Luque, Carmen; Soldevilla Perez, Susana; Gastaca Abasolo, Irene; Adanez Garcia, Jose; Teulon Gonzalez, Maria; Puertas Prieto, Alberto; Ostos Serna, Rosa; Del Pilar Guadix Martin, Maria; Catalina Coello, Monica; Ferriols Perez, Elena; Caño Aguilar, Africa; De la Cruz Conty, Maria Luisa; Sainz Bueno, Jose Antonio
BMC pregnancy and childbirth, 04/2021, Letnik: 21, Številka: 1Journal Article
To determine whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, the cause of COVID-19 disease) exposure in pregnancy, compared to non-exposure, is associated with infection-related obstetric morbidity. We conducted a multicentre prospective study in pregnancy based on a universal antenatal screening program for SARS-CoV-2 infection. Throughout Spain 45 hospitals tested all women at admission on delivery ward using polymerase-chain-reaction (PCR) for COVID-19 since late March 2020. The cohort of positive mothers and the concurrent sample of negative mothers was followed up until 6-weeks post-partum. Multivariable logistic regression analysis, adjusting for known confounding variables, determined the adjusted odds ratio (aOR) with 95% confidence intervals (95% CI) of the association of SARS-CoV-2 infection and obstetric outcomes. Preterm delivery (primary), premature rupture of membranes and neonatal intensive care unit admissions. Among 1009 screened pregnancies, 246 were SARS-CoV-2 positive. Compared to negative mothers (763 cases), SARS-CoV-2 infection increased the odds of preterm birth (34 vs 51, 13.8% vs 6.7%, aOR 2.12, 95% CI 1.32-3.36, p = 0.002); iatrogenic preterm delivery was more frequent in infected women (4.9% vs 1.3%, p = 0.001), while the occurrence of spontaneous preterm deliveries was statistically similar (6.1% vs 4.7%). An increased risk of premature rupture of membranes at term (39 vs 75, 15.8% vs 9.8%, aOR 1.70, 95% CI 1.11-2.57, p = 0.013) and neonatal intensive care unit admissions (23 vs 18, 9.3% vs 2.4%, aOR 4.62, 95% CI 2.43-8.94, p < 0.001) was also observed in positive mothers. This prospective multicentre study demonstrated that pregnant women infected with SARS-CoV-2 have more infection-related obstetric morbidity. This hypothesis merits evaluation of a causal association in further research.
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