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Maternal Outcomes and Risk Factors for Severity Among Pregnant Women With COVID-19: A Case Control Study From the COVI-Preg International Registry

2020; RELX Group (Netherlands); Linguagem: Inglês

10.2139/ssrn.3724278

1556-5068

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

COVID-19 and healthcare impacts

Background: Recent evidence suggests that pregnant women might be at higher risk of severe disease associated with the emerging pandemic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), while exposed fetuses/newborns could suffer from preterm birth, growth restriction and neonatal infections. The magnitude of this increased risk and specific risk factors for severity remains unclear.Methods: We performed a case control study comparing pregnant women with severe coronavirus disease 19 (case) to pregnant women with a milder form (controls) enrolled in COVI-Preg international registry cohort between from March 24 to July 26, 2020. Risk factors for severity, obstetrical, fetal and neonatal outcomes were assessed.Findings: A total of 926 pregnant women with a positive test for SARS-CoV-2 were included, among which 92 (9.9%) presented a severe COVID-19 disease. Risk factors for severe maternal outcomes were pulmonary comorbidities [aOR 4.3, 95% CI 1.9-9.5], hypertensive disorders [aOR 2.7, 95% CI 1.0-7.0] and diabetes [aOR2.2, 95% CI 1.1-4.5]. Pregnant women with severe maternal outcomes were at higher risk of cesarean sections [70.7% (n=53/75)], preterm deliveries [62.7% (n= 32/51)] and newborns requiring admission to the neonatal intensive care unit [41.3% (n=31/75)].Interpretation: Pregnant women, particularly those with associated comorbidities, seem to be at higher risk of severe complications of SARS-CoV-2 infection. Obstetrical and neonatal outcomes appear to be influenced by the severity of maternal disease; complications include cesarean sections, prematurity and neonatal admission to the intensive care unit.Funding Statement: None.Declaration of Interests: The authors declare that they have no conflicts of interest.Ethics Approval Statement: The study was approved by both the Swiss Ethical Board (CER-VD- 2020-00548) and the local ethics boards at each participating center.