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BIBTEX RIS

Maternal and perinatal outcomes in high compared to low risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection (phase 2): the World Association of Perinatal Medicine working group on coronavirus disease 2019

2021; Elsevier BV; Volume: 3; Issue: 4 Linguagem: Inglês

10.1016/j.ajogmf.2021.100329

2589-9333

F. D’Antonio, Cihat Şen, Daniele Di Mascio, Alberto Galindo, Cecilia Villalaín, Ignacio Herraı̀z, Resul Arısoy, Ali Ovayolu, Hasan Eroğlu, Manuel Guerra Canales, Subhashini Ladella, Liviu Cojocaru, Özhan Turan, Şifa Turan, Eran Hadar, Noa A. Brzezinski‐Sinai, Sarah Dollinger, Özlem Özgün Uyanıklar, Sakine Rahımlı Ocakoğlu, Zeliha Atak, Tanja Premru Sršen, Lilijana Kornhauser-Cerar, Mirjam Druškovič, Liana Pleș, Reyhan Gündüz, Elif Ağaçayak, Javier Alfonso Schvartzman, Mercedes Negri Malbran, Marco Liberati, F. Di Sebastiano, Ludovica Oronzi, Chiara Cerra, Danilo Buca, Angelo Cagnacci, Arianna Ramone, Fabio Barra, Andrea Roberto Carosso, Chiara Benedetto, Stefano Cosma, Axelle Pintiaux, Caroline Daelemans, Elena Costa, Ayşegül Özel, Murat Muhçu, Jesús S. Jiménez López, C Alvarado, Anna Luengo Piqueras, Dolores Esteban Oliva, G. Schera, N. Volpe, T. Frusca, Igor Samardjiski, Slagjana Simeonova, Irena Aleksioska Papestiev, Javier Hojman, Ilgın Türkçüoğlu, Antonella Cromi, Antonio Simone Laganà, Fabio Ghezzi, Angelo Sirico, Alessandra Familiari, Giovanni Scambia, Zulfiya Khodjaeva Gennady T. Sukhikh, Ksenia A. Gorina, Renato Augusto Moreira de Sá, Mariana Vaz, Otto Henrique May Feuerschuette, Anna Nunzia Della Gatta, A. Youssef, Gaetana Di Donna, Alicia Martínez‐Varea, Gabriela Loscalzo, José Morales Roselló, Vedran Stefanović, Irmeli Nupponen, Kaisa Nelskylä, Rodrigo Ponce Ayala, Rebeca Garrote Molpeceres, Asunción Pino Vázquez, Fabrizio Sandri, I. Cataneo, Marinella Lenzi, Esra Tuştaş Haberal, Erasmo Huertas, Amadeo Sánchez, Pedro Arango, Amanda Bermejo, María Mónica Gonzalez Alcántara, Gökhan Göynümer, Erhan Okuyan, Mădălina Ciuhodaru, Ana Concheiro‐Guisán, Alejandra Martínez Schulte, Valentina Esposito, Valentina De Robertis, Snezana Zdjelar, Milan Lacković, Sladjana Mihajlovic, Nelly Jekova, Gabriele Saccone, Mehmet Aslan, Maria Carmela Di Dedda, Maisuri T. Chalid, Jose Enrique Moros Canache, G. Daskalakis, Panos J. Antsaklis, Enrique Criado Vega, Elisa Cueto, Chiara Taccaliti, Yeliz Aykanat, Şerife Özlem Genç, Bernd Froessler, P Radulova, Danila Morano, Beatrice Bianchi, Maria Giulia Marino, Gabriella Meccariello, Bindu Rohatgi, Antonio Schiattarella, Maddalena Morlando, Nicola Colacurci, Andrea Villasco, Nicoletta Biglia, Ana Marques, Alessandra Gatti, Daniela Luvero, Roberto Angioli, Alejandro Pittaro, Albert Lila, B Zlatohlávková,

Maternal and fetal healthcare

It has still to be ascertained whether severe acute respiratory syndrome coronavirus 2 infection in pregnancy is associated with worse maternal and fetal outcomes compared to low risk gestations.This study aimed to evaluate maternal and perinatal outcomes in high- and low-risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection.This was a multinational retrospective cohort study involving women with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection from 76 centers from 25 countries in Europe, the United States, South America, Asia, and Australia from April 4, 2020, to October 28, 2020. The primary outcome was a composite measure of maternal mortality and morbidity, including admission to the intensive care unit, use of mechanical ventilation, or death. The secondary outcome was a composite measure of adverse perinatal outcome, including miscarriage, fetal loss, neonatal and perinatal death, and admission to the neonatal intensive care unit. All outcomes were assessed in high- and low-risk pregnancies. Pregnancies were considered high risk in case of either preexisting chronic medical conditions in pregnancy or obstetrical disorders occurring in pregnancy. The Fisher exact test and logistic regression analysis were used to analyze the data.A total of 887 singleton pregnancies who tested positive for severe acute respiratory syndrome coronavirus 2 infection using reverse transcription-polymerase chain reaction of nasal and pharyngeal swab specimens were included in the study. The risk of composite adverse maternal outcomes was higher in high-risk pregnancies than in low-risk pregnancies (odds ratio, 1.52; 95% confidence interval, 1.03-2.24; P=.035). In addition, women carrying high-risk pregnancies were at higher risk of hospital admission (odds ratio, 1.48; 95% confidence interval, 1.07-2.04; P=.002), presence of severe respiratory symptoms (odds ratio, 2.13; 95% confidence interval, 0.41-3.21; P=.001), admission to the intensive care unit (odds ratio, 2.63; 95% confidence interval, 1.42-4.88), and invasive mechanical ventilation (odds ratio, 2.65; 95% confidence interval, 1.19-5.94; P=.002). When exploring perinatal outcomes, high-risk pregnancies were at high risk of adverse perinatal outcomes (odds ratio, 1.78; 95% confidence interval, 0.15-2.72; P=.009). However, such association was mainly because of the higher incidence of miscarriage in high-risk pregnancies compared with that in low-risk pregnancies (5.3% vs 1.6%, P=.008); furthermore, there was no difference in other explored outcomes between the 2 study groups. At logistic regression analysis, maternal age (odds ratio, 1.12; 95% confidence interval, 1.02-1.22; P=.023) and high-risk pregnancy (odds ratio, 4.21; 95% confidence interval, 3.90-5.11; P<.001) were independently associated with adverse maternal outcomes.High-risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection were at higher risk of adverse maternal outcomes than low-risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection.