The association between SARS-CoV-2 infection and preterm delivery: a prospective study with a multivariable analysis

BMC Pregnancy and Childbirth

Montserrat Macia Badia¹  Laura Forcen Acebal²  Clara Martinez Diago³  Antonio Sanchez Muñoz⁴  Pablo Guillermo Del Barrio Fernandez⁵  Carmen Baena Luque⁶  Maria del Carmen Barbancho Lopez⁷  Alicia Martinez Varea⁸  Marta Muner Hernandez⁹  Elena Ferriols Perez^1,10  Oscar Martinez-Perez^1,11  Maria Begoña Encinas Pardilla^1,11  Maria Suarez Arana^1,12  Rut Bernardo Vega^1,13  Noelia Perez Perez^1,14  Juan Carlos Wizner de Alva^1,15  Maria Rosa Vila Hernandez^1,16  Carmen Maria Orizales Lago^1,17  Camino Fernandez Fernandez^1,18  Ruben Alonso Saiz^1,19  Alejandra Maria Cano Garcia^2,20  Maria Teulon Gonzalez^2,21  Ana Villalba Yarza^2,22  Cristina Casanova Pedraz^2,23  Jose Antonio Sainz Bueno^2,24  Cristina Alvarez Colomo^2,25  Rosa Ostos Serna^2,26  Monica Catalina Coello^2,27  Jose Adanez Garcia^2,28  Laia Pratcorona Alicart^2,29  Macarena Alférez Alvarez-Mallo^3,30  Monica Lopez Rodriguez^3,31  Cristina Lesmes Heredia^3,32  Marta Ruth Meca Casbas^3,33  Olga Nieto Velasco^3,34  Onofre Alomar Mateu^3,35  Africa Caño Aguilar^3,36  Begoña Muñoz Abellana^3,37  Eva Moran Antolin^3,38  Albert Tubau Navarra^3,39  Irene Gastaca Abasolo^4,40  Maria Jesus Janeiro Freire^4,41  Oscar Vaquerizo Ruiz^4,42  Laura Fuentes Ricoy^4,43  Susana Soldevilla Perez^4,44  Maria del Pilar Guadix Martin^4,45  Maria Jose Nuñez Valera^4,46  Alberto Puertas Prieto^4,47  Pilar Prats Rodriguez^4,48  Maria Luisa De la Cruz Conty^4,49 

[1] Department Gynaecology and Obstetrics, Arnau de Vilanova University Hospital, Lleida, Catalunya, Spain;Department Gynaecology and Obstetrics, Doce de Octubre University Hospital, Comunidad de Madrid, Madrid, Spain;Department Gynaecology and Obstetrics, Doctor Josep Trueta University Hospital of Girona, Girona, Catalunya, Spain;Department Gynaecology and Obstetrics, General University Hospital of Ciudad Real, Ciudad Real, Castilla-La Mancha, Spain;Department Gynaecology and Obstetrics, Getafe University Hospital, Getafe, Madrid, Spain;Department Gynaecology and Obstetrics, Infanta Margarita Hospital, Andalucía, Cabra, Spain;Department Gynaecology and Obstetrics, Infanta Sofia University Hospital, San Sebastian de los Reyes, Madrid, Spain;Department Gynaecology and Obstetrics, La Fe University and Polytechnic Hospital, Comunidad Valenciana, Valencia, Spain;Department Gynaecology and Obstetrics, La Paz University Hospital. Madrid, Madrid, Spain;Department Gynaecology and Obstetrics, Parc de Salut Mar University Hospital, Barcelona, Catalunya, Spain;Department Gynaecology and Obstetrics, Puerta de Hierro University Hospital of Majadahonda, Majadahonda, Madrid, Spain;Department Gynaecology and Obstetrics, Regional University Hospital of Malaga, Malaga, Andalucía, Spain;Department Gynaecology and Obstetrics, Rio Hortega University Hospital, Valladolid, Castilla y León, Spain;Department Gynaecology and Obstetrics, San Carlos University Hospital. Madrid, Madrid, Spain;Department Gynaecology and Obstetrics, San Pedro de Alcántara Hospital, Caceres, Extremadura, Spain;Department Gynaecology and Obstetrics, Santa Caterina Hospital, Girona, Catalunya, Spain;Department Gynaecology and Obstetrics, Severo Ochoa University Hospital, Leganes, Madrid, Spain;Department Gynaecology and Obstetrics, University Assistance Complex of Leon, Leon, Castilla y Leon, Spain;Department Gynaecology and Obstetrics, University Hospital of Burgos, Burgos, Castilla y León, Spain;Department Gynaecology and Obstetrics, University Hospital of El Tajo, Aranjuez, Madrid, Spain;Department Gynaecology and Obstetrics, University Hospital of Fuenlabrada, Fuenlabrada, Madrid, Spain;Department Gynaecology and Obstetrics, University Hospital of Salamanca, Salamanca, Castilla y León, Spain;Department Gynaecology and Obstetrics, University Hospital of Torrejon, Torrejon de Ardoz, Madrid, Spain;Department Gynaecology and Obstetrics, University of Seville, G. Chacon (Viamed Santa Angela de la Cruz Hospital), Sevilla, Andalucia, Spain;Department Gynaecology and Obstetrics, Valladolid University Hospital, Valladolid, Castilla y León, Spain;Department Gynaecology and Obstetrics, Virgen de Valme University Hospital, Sevilla, Andalucía, Spain;Department Gynaecology and Obstetrics, Virgen de la Concha Hospital, Zamora, Castilla y León, Spain;Department Obstetrics and Gynaecology, Central University Hospital of Asturias, Oviedo, Asturias, Spain;Department Obstetrics and Gynaecology, Germans Trias i Pujol University Hospital, Barcelona, Catalunya, Spain;Department Obstetrics and Gynaecology, HM Hospitals, Madrid, Spain;Department Obstetrics and Gynaecology, Joan XXIII University Hospital of Tarragona, Tarragona, Catalunya, Spain;Department Obstetrics and Gynaecology, Parc Taulí Hospital, Barcelona, Catalunya, Spain;Department Obstetrics and Gynaecology, Poniente Hospital of Almería, El Ejido, Andalucía, Spain;Department Obstetrics and Gynaecology, Quironsalud Madrid University Hospital. Madrid, Madrid, Spain;Department Obstetrics and Gynaecology, Regional Hospital of Inca, Inca, Illes Balears, Spain;Department Obstetrics and Gynaecology, San Cecilio University Hospital of Granada, Granada, Andalucía, Spain;Department Obstetrics and Gynaecology, Sant Joan de Reus University Hospital, Reus, Catalunya, Spain;Department Obstetrics and Gynaecology, Son Espases University Hospital, Palma de Mallorca, Illes Balears, Spain;Department Obstetrics and Gynaecology, Son Llatzer University Hospital, Palma de Mallorca, Illes Balears, Spain;Department Obstetrics and Gynaecology, Txagorritxu University Hospital of Araba, Vitoria-Gasteiz, País Vasco, Spain;Department Obstetrics and Gynaecology, University Hospital Complex of A Coruña, A Coruña, Spain;Department Obstetrics and Gynaecology, University Hospital of Cabueñes, Gijon, Asturias, Spain;Department Obstetrics and Gynaecology, University Hospital of Ferrol, Ferrol, A Coruña, Spain;Department Obstetrics and Gynaecology, University Hospital of Jerez de la Frontera, Jerez de la Frontera, Andalucía, Spain;Department Obstetrics and Gynaecology, Virgen Macarena University Hospital, Sevilla, Andalucía, Spain;Department Obstetrics and Gynaecology, Virgen de la Luz Hospital, Cuenca, Castilla-La Mancha, Spain;Department Obstetrics and Gynaecology, Virgen de las Nieves University Hospital, Granada, Andalucía, Spain;Department Reproductive Medicine and Gynaecology, Obstetrics, Dexeus University Hospital, Barcelona, Catalunya, Spain;Fundación de Investigación Biomédica, Puerta de Hierro University Hospital of Majadahonda, Majadahonda, Madrid, Spain;

关键词: SARS-CoV-2;    Coronavirus;    COVID-19;    Pregnancy;    Premature birth;    Premature rupture of membranes;    Intensive care units, neonatal;   

DOI  :  10.1186/s12884-021-03742-4

来源: Springer

【 摘 要 】

BackgroundTo 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.MethodsWe 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. Main outcome measures: Preterm delivery (primary), premature rupture of membranes and neonatal intensive care unit admissions.ResultsAmong 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.ConclusionThis 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.

【 授权许可】

CC BY