Abstract

Background

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.

Methods

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

Results

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.

Conclusion

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.

Details

Title
The association between SARS-CoV-2 infection and preterm delivery: a prospective study with a multivariable analysis
Author
Martinez-Perez, Oscar  VIAFID ORCID Logo  ; Pilar Prats Rodriguez; Hernandez, Marta Muner; Maria Begoña Encinas Pardilla; Noelia Perez Perez; Rosa Vila Hernandez, Maria; Ana Villalba Yarza; Olga Nieto Velasco; Pablo Guillermo Del Barrio Fernandez; Acebal, Laura Forcen; Carmen Maria Orizales Lago; Alicia Martinez Varea; Begoña Muñoz Abellana; Maria Suarez Arana; Laura Fuentes Ricoy; Clara Martinez Diago; Maria Jesus Janeiro Freire; Alvarez-Mallo, Macarena Alférez; Cristina Casanova Pedraz; Onofre Alomar Mateu; Cristina Lesmes Heredia; Juan Carlos Wizner de Alva; Rut Bernardo Vega; Montserrat Macia Badia; Cristina Alvarez Colomo; Antonio Sanchez Muñoz; Alicart, Laia Pratcorona; Ruben Alonso Saiz; Monica Lopez Rodriguez; Maria del Carmen Barbancho Lopez; Marta Ruth Meca Casbas; Oscar Vaquerizo Ruiz; Eva Moran Antolin; Nuñez Valera, Maria Jose; Camino Fernandez Fernandez; Albert Tubau Navarra; Cano Garcia, Alejandra Maria; Carmen Baena Luque; Susana Soldevilla Perez; Abasolo, Irene Gastaca; Jose Adanez Garcia; Maria Teulon Gonzalez; Alberto Puertas Prieto; Rosa Ostos Serna; Maria del Pilar Guadix Martin; Coello, Monica Catalina; Perez, Elena Ferriols; Africa Caño Aguilar; Maria Luisa De la Cruz Conty; Sainz Bueno, Jose Antonio; Spanish Obstetric Emergency Group
Pages
1-11
Section
Research article
Publication year
2021
Publication date
2021
Publisher
Springer Nature B.V.
e-ISSN
14712393
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1186/s12884-021-03742-4
ProQuest document ID
2514810301
Copyright
© 2021. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.