1. Pregnancy and neonatal outcomes of COVID-19: The PAN-COVID study
- Author
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E. Mullins, A. Perry, J. Banerjee, J. Townson, D. Grozeva, R. Milton, N. Kirby, R. Playle, T. Bourne, C. Lees, Abby Rand, Aethele Khunda, Aleš Roztočil, Alexandra J Kermack, Ami Mackay, Amit Verma, Amna Ahmed, Amy Mahdi, Anam Fayadh, Andrea Dall'Asta, Andrea Harrington, Angeliki Gerede, Avideah Nejad, Barkha Sinha, Beth Peers, Bev Hammond, Bini Ajay, Caroline Dixon, Caroline Everden, Carrie Heal, Catherine Bressington, Cheryl Wyatt, Chris Flood, Christine Möller-Christensen, Clare O'Brien, Coralie Glenn-Sansum, Coralie Huson, Dimitrios Rallis, Donna Perkins, Donna Southam, Donna Wixted, Alexandra Viner, Anila Asghar, Antony Nicoll, Caroline Knight, Gillian McKeown, Hema Divakar, Plastiras Panagiotis Christofidis, Prakash Satodia, Rachel Liebling, Rita Arya, Rukhsana Kousar, Ruta Gada, Sankara Narayanan, Stamatina Iliodromiti, Vibha Giri, Vimal Vasu, Wassim Hassan, Zoe Woodward, E. Mutema, Eleanor MK Jarvie, Elena Romero, Emma Collins, Emma Meadows, Emma Mills, Emma Tanton, Enxhi Vrapi, Ernawati Darmawan, Fabio Barra, Federico Prefumo, Fidelma Lee, Hayley L. Martin, Helen Gbinigie, Helen Millward, Hilary Owen, Isobel Crawford, Jacqueline Tipper, Jacqui Jennings, Jamie-Louise Raven, Jane Cantliffe, Jane Radford, Janet Cresswell, Jennifer Syson, Jessie Brain, Joanna Mead, Jude Mossop, Julie Goddard, Julie Grindey, Karen Cloherty, Karen Watkins, Kate Robinson, Katie Barker, Kerry Elliott, Kim Hinshaw, Kirsty Revell, Laura Camarasa, Laura Harris, Laurie Windsor, Leanne Sherris, Lianne Chapman, Linda Bishop, Liona Chiu Yee POON, Lisa Frankland, Liz Glyn-Jones, Louise Emmet, Louise Swaminathan, M.I Aldika Akbar, Maggie Armstrong, Mahalakshmi Gorti, Mairead Black, Mani Malarselvi, Manjiri Khare, Mark Chester, Martina Andrasova, Maryanne Bray, Mauro Parra-Cordero, MD Roland Berger, Michelle Anderson, Millicent Anim-Somuah, Mingxing XIE, Miriam Bourke, Mohamed Elbahnasawy, Mohamed Sobhy Bakry, Ahmar Shah, BA RATHER, David Churchill, Ling Wee, Salman Kidwai, Trevor Balling, Allison Amin, Sandra Essien, Ms Sameena Kausar, Ms.Jyothi Rajeswary, Muglu Javaid, Narendra Aladangady, Neil Shah, Nichola Bale, Nicky Mason, Pensée Wu, Lavinia Margarit, Rabia Zill-e-Huma, Rachel Newport, Robin Hughes, Roobin Jokhi, Roshni Mansfield, Ru Davies, Ruth Davies, Sam Ratcliffe, Sandra Greer, Sarah Coxon, Sarah Ekladios, Sarah Stables, Shanteela McCooty, Sharon Gowans, Sharon Jones, Shazia Jaleel, Shelly Higgins, Sherry Halawa, Siân C Harrington, Sophie Robinson, Soum Nallapeta, Stephanie Grigsby, Susara Blunden, SSA Tiziana Frusca, Veerareddy Sukrutha, Vicki Atkinson, Victoria Murtha, Waldo Germán Caro, Zoe Garner, and Medical Research Council (MRC)
- Subjects
SARS-CoV-2 ,Fetal growth restriction ,Infant, Newborn ,Pregnancy Outcome ,COVID-19 ,Infant ,Obstetrics and Gynecology ,Perinatal ,Stillbirth ,Fetal ,Pre-Eclampsia ,Reproductive Medicine ,Pregnancy ,Neonatal ,Humans ,Premature Birth ,1114 Paediatrics and Reproductive Medicine ,Eclampsia ,Female ,Prospective Studies ,Pregnancy Complications, Infectious ,Infection ,Obstetrics & Reproductive Medicine ,PAN-COVID Investigators ,COVID - Abstract
OBJECTIVE: To assess perinatal outcomes for pregnancies affected by suspected or confirmed SARS-CoV-2 infection. METHODS: Prospective, web-based registry. Pregnant women were invited to participate if they had suspected or confirmed SARS-CoV-2 infection between 1st January 2020 and 31st March 2021 to assess the impact of infection on maternal and perinatal outcomes including miscarriage, stillbirth, fetal growth restriction, pre-term birth and transmission to the infant. RESULTS: Between April 2020 and March 2021, the study recruited 8239 participants who had suspected or confirmed SARs-CoV-2 infection episodes in pregnancy between January 2020 and March 2021. Maternal death affected 14/8197 (0.2%) participants, 176/8187 (2.2%) of participants required ventilatory support. Pre-eclampsia affected 389/8189 (4.8%) participants, eclampsia was reported in 40/ 8024 (0.5%) of all participants. Stillbirth affected 35/8187 (0.4 %) participants. In participants delivering within 2 weeks of delivery 21/2686 (0.8 %) were affected by stillbirth compared with 8/4596 (0.2 %) delivering ≥ 2 weeks after infection (95 % CI 0.3-1.0). SGA affected 744/7696 (9.3 %) of livebirths, FGR affected 360/8175 (4.4 %) of all pregnancies. Pre-term birth occurred in 922/8066 (11.5%), the majority of these were indicated pre-term births, 220/7987 (2.8%) participants experienced spontaneous pre-term births. Early neonatal deaths affected 11/8050 livebirths. Of all neonates, 80/7993 (1.0%) tested positive for SARS-CoV-2. CONCLUSIONS: Infection was associated with indicated pre-term birth, most commonly for fetal compromise. The overall proportions of women affected by SGA and FGR were not higher than expected, however there was the proportion affected by stillbirth in participants delivering within 2 weeks of infection was significantly higher than those delivering ≥ 2 weeks after infection. We suggest that clinicians' threshold for delivery should be low if there are concerns with fetal movements or fetal heart rate monitoring in the time around infection. The proportion affected by pre-eclampsia amongst participants was not higher than would be expected, although we report a higher than expected proportion affected by eclampsia. There appears to be no effect on birthweight or congenital malformations in women affected by SARS-CoV-2 infection in pregnancy and neonatal infection is uncommon. This study reflects a population with a range of infection severity for SARS-COV-2 in pregnancy, generalisable to whole obstetric populations.
- Published
- 2022