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1. Maternal outcomes and risk factors for COVID-19 severity among pregnant women

Author

Manon Vouga, Guillaume Favre, Oscar Martinez-Perez, Leo Pomar, Laura Forcen Acebal, Alejandra Abascal-Saiz, Maria Rosa Vila Hernandez, Najeh Hcini, Véronique Lambert, Gabriel Carles, Joanna Sichitiu, Laurent Salomon, Julien Stirnemann, Yves Ville, Begoña Martinez de Tejada, Anna Goncé, Ameth Hawkins-Villarreal, Karen Castillo, Eduard Gratacos Solsona, Lucas Trigo, Brian Cleary, Michael Geary, Helena Bartels, Feras Al-Kharouf, Fergal Malone, Mary Higgins, Niamh Keating, Susan Knowles, Christophe Poncelet, Carolina Carvalho Ribeiro-do-Valle, Fernanda Surita, Amanda Dantas-Silva, Carolina Borrelli, Adriana Gomes Luz, Javiera Fuenzalida, Jorge Carvajal, Manuel Guerra Canales, Olivia Hernandez, Olga Grechukhina, Albert I. Ko, Uma Reddy, Rita Figueiredo, Marina Moucho, Pedro Viana Pinto, Carmen De Luca, Marco De Santis, Diogo Ayres de Campos, Inês Martins, Charles Garabedian, Damien Subtil, Betania Bohrer, Maria Lucia Da Rocha Oppermann, Maria Celeste Osorio Wender, Lavinia Schuler-Faccini, Maria Teresa Vieira Sanseverino, Camila Giugliani, Luciana Friedrich, Mariana Horn Scherer, Nicolas Mottet, Guillaume Ducarme, Helene Pelerin, Chloe Moreau, Bénédicte Breton, Thibaud Quibel, Patrick Rozenberg, Eric Giannoni, Cristina Granado, Cécile Monod, Doris Mueller, Irene Hoesli, Dirk Bassler, Sandra Heldstab, Nicole Ochsenbein Kölble, Loïc Sentilhes, Melissa Charvet, Jan Deprest, Jute Richter, Lennart Van der Veeken, Béatrice Eggel-Hort, Gaetan Plantefeve, Mohamed Derouich, Albaro José Nieto Calvache, Maria Camila Lopez-Giron, Juan Manuel Burgos-Luna, Maria Fernanda Escobar-Vidarte, Kurt Hecher, Ann-Christin Tallarek, Eran Hadar, Karina Krajden Haratz, Uri Amikam, Gustavo Malinger, Ron Maymon, Yariv Yogev, Leonhard Schäffer, Arnaud Toussaint, Marie-Claude Rossier, Renato Augusto Moreira De Sa, 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 Andrea Heldstab, Monya Todesco Bernasconi, Gaston Grant, Anis Feki, Anne-Claude Muller Brochut, Marylene Giral, Lucie Sedille, Andrea Papadia, Romina Capoccia Brugger, Brigitte Weber, Tina Fischer, Christian Kahlert, Karin Nielsen Saines, Mary Cambou, Panagiotis Kanellos, Xiang Chen, Mingzhu Yin, Annina Haessig, Sandrine Ackermann, David Baud, and Alice Panchaud

Subjects
Medicine, Science
Abstract

Abstract Pregnant women may be at higher risk of severe complications associated with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which may lead to obstetrical complications. We performed a case control study comparing pregnant women with severe coronavirus disease 19 (cases) to pregnant women with a milder form (controls) enrolled in the COVI-Preg international registry cohort between March 24 and July 26, 2020. Risk factors for severity, obstetrical and immediate neonatal outcomes were assessed. A total of 926 pregnant women with a positive test for SARS-CoV-2 were included, among which 92 (9.9%) presented with 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 caesarean section [70.7% (n = 53/75)], preterm delivery [62.7% (n = 32/51)] and newborns requiring admission to the neonatal intensive care unit [41.3% (n = 31/75)]. In this study, several risk factors for developing severe complications of SARS-CoV-2 infection among pregnant women were identified including pulmonary comorbidities, hypertensive disorders and diabetes. Obstetrical and neonatal outcomes appear to be influenced by the severity of maternal disease.

Published
2021
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2. Maternal and perinatal outcomes following pre-Delta, Delta, and Omicron SARS-CoV-2 variants infection among unvaccinated pregnant women in France and Switzerland: a prospective cohort study using the COVI-PREG registry

Author

Guillaume Favre, Emeline Maisonneuve, Léo Pomar, Charlotte Daire, Christophe Poncelet, Thibaud Quibel, Cécile Monod, Begoña Martinez de Tejada, Leonhard Schäffer, Andrea Papadia, Anda Petronela Radan, Monya Todesco-Bernasconi, Yves Ville, Cora Alexandra Voekt, Béatrice Eggel-Hort, Romina Capoccia-Brugger, Silke Johann, Claudia Grawe, Sophie Defert, Nicolas Mottet, Christian R. Kahlert, Charles Garabedian, Loïc Sentilhes, Brigitte Weber, Steffi Leu, Dirk Bassler, Karine Lepigeon, Ursula Winterfeld, Alice Panchaud, David Baud, Irene Hoesli, Sonia Campelo, Véronique Othenin-Girard, Anett Hernadi, Maria Luisa Gasparri, Antonilli Morena, Christian Polli, Edoardo Taddei, Karoline Aebi-Popp, Luigi Raio, Daniel Surbek, Mirjam Moser, Laurent Salomon, Johana Sichitiu, Julien Stirnemann, Jérôme Dimet, Tina Fischer, Louise Ghesquiere, Amaury Brot, Clémence Houssin, Aurélien Mattuizzi, Stefanie Sturm, Caroline Eggemann, Edouard Ha, Jérôme Mathis, Marie-Claude Rossier, Andrea Bloch, Martin Kaufmann, Carina Britschgi, Panagiotis Kanellos, Bénédicte Breton, Carolin Blume, Stylianos Kalimeris, Arnaud Toussaint, Guillaume Ducarme, Chloé Moreau, Hélène Pelerin, Mohamed Derouich, Cecile Le Parco, Gaetan Plantefeve, Anis Feki, Gaston Grant, Kathrin Bütikofer, Ina Hoffmann, Jessica Maisel, Elke Barbara Prentl, Brigitte Frey Tirri, Grit Vetter, Lucie Sedille, Michel Boulvain, Annina Haessig, French and Swiss COVI-PREG group, Hoesli, I., Campelo, S., Othenin-Girard, V., Hernadi, A., Gasparri, M.L., Morena, A., Polli, C., Taddei, E., Aebi-Popp, K., Raio, L., Surbek, D., Moser, M., Salomon, L., Sichitiu, J., Stirnemann, J., Dimet, J., Fischer, T., Ghesquiere, L., Brot, A., Houssin, C., Mattuizzi, A., Sturm, S., Eggemann, C., Ha, E., Mathis, J., Rossier, M.C., Bloch, A., Kaufmann, M., Britschgi, C., Kanellos, P., Breton, B., Blume, C., Kalimeris, S., Toussaint, A., Ducarme, G., Moreau, C., Pelerin, H., Derouich, M., Le Parco, C., Plantefeve, G., Feki, A., Grant, G., Bütikofer, K., Hoffmann, I., Maisel, J., Prentl, E.B., Tirri, B.F., Vetter, G., Sedille, L., Boulvain, M., and Haessig, A.

Subjects
Oncology, 360 Social problems & social services, Health Policy, Internal Medicine, COVID-19, Omicron, Pregnancy, Pregnant women, SARS-CoV-2, Variant, 610 Medicine & health
Abstract

BACKGROUND SARS-CoV-2 positive pregnant women are at higher risk of adverse outcomes, but little evidence is available on how variants impact that risk. We aim to evaluate maternal and perinatal outcomes among unvaccinated pregnant women that tested positive for SARS-CoV-2, stratified by pre-Delta, Delta, and Omicron periods. METHODS This prospective study enrolled women from March 2020 to September 2022. Exposure to the different SARS-CoV-2 variants was defined by their periods of predominance. The primary outcome was severe maternal adverse outcome defined as either intensive care unit admission, acute respiratory distress syndrome, advanced oxygen supplementation, or maternal death. The secondary outcomes were preterm birth and other perinatal outcomes. FINDINGS Overall, 1402, 262, and 391 SARS-CoV-2 positive pregnant women were enrolled during the pre-Delta, Delta, and Omicron periods respectively. Severe maternal adverse outcome was reported in 3.4% (n = 947/1402; 95% confidence intervals (95%CI) 2.5-4.5), 6.5% (n = 7/262; 95%CI 3.8-10.2), and 1.0% (n = 4/391; 95%CI 0.3-2.6) of women during the pre-Delta, Delta, and Omicron periods. The risk of severe maternal adverse outcome was higher during the Delta vs pre-Delta period (adjusted risk ratio (aRR) = 1.8; 95%CI 1.1-3.2) and lower during the Omicron vs pre-Delta period (aRR = 0.3; 95%CI, 0.1-0.8). The risks of hospitalization for COVID-19 were 12.6% (n = 176/1402; 95%CI 10.9-14.4), 17.2% (n = 45/262; 95%CI 12.8-22.3), and 12.5% (n = 49/391; 95%CI 9.4-16.2), during the pre-Delta, Delta, and Omicron period, respectively. Pregnancy complications occurred after SARS-CoV-2 exposure in 30.0% (n = 363/1212; 95%CI 27.4-32.6), 35.2% (n = 83/236; 95%CI 29.1-41.6), and 30.3% (n = 105/347; 95%CI 25.5-35.4) of patients during the pre-Delta, Delta, and Omicron periods, respectively. Stillbirths were reported in 0.5% (n = 6/1159; 95%CI 0.2-1.1), 2.8% (n = 6/210; 95%CI 1.0-6.0), and 0.9% (n = 2/213; 95%CI 0.1-3.4) or patients during the pre-Delta, Delta, and Omicron periods respectively. INTERPRETATION The Delta period was associated with a higher risk of severe maternal adverse outcome and the Omicron period with a lower risk of severe adverse outcome compared to pre-Delta era. The reported risk of hospitalization was high during the Omicron period and should not be trivialized. FUNDING Swiss Federal Office of Public Health, Fondation CHUV.

Published
2023

3. Maternal outcomes and risk factors for COVID-19 severity among pregnant women

Author

Andrea Papadia, Marco De Santis, Brian Cleary, Feras Al-Kharouf, Irene Hoesli, Kurt Hecher, Javiera Fuenzalida, Sandrine Ackermann, Guillaume Favre, Anis Feki, Lucie Sedille, Ameth Hawkins-Villarreal, Lavinia Schuler-Faccini, Chloe Moreau, Carmen De Luca, David Baud, Eduard Gratacos Solsona, Fernanda Garanhani Surita, Andrea Bloch, Silke Johann, Begoña Martinez de Tejada, Karen Castillo, Uri Amikam, Claudia Grawe, Mariana Horn Scherer, Uma M. Reddy, Adriana Gomes Luz, Véronique Lambert, Ron Maymon, Olga Grechukhina, Betania Bohrer, Anda-Petronela Radan, Alejandra Abascal-Saiz, Karin Nielsen Saines, Marie-Claude Rossier, Najeh Hcini, Sandra A. Heldstab, Oscar Martinez-Perez, Martin Kaufmann, Renato Augusto Moreira de sa, Pedro Viana Pinto, Jorge A Carvajal, Cristina Granado, Helena Bartels, Jute Richter, Yves Ville, Inês S. Martins, Melissa Charvet, Mohamed Derouich, Sandra Andrea Heldstab, Anne-Claude Muller Brochut, Gustavo Malinger, Albert I. Ko, Karoline Aebi-Popp, Gabriel Carles, Julien Stirnemann, Carolina Borrelli, Manon Vouga, Guillaume Ducarme, Marylene Giral, Michel Boulvain, Jan Deprest, Mary Catherine Cambou, Maria Celeste Osório Wender, Mingzhu Yin, Susan Knowles, María Fernanda Escobar-Vidarte, Annina Haessig, Xiang Chen, Carolina C. Ribeiro-do-Valle, Gaston Grant, Albaro José Nieto Calvache, Maria Lúcia Rocha Oppermann, Manuel Guerra Canales, Anna Goncé, Monya Todesco Bernasconi, Brigitte Strizek, Tina Fischer, Loïc Sentilhes, Alice Panchaud, Maria Camila Lopez-Giron, Gaetan Plantefeve, Cécile Monod, Laura Forcen Acebal, Marina Moucho, Juan Manuel Burgos-Luna, Brigitte Weber, Charles Garabedian, Amanda Dantas-Silva, Thibaud Quibel, Camila Giugliani, Fergal D. Malone, Patrick Rozenberg, Eran Hadar, Diogo Ayres de Campos, Paul Böckenhoff, Mary Higgins, Rita Figueiredo, Karina Krajden Haratz, Olivia Hernandez, Lennart Van der Veeken, Luigi Raio, N. Kölble, Christian R Kahlert, Arnaud Toussaint, Maria Rosa Vila Hernandez, Luciana Friedrich, Dirk Bassler, Damien Subtil, Béatrice Eggel-Hort, Eric Giannoni, Ann-Christin Tallarek, Joanna Sichitiu, Nicolas Mottet, Panagiotis Kanellos, Bénédicte Breton, Leonhard Schäffer, Léo Pomar, Maria Teresa Vieira Sanseverino, Niamh Keating, Daniel Surbek, Romina Capoccia Brugger, Laurent Salomon, Michael Geary, Christophe Poncelet, Doris Mueller, Helene Pelerin, Yariv Yogev, and Lucas Trigo

Subjects
Adult, Reproductive signs and symptoms, medicine.medical_specialty, Neonatal intensive care unit, Science, medicine.medical_treatment, 610 Medicine & health, Disease, macromolecular substances, 01 natural sciences, Article, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, 360 Social problems & social services, Respiratory signs and symptoms, Diabetes mellitus, Humans, Medicine, Caesarean section, 030212 general & internal medicine, Pregnancy Complications, Infectious, 0101 mathematics, Clinical microbiology, Multidisciplinary, SARS-CoV-2, business.industry, Obstetrics, 010102 general mathematics, Pregnancy Outcome, Case-control study, COVID-19, medicine.disease, Risk factors, Viral infection, Premature birth, Case-Control Studies, Cohort, Premature Birth, Female, Pregnant Women, Infection, business
Abstract

Pregnant women may be at higher risk of severe complications associated with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which may lead to obstetrical complications. We performed a case control study comparing pregnant women with severe coronavirus disease 19 (cases) to pregnant women with a milder form (controls) enrolled in the COVI-Preg international registry cohort between March 24 and July 26, 2020. Risk factors for severity, obstetrical and immediate neonatal outcomes were assessed. A total of 926 pregnant women with a positive test for SARS-CoV-2 were included, among which 92 (9.9%) presented with 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 caesarean section [70.7% (n = 53/75)], preterm delivery [62.7% (n = 32/51)] and newborns requiring admission to the neonatal intensive care unit [41.3% (n = 31/75)]. In this study, several risk factors for developing severe complications of SARS-CoV-2 infection among pregnant women were identified including pulmonary comorbidities, hypertensive disorders and diabetes. Obstetrical and neonatal outcomes appear to be influenced by the severity of maternal disease. ispartof: SCIENTIFIC REPORTS vol:11 issue:1 ispartof: location:England status: published

Published
2021

4. Maternal and Obstetrical Outcomes in a Cohort of Pregnant Women Tested for SARS-CoV-2: Interim Results of the COVI-Preg International Registry

Author

Javiera Fuenzalida, Mary Catherine Cambou, Sanseverino Mtv, Lucie Sedille, Abascal A, Feras Al-Kharouf, Ann-Christin Tallarek, Jute Richter, Guillaume Ducarme, Joanna Sichitiu, Anis Feki, Mingzhu Yin, Léo Pomar, Bénédicte Breton, Amanda Dantas-Silva, Luigi Raio, Carolina Borrelli, Dirk Bassler, Tina Fischer, Anna Goncé, Christian R Kahlert, Maria Camila Lopez-Giron, Stiremann J, Veeken LVd, Gaetan Plantefeve, Romina Capoccia Brugger, Claudia Grawe, Garanhani Surita, Mariana Horn Scherer, Arnaud Toussaint, Leonhard Schäffer, Karin Nielsen Saines, Niamh Keating, Karoline Aebi-Popp, Pedro Viana Pinto, Guillaume Favre, Daniel Surbek, Helena Bartels, Manuel Guerra Canales, Christophe Poncelet, Luciana Friedrich, Marie-Claude Rossier, Nicolas Mottet, Melissa Charvet, Anda-Petronela Radan, Najeh Hcini, Marina Moucho, Marylene Giral, Mohamed Derouich, Yves Ville, Oppermann Mldr, Ribeiro-do-Valle F, Andrea Bloch, Laura Forcen Acebal, Brigitte Weber, Fergal D. Malone, Adriana Gomes Luz, Celeste M, Silke Johann, Cristina Granado, David Baud, X. Chen, Hernandez Mrv, Eduard Gratacos Solsona, Karina Krajden Haratz, Manon Vouga, Kurt Hecher, Brigitte Strizek, Karen Castillo, Perez Om, Sandra A. Heldstab, Thibaud Quibel, Lambert, Paul Böckenhoff, Tejada BMd, Laurent Salomon, Michael Geary, Doris Mueller, Helene Pelerin, Lucas Trigo, Betania Bohrer, Gustavo Malinger, Gaston Grant, Loïc Sentilhes, Cécile Monod, sa RAMd, Charles Garabedian, Yariv Yogev, Béatrice Eggel-Hort, Panagiotis Kanellos, Damien Subtil, Martin Kaufmann, Wender O, Albert I. Ko, Brian Cleary, Irene Hoesli, Uma M. Reddy, Anne-Claude Muller Brochut, Susan Knowles, Jan Deprest, Calvache Ajn, Andrea Papadia, Rita Figueiredo, Santis, Carolina Prado de França Carvalho, Campos DAd, Monya Todesco Bernasconi, Lavinia Schuler-Faccini, Eran Hadar, Olivia Hernandez, María Fernanda Escobar-Vidarte, Annina Haessig, Gabriel Carles, Patrick Rozenberg, Hawkins-Villareal A, Alice Panchaud, N. Kölble, Juan Manuel Burgos-Luna, Camila Giugliani, Ron Maymon, Olga Grechukhina, Mary Higgins, Chloe Moreau, Carmen De Luca, and Michel Boulvain

Subjects
Pregnancy, medicine.medical_specialty, Fetus, Neonatal intensive care unit, business.industry, Obstetrics, medicine.disease, Diabetes mellitus, Cohort, Pandemic, Medicine, Gestation, Maternal death, business
Abstract

Background: Pregnant women represent a vulnerable population at higher risk of complications of infectious diseases. Data regarding the consequences of the emerging pandemic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during pregnancy are scarce. Recent evidence suggests that pregnant women might be at higher risk of severe disease, while exposed fetuses and newborns could suffer from preterm birth, growth restriction and neonatal infections. Methods: We developed an international web registry to allow structured data collection. Pregnant women at any stage during gestation tested for SARS-CoV-2 infection were enrolled. Maternal, obstetrical and neonatal outcomes were recorded. Findings: 1033 pregnant women tested for SARS-CoV-2 were included, among which 926 tested positive and 107 tested negative. Positive pregnant women were at higher risk of severe maternal outcomes compared to negative women [aRR 5.6, 95% CI 1.4-22.7]. Risk factors for severe maternal outcomes among positive women 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]. No difference in term of obstetrical and neonatal outcomes were observed between positive and negative women. Positive 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)]. A positive neonatal SARS-CoV-2 test was observed in 2.9% (n=11/384) of newborns with an available test at birth. Interpretation: Pregnant women, particularly those with associated comorbidities, seem to be at higher risk of severe complications of SARS-CoV-2 infection. Preliminary data regarding obstetrical and neonatal outcomes among women with a mild disease are reassuring. Funding Statement: None. Declaration of Interests: The authors declare that we 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.

Published
2020

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

Author

Renato Augusto Moreira de sa, Nicolas Mottet, Andrea Bloch, Silke Johann, Alejandra Abascal, Javiera Fuenzalida, Manuel Guerra Canales, Mary Catherine Cambou, Betania Bohrer, David Baud, Eduard Gratacos Solsona, Mary Higgins, Karen Castillo, Martin Kaufmann, Lucie Sedille, Claudia Grawe, Garanhani Surita, Mariana Horn Scherer, Adriana Gomes Luz, Véronique Lambert, Olga Grechukhina, Fergal D. Malone, Karin Nielsen Saines, Helena Bartels, Melissa Charvet, Marylene Giral, Gustavo Malinger, Cristina Granado, Ann-Christin Tallarek, Joanna Sichitiu, Carolina Prado de França Carvalho, Léo Pomar, Oscar Martinez Perez, Albert I. Ko, Bénédicte Breton, Feras Al-Kharouf, Karoline Aebi-Popp, Kurt Hecher, Jorge A Carvajal, Maria Celeste, Xiang Chen, Marina Moucho, Manon Vouga, Lavinia Schuler-Faccini, Gaston Grant, Anna Goncé, Maria Camila Lopez-Giron, Carolina Borrelli, Romina Capoccia Brugger, Maria Lúcia Rocha Oppermann, Loïc Sentilhes, Uma M. Reddy, Sandra Andrea Heldstab, Béatrice Eggel-Hort, Cécile Monod, Brian Cleary, Gabriel Carles, Michel Boulvain, Leonhard Schäffer, Anis Feki, Susan Knowles, Anne-Claude Muller Brochut, Charles Garabedian, Luigi Raio, Maria Teresa Vieira Sanseverino, Niamh Keating, Lucas Trigo, Jute Richter, Patrick Rozenberg, Annina Haessig, Jan Deprest, Christian R Kahlert, Daniel Surbek, Diogo Ayres de Campos, Dirk Bassler, N. Kölble, Lennart Van der Veeken, Arnaud Toussaint, Monya Todesco Bernasconi, Damien Subtil, Laurent Salomon, Michael Geary, Juan Manuel Burgos-Luna, Ameth Hawkins-Villareal, Sandra A. Heldstab, Irene Hoesli, Eran Hadar, Begoña Martinez de Tejada, Guillaume Favre, Doris Mueller, Olivia Hernandez, Marie-Claude Rossier, Rita Figueiredo, Najeh Hcini, Helene Pelerin, Ron Maymon, Yves Ville, Julien Stiremann, Guillaume Ducarme, Mingzhu Yin, Andrea Papadia, Osorio Wender, Yariv Yogev, Thibaud Quibel, Gaetan Plantefeve, Amanda Dantas-Silva, Marco De Santis, Maria Rosa Vila Hernandez, Pedro Viana Pinto, Luciana Friedrich, Paul Böckenhoff, Mohamed Derouich, Brigitte Strizek, Christophe Poncelet, Panagiotis Kanellos, Tina Fischer, Anda-Petronela Radan, Laura Forcen Acebal, Brigitte Weber, Karina Krajden Haratz, Fernanda Ribeiro-do-Valle, Chloe Moreau, Carmen De Luca, María Fernanda Escobar-Vidarte, Albaro José Nieto Calvache, Alice Panchaud, and Camila Giugliani

Subjects
Pregnancy, medicine.medical_specialty, Neonatal intensive care unit, Obstetrics, business.industry, Case-control study, Specific risk, Disease, medicine.disease, Intensive care unit, law.invention, law, Diabetes mellitus, Cohort, medicine, business
Abstract

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.

Published
2020

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