Timing and severity of COVID-19 during pregnancy and risk of preterm birth in the International Registry of Coronavirus Exposure in Pregnancy

BMC Pregnancy and Childbirth, Journal Year: 2022, Volume and Issue: 22(1)

Published: Oct. 18, 2022

Studies of preterm delivery after COVID-19 are often subject to selection bias and do not distinguish between early vs. late infection in pregnancy, nor spontaneous medically indicated delivery. This study aimed estimate the risk birth (overall, spontaneous, indicated) during while considering different levels disease severity timing.Pregnant recently pregnant people who were tested for or clinically diagnosed with pregnancy enrolled an international internet-based cohort June 2020 July 2021. We used several analytic approaches minimize confounding immortal time bias, including multivariable regression, time-to-delivery models, a case-time-control design.Among 14,264 eligible participants from 70 countries did report loss before 20 gestational weeks, 5893 had completed their pregnancies reported information; others censored at last follow-up. Participants symptomatic weeks' gestation no increased compared those testing negative, adjusted risks 10.0% (95% CI 7.8, 12.0) 9.8% (9.1, 10.5). Mild later was clearly associated In contrast, severe led increase milder disease. For example, ratio comparing mild/moderate 35 weeks 2.8 (2.0, 4.0); corresponding ratios 3.7 7.0) 2.3 (1.2, 3.9), respectively.Severe sharply COVID-19. elevated primarily due deliveries, included cesarean sections, although also observed. mild moderate conferred minimal risk, as pregnancy.

Language: Английский

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Adverse Perinatal Outcomes in COVID-19 Infected Pregnant Women: A Systematic Review and Meta-Analysis

Healthcare, Journal Year: 2022, Volume and Issue: 10(2), P. 203 - 203

Published: Jan. 20, 2022

The impact of COVID-19 virus infection during pregnancy is still unclear. This systematic review and meta-analysis aimed to quantitatively pool the evidence on perinatal outcomes. Databases Medline, Embase, Cochrane library were searched using keywords related outcomes from December 2019 30 June 2021. Observational studies comparing in with a non-infected comparator included. screening process quality assessment included performed independently by two reviewers. Meta-analyses used comparative dichotomous data database search yielded 4049 results, 1254 which duplicates. We total 21 observational that assessed adverse infection. odds maternal death (pooled OR: 7.05 [2.41−20.65]), preeclampsia 1.39 [1.29−1.50]), cesarean delivery 1.67 [1.29−2.15]), fetal distress 1.66 [1.35−2.05]), preterm birth 1.86 [1.34−2.58]), low weight 1.69 [1.35−2.11]), stillbirth 1.46 [1.16−1.85]), 5th minute Apgar score less than 7 1.44 [1.11−1.86]) admissions neonatal intensive care unit 2.12 [1.36−3.32]) higher among infected pregnant women compared women.

Language: Английский

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Effect of COVID-19 vaccination and booster on maternal–fetal outcomes: a retrospective cohort study

The Lancet Digital Health, Journal Year: 2023, Volume and Issue: 5(9), P. e594 - e606

Published: Aug. 1, 2023

COVID-19 in pregnant people increases the risk for poor maternal-fetal outcomes. However, vaccination hesitancy remains due to concerns over vaccine's potential effects on Here we examine impact of and boosters maternal SARS-CoV-2 infections birth

Language: Английский

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Maternal and Newborn Hospital Outcomes of Perinatal SARS-CoV-2 Infection: A National Registry

PEDIATRICS, Journal Year: 2023, Volume and Issue: 151(2)

Published: Jan. 4, 2023

OBJECTIVES The American Academy of Pediatrics National Registry for the Surveillance and Epidemiology Perinatal coronavirus disease 2019 (COVID-19) (NPC-19) was developed to provide information on effects perinatal severe acute respiratory syndrome 2 (SARS-CoV-2) infection. METHODS COVID-19 participating centers entered maternal newborn data pregnant persons who tested positive SARS-CoV-2 infection between 14 days before 10 after delivery. Incidence morbidities associated with were assessed. RESULTS From April 6, 2020 March 19, 2021, 242 in United States reported 7524 persons; at time delivery, 78.1% these asymptomatic, 18.2% symptomatic but not hospitalized specifically COVID-19, 3.4% treatment, 18 (0.2%) died hospital COVID-related complications. Among 7648 newborns, 6486 (84.8%) SARS-CoV-2, 144 (2.2%) positive; highest rate observed when mothers first immediate postpartum period (17 125, 13.6%). No deaths attributable Overall, 15.6% newborns preterm: among 30.1% polymerase chain reaction-positive 16.2% reaction-negative born preterm (P < .001). Need mechanical ventilation did differ by test result, those tests more likely be admitted a NICU. CONCLUSIONS Early pandemic, acquired variable rates without apparent short-term effects. During that preceded widespread availability vaccines, we higher than expected numbers births in-hospital deaths.

Language: Английский

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COVID-19 Vaccination in the First Trimester and Major Structural Birth Defects Among Live Births

JAMA Pediatrics, Journal Year: 2024, Volume and Issue: 178(8), P. 823 - 823

Published: Aug. 1, 2024

Importance COVID-19 vaccination is recommended throughout pregnancy to prevent complications and adverse birth outcomes associated with disease. To date, data on defects after first-trimester are limited. Objective evaluate the risks for selected major structural among live-born infants receipt of a messenger RNA (mRNA) vaccine. Design, Setting, Participants This was retrospective cohort study singleton pregnancies estimated last menstrual period (LMP) between September 13, 2020, April 3, 2021, ending in live from March 5, January 25, 2022. Included were 8 health systems California, Oregon, Washington, Colorado, Minnesota, Wisconsin Vaccine Safety Datalink. Exposures Receipt 1 or 2 mRNA vaccine doses first trimester, as part primary series. Main Outcomes Measures Selected infants, identified electronic using validated algorithms, neural tube confirmed via medical record review. Results Among 42 156 eligible (mean [SD] maternal age, 30.9 [5.0] years) 7632 (18.1%) received an trimester. Of 34 524 without vaccination, 2045 (5.9%) vaccinated before pregnancy, 13 494 (39.1%) during second third 18 985 (55.0%) unvaccinated pregnancy. Compared pregnant people those trimester older 32.3 [4.5] years vs 30.6 [5.1] differed by LMP date. After applying stabilized inverse probability weighting, differences baseline characteristics persons negligible (standardized mean difference <0.20). occurred 113 (1.48%) 488 (1.41%) exposure; adjusted prevalence ratio 1.02 (95% CI, 0.78-1.33). In secondary analyses, defect grouped organ system, no significant identified. Conclusions Relevance this multisite study, exposure not increased risk defects.

Language: Английский

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Overview of U.S. COVID-19 vaccine safety surveillance systems

Vaccine, Journal Year: 2024, Volume and Issue: 42, P. 125748 - 125748

Published: April 16, 2024

The U.S. COVID-19 vaccination program, which commenced in December 2020, has been instrumental preventing morbidity and mortality from disease. Safety monitoring an essential component of the program. federal government undertook a comprehensive coordinated approach to implement complementary safety systems communicate findings timely transparent way healthcare providers, policymakers, public. Monitoring involved both well-established newly developed that relied on spontaneous (passive) active surveillance methods. Clinical consultation for individual cases adverse events following was performed, special populations, such as pregnant persons, conducted. This report describes government's vaccine programs used by Centers Disease Control Prevention, Food Drug Administration, Department Defense, Veterans Affairs, Indian Health Service. Using event myocarditis mRNA model, we demonstrate how multiple, worked rapidly detect, assess, verify signal. In addition, longer-term follow-up conducted evaluate recovery status vaccination. Finally, process communication dissemination data is described, highlighting responsiveness robustness infrastructure during national

Language: Английский

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Spatial clusters, social determinants of health and risk of maternal mortality by COVID-19 in Brazil: a national population-based ecological study

The Lancet Regional Health - Americas, Journal Year: 2021, Volume and Issue: 3, P. 100076 - 100076

Published: Sept. 10, 2021

Detailed information on how socio-economic characteristics are related to COVID-19 incident cases and maternal deaths is needed. We investigated the spatial distribution of in Brazil their association with social determinants health.

Language: Английский

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Pregnancy and COVID-19: prevention, vaccination, therapy, and beyond

TURKISH JOURNAL OF MEDICAL SCIENCES, Journal Year: 2021, Volume and Issue: 51(SI-1), P. 3312 - 3326

Published: Sept. 19, 2021

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has alarmed the world since its first emergence. As pregnancy is characterized significant changes in cardiovascular, respiratory, endocrine, and immunological systems, there are concerns on issues like course of pregnant women, safety medications, route delivery risk obstetric complications. The aim this review to summarize current literature management women during COVID-19 pandemic. Although more than 90% with recover without serious morbidity, rapid deterioration higher rates complications may be observed. vertical transmission not been clearly revealed yet. Decreasing number prenatal visits, shortening time allocated for examinations, active use telemedicine services, limiting persons healthcare settings, combining tests same visit, restricting visitors providing a safe environment facilities, strict hygiene control, personal protective equipment visits main strategies control spread according guidelines. new medication alternatives being proposed every day treatment COVID-19, our knowledge about most these drugs limited. Preliminary results promising administration SARS-CoV-2 vaccines population. Timing should decided based maternal health condition, accompanying gestational age. Cesarean performed indications. Breast feeding encouraged as long necessary precautions viral taken. In conclusion, an individualized approach provided multidisciplinary team achieve favorable outcomes.

Language: Английский

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Comparison of Severe Maternal Morbidities Associated With Delivery During Periods of Circulation of Specific SARS-CoV-2 Variants

JAMA Network Open, Journal Year: 2022, Volume and Issue: 5(8), P. e2226436 - e2226436

Published: Aug. 12, 2022

Infection with SARS-CoV-2, which causes COVID-19, is associated adverse maternal outcomes. While it known that severity of COVID-19 varies by viral strain, the extent to this variation reflected in outcomes, including nonpulmonary not well characterized.To evaluate associations SARS-CoV-2 infection severe morbidities (SMM) pregnant patients delivering during 4 pandemic periods characterized predominant strains.This retrospective cohort study included a multicenter, geographically diverse US health system between March 2020 and January 2022. Individuals were propensity-matched as many individuals without evidence based on demographic clinical variables time dominant strain SARS-CoV-2: December (wild type); June 2021 (Alpha [B.1.1.7]); July November (Delta [B.1.617.2]); 2022 (Omicron [B.1.1.529]). Data analyzed from October 2022.Positive nucleic acid amplification test result delivery encounter.The primary outcome was any SMM event, defined Centers for Disease Control Prevention, hospitalization delivery. Secondary outcomes number SMM, respiratory nonrespiratory nontransfusion events.Over all periods, there 3129 median (IQR) age 29.1 (24.6-33.2) years. They propensity matched total 12 504 29.2 (24.7-33.2) Patients had significantly higher rates events than those except Omicron. risk increased wild-type (odds ratio [OR], 2.74 [95% CI, 1.85-4.03]) Alpha variant (OR, 2.57 1.69-4.01]), Delta period 7.69 5.19-11.54]; P trend < .001). The findings similar complications, For example, vs 2.16 1.40-3.27]) 1.96 1.20-3.12]), highest 4.65 2.97-7.29]), Omicron 1.21 0.67-2.08]; .001).This found compared other strains. Given potential new strains, these underscore importance preventive measures.

Language: Английский

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Association of Infection with Different SARS-CoV-2 Variants during Pregnancy with Maternal and Perinatal Outcomes: A Systematic Review and Meta-Analysis

International Journal of Environmental Research and Public Health, Journal Year: 2022, Volume and Issue: 19(23), P. 15932 - 15932

Published: Nov. 29, 2022

The aim of this study is to review the currently available data, and explore association infection with different severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants during pregnancy maternal perinatal outcomes in real world. Observational cohort studies were analyzed that described SARS-CoV-2 pregnancy. Random-effects inverse-variance models used evaluate pooled prevalence (PP) its 95% confidence interval (CI) for outcomes. Random effects estimate odds ratios (OR) their CI between Delta pre-Delta periods, Omicron periods. Eighteen studies, involving a total 133,058 cases (99,567 wild type or pre-variant 33,494 variant infections), included meta-analysis. Among pregnant women infections, PPs required support, critical illness, intensive care unit (ICU) admission, death, preterm birth <37 weeks were, respectively, 27.24% (95%CI, 20.51−33.97%), 24.96% 15.96−33.96%), 11.31% 4.00−18.61%), 4.20% 1.43−6.97%), 33.85% 21.54−46.17%) period, which higher than those while corresponding 10.74% 6.05−15.46%), 11.99% 6.23−17.74%), 4.17% 1.53−6.80%), 0.63% 0.05−1.20%), 18.58% 9.52−27.65%). ICU admission 2.63% 0.98−4.28%), 1.11% 0.29−1.94%), 1.83% 0.85−2.81%) lower These results suggest infections are associated less neonatal adverse outcomes, though need did also occur infections. Since predominant strain globally, has highest rates transmission, it still important remain vigilant protecting vulnerable populations mothers infants. In particular, obstetricians gynecologists should not ignore risks births patients order protect health

Language: Английский

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