Association of SARS-CoV-2 Infection With Serious Maternal Morbidity and Mortality From Obstetric Complications

JAMA, Journal Year: 2022, Volume and Issue: 327(8), P. 748 - 748

Published: Feb. 7, 2022

It remains unknown whether SARS-CoV-2 infection specifically increases the risk of serious obstetric morbidity. To evaluate association with maternal morbidity or mortality from common complications. Retrospective cohort study 14 104 pregnant and postpartum patients delivered between March 1, 2020, December 31, 2020 (with final follow-up to February 11, 2021), at 17 US hospitals participating in Eunice Kennedy Shriver National Institute Child Health Human Development's Gestational Research Assessments COVID-19 (GRAVID) Study. All were included compared those without a positive test result who on randomly selected dates over same period. was based nucleic acid antigen result. Secondary analyses further stratified by disease severity. The primary outcome composite death related hypertensive disorders pregnancy, hemorrhage, other than SARS-CoV-2. main secondary cesarean birth. Of (mean age, 29.7 years), 2352 had 11 752 did not have Compared result, significantly associated (13.4% vs 9.2%; difference, 4.2% [95% CI, 2.8%-5.6%]; adjusted relative [aRR], 1.41 1.23-1.61]). 5 deaths group. birth (34.7% 32.4%; aRR, 1.05 0.99-1.11]). moderate higher severity (n = 586) (26.1% 16.9% 13.3%-20.4%]; 2.06 1.73-2.46]) major (45.4% 12.8% 8.7%-16.8%]; 1.17 1.07-1.28]), but mild asymptomatic 1766) (9.2% 0% -1.4% 1.4%]; 1.11 0.94-1.32]) (31.2% -3.6% 0.8%]; 1.00 0.93-1.07]). Among individuals hospitals, an increased for

Language: Английский

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Maternal respiratory SARS-CoV-2 infection in pregnancy is associated with a robust inflammatory response at the maternal-fetal interface

Med, Journal Year: 2021, Volume and Issue: 2(5), P. 591 - 610.e10

Published: April 30, 2021

BackgroundPregnant women are at increased risk for severe outcomes from coronavirus disease 2019 (COVID-19), but the pathophysiology underlying this morbidity and its potential effect on developing fetus is not well understood.MethodsWe assessed placental histology, ACE2 expression, viral immune dynamics term placenta in pregnant with without respiratory acute syndrome 2 (SARS-CoV-2) infection.FindingsThe majority (13 of 15) placentas analyzed had no detectable RNA. was detected by immunohistochemistry syncytiotrophoblast cells normal during early pregnancy rarely seen healthy full term, suggesting that low expression may protect infection. Using immortalized cell lines primary isolated cells, we found cytotrophoblasts, trophoblast stem precursors to syncytiotrophoblasts, rather than syncytiotrophoblasts or Hofbauer most vulnerable SARS-CoV-2 infection vitro. To better understand mechanisms shielding vivo, performed bulk single-cell transcriptomics analyses maternal-fetal interface SARS-CoV-2-infected exhibited robust responses, including activation natural killer (NK) T interferon-related genes, as markers associated complications such preeclampsia.ConclusionsSARS-CoV-2 late even absence local invasion.FundingNIH (T32GM007205, F30HD093350, K23MH118999, R01AI157488, U01DA040588) Fast Grant funding support Emergent Ventures Mercatus Center.

Language: Английский

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COVID‐19 in pregnancy: Placental and neonatal involvement

American Journal of Reproductive Immunology, Journal Year: 2020, Volume and Issue: 84(5)

Published: July 17, 2020

Since December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused over 12 million infections and more than 550 000 deaths.

Language: Английский

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

BMC Pregnancy and Childbirth, Journal Year: 2021, Volume and Issue: 21(1)

Published: April 1, 2021

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 pregnancy based on universal antenatal screening program for SARS-CoV-2 infection. Throughout Spain 45 hospitals tested all women at admission delivery ward using polymerase-chain-reaction (PCR) since late March 2020. The cohort positive mothers and concurrent sample negative was followed up until 6-weeks post-partum. Multivariable logistic regression analysis, adjusting known confounding variables, determined adjusted odds ratio (aOR) 95% confidence intervals (95% CI) association infection outcomes. Main outcome measures: Preterm (primary), premature rupture membranes neonatal intensive care unit admissions. Results Among 1009 screened pregnancies, 246 were positive. Compared (763 cases), increased preterm birth (34 vs 51, 13.8% 6.7%, aOR 2.12, CI 1.32–3.36, p = 0.002); iatrogenic more frequent infected (4.9% 1.3%, 0.001), while occurrence spontaneous deliveries statistically similar (6.1% 4.7%). An risk term (39 75, 15.8% 9.8%, 1.70, 1.11–2.57, 0.013) admissions (23 18, 9.3% 2.4%, 4.62, 2.43–8.94, < 0.001) also observed mothers. Conclusion This demonstrated that pregnant have hypothesis merits evaluation causal further research.

Language: Английский

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COVID-19 and cause of pregnancy loss during the pandemic: A systematic review

PLoS ONE, Journal Year: 2021, Volume and Issue: 16(8), P. e0255994 - e0255994

Published: Aug. 11, 2021

Introduction The association between Coronavirus Disease 2019 (COVID-19) and abortion has been debated since the beginning of COVID-19 pandemic. We aimed to conduct this systematic review understand better potential effects Severe Acute Respiratory Syndrome 2 (SARS-CoV-2) on fetal loss in infected mothers presented with following infection. Methods included articles published PubMed/Medline, Web Science, clinicaltrials.gov, Embase databases 2020 through a comprehensive search via appropriate keywords, including synonyms. All studies data confirmed pregnant females were collected. Results Out 208 potentially relevant articles, 11 eligible include review. reports because reasons: (1) First-trimester miscarriage; (2) Late (3) complication infection pregnancy; (4) disease artificial pregnancy. was found 5 studies, second-trimester 7 studies. Two patients acquired during hospital stay while they referred for abortion. Reports related show that most miscarriages due first trimester placental insufficiency. Conclusions There is an increased risk positive test result SARS-CoV-2, which several case series have identified Placental inflammation viral may growth retardation induce not any consistent evidence vertical transmission virus from mother fetus, requires further investigation.

Language: Английский

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Adverse Pregnancy Outcomes Among Individuals With and Without Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)

Obstetrics and Gynecology, Journal Year: 2021, Volume and Issue: 137(4), P. 585 - 596

Published: March 10, 2021

OBJECTIVE: To compare the risk of intrauterine fetal death (20 weeks gestation or later) and neonatal among individuals who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) compared with those negative SARS-CoV-2 on admission delivery. DATA SOURCES: MEDLINE, Ovid, EMBASE, Cumulative Index to Nursing Allied Health, Cochrane Library were searched from their inception until July 17, 2020. Hand search additional articles continued through September 24, ClinicalTrials.gov was October 21, METHODS OF STUDY SELECTION: The inclusion criteria publications that at least 20 cases both pregnant patients labor delivery negative. Exclusion fewer than in either category lacking data primary outcomes. A systematic selected databases performed, co-primary outcomes being rates death. Secondary included maternal adverse TABULATION, INTEGRATION, AND RESULTS: Of 941 completed trials identified, six studies met criteria. Our analysis 728 deliveries 3,836 contemporaneous Intrauterine occurred 8 (1.1%) 44 ( P =.60). Neonatal 0 432 (0.0%) 5 2,400 (0.2%) =.90). Preterm birth 95 714 (13.3%) 446 3,759 (11.9%) =.31). Maternal 3 559 (0.5%) 3,155 (0.3%) =.23). CONCLUSION: incidences similar when admitted Other immediate newborns also born SARS-CoV-2. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, CRD42020203475.

Language: Английский

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COVID-19 and pregnancy: clinical outcomes; mechanisms, and vaccine efficacy

Translational research, Journal Year: 2022, Volume and Issue: 251, P. 84 - 95

Published: Aug. 12, 2022

Language: Английский

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SARS-CoV-2 infection in the first trimester and the risk of early miscarriage: a UK population-based prospective cohort study of 3041 pregnancies conceived during the pandemic

Human Reproduction, Journal Year: 2022, Volume and Issue: 37(6), P. 1126 - 1133

Published: March 25, 2022

Does maternal infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the first trimester affect risk of miscarriage before 13 week's gestation?

Language: Английский

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Maternal SARS-CoV-2, Placental Changes and Brain Injury in 2 Neonates

PEDIATRICS, Journal Year: 2023, Volume and Issue: 151(5)

Published: April 6, 2023

Long-term neurodevelopmental sequelae are a potential concern in neonates following utero exposure to severe acute respiratory syndrome coronavirus disease 2 (SARS-CoV-2). We report born SARS-CoV-2 positive mothers, who displayed early-onset (day 1) seizures, acquired microcephaly, and significant developmental delay over time. Sequential MRI showed parenchymal atrophy cystic encephalomalacia. At birth, neither infant was (nasopharyngeal swab, reverse transcription polymerase chain reaction), but both had detectable antibodies increased blood inflammatory markers. Placentas from mothers SARS-CoV-2-nucleocapsid protein spike glycoprotein 1 the syncytiotrophoblast, fetal vascular malperfusion, significantly oxidative stress markers pyrin domain containing protein, macrophage βη, stromal cell-derived factor 1, interleukin 13, 10, whereas human chorionic gonadotropin markedly decreased. One (case experienced sudden unexpected death at 13 months of age. The deceased infant's brain evidence by immunofluorescence, with colocalization nucleocapsid around nucleus as well within cytoplasm. constellation clinical findings, placental pathology, immunohistochemical changes strongly suggests that second-trimester maternal infection placentitis triggered an response injury fetoplacental unit affected brain. demonstration also raises possibility directly contributed ongoing injury. In infants, neurologic findings birth mimicked presentation hypoxic-ischemic encephalopathy newborn progressed beyond neonatal period.

Language: Английский

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Susceptibility to COVID-19 in Pregnancy, Labor, and Postpartum Period: Immune System, Vertical Transmission, and Breastfeeding

Frontiers in Global Women s Health, Journal Year: 2021, Volume and Issue: 2

Published: Feb. 17, 2021

The new coronavirus (SARS-Cov-2) was first identified in late 2019 as the RNA virus coronaviridae family responsible for causing COVID-19 residents of China's Hubei province. In mid-March 2020 WHO declared pandemic caused by this a result thousands people infected all over world. Epidemiological evidence obtained from other pandemics, such influenza and ebola, suggest that pregnant women are more susceptible to serious complications death viral infection. Physiological changes anatomical structure respiratory system well immune during pregnancy-puerperal period seem contribute greater risk. Thus, be SARS-COV-2 or viruses have disease. fact, can alter responses at maternal-fetal interface, affecting well-being both mother her fetus. There is still no sufficient literature support occurrence vertical transmission through breastfeeding, but prevalence prematurity high among SARS-Cov-2. review, may increase susceptibility SARS-Cov-2 discussed possible mechanisms involved fetus breastfeeding.

Language: Английский

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