Maternal and perinatal outcomes of pregnant women with SARS-CoV-2 infection at the time of birth in England: national cohort study

The association between asthma exacerbation during pregnancy and adverse maternal and child health outcomes have not been investigated appropriately. Our objective was to determine the short- and long-term intergenerational effect of asthma exacerbation in pregnant women with asthma.A population cohort study was conducted using data from the Ontario asthma surveillance system and population-level health administrative data. Asthma exacerbation in pregnant women with asthma was defined as at least one of the following criteria: at least five physician visits, or one emergency department visit or one hospital admission for asthma during pregnancy. Pregnancy complications, adverse perinatal outcomes and early childhood respiratory disorders were identified using International Classification of Disease codes (9th and 10th revisions).The cohort consisted of 103 424 singleton pregnancies in women with asthma. Asthma exacerbation in pregnant women with asthma was associated with higher odds of pre-eclampsia (OR 1.30, 95% CI 1.12–1.51) and pregnancy-induced hypertension (OR 1.17, 95% CI 1.02–1.33); babies had higher odds of low birthweight (OR 1.14, 95% CI 1.00–1.31), preterm birth (OR 1.14, 95% CI 1.01–1.29) and congenital malformations (OR 1.21, 95% CI 1.05–1.39). Children born to women with asthma exacerbation during pregnancy had elevated risk of asthma (OR 1.23, 95% CI 1.13–1.33) and pneumonia (OR 1.12, 95% CI 1.03–1.22) during the first 5 years of life.Asthma exacerbation during pregnancy in women with asthma showed increased risk of pregnancy complications, adverse perinatal outcomes and early childhood respiratory disorders in their children, indicating that appropriate asthma management may reduce the risk of adverse health outcomes.

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Erratum: Effects of short inter-pregnancy interval on maternal and perinatal outcomes: A cohort study of pregnant women in a low-income country

Nigerian Journal of Clinical Practice ◽

10.4103/1119-3077.291855 ◽

2020 ◽

Vol 23 (8) ◽

pp. 1181

Keyword(s):

Cohort Study ◽

Pregnant Women ◽

Low Income ◽

Perinatal Outcomes ◽

Income Country ◽

Low Income Country ◽

Inter Pregnancy Interval

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Perinatal outcomes after maternal 2009/H1N1 infection: national cohort study

BMJ ◽

10.1136/bmj.d3214 ◽

2011 ◽

Vol 342 (jun14 2) ◽

pp. d3214-d3214 ◽

Cited By ~ 160

Author(s):

M. Pierce ◽

J. J. Kurinczuk ◽

P. Spark ◽

P. Brocklehurst ◽

M. Knight ◽

...

Keyword(s):

Cohort Study ◽

Perinatal Outcomes ◽

H1n1 Infection ◽

National Cohort ◽

2009 H1n1

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Characteristics and outcomes of pregnant women hospitalised with confirmed SARS-CoV-2 infection in the UK: a national cohort study using the UK Obstetric Surveillance System (UKOSS)

10.1101/2020.05.08.20089268 ◽

2020 ◽

Cited By ~ 14

Author(s):

Marian Knight ◽

Kathryn Bunch ◽

Nicola Vousden ◽

Eddie Morris ◽

Nigel Simpson ◽

...

Keyword(s):

Cohort Study ◽

Pregnant Women ◽

Surveillance System ◽

Perinatal Death ◽

Strong Association ◽

Population Based ◽

Overweight And Obesity ◽

National Cohort ◽

Level 3 ◽

The Uk

AbstractObjectiveTo describe a national cohort of pregnant women hospitalised with SARS-CoV-2 infection in the UK, identify factors associated with infection and describe outcomes, including transmission of infection, for mother and infant.DesignProspective national population-based cohort study using the UK Obstetric Surveillance System (UKOSS).SettingAll 194 obstetric units in the UKParticipants427 pregnant women admitted to hospital with confirmed Sars-CoV-2 infection between 01/03/2020 and 14/04/2020. 694 comparison women who gave birth between 01/11/2017 and 31/10/2018.Main outcome measuresIncidence of maternal hospitalisation, infant infection. Rates of maternal death, level 3 critical care unit admission, preterm birth, stillbirth, early neonatal death, perinatal death; odds ratios for infected versus comparison women.ResultsEstimated incidence of hospitalisation with confirmed SARS-CoV-2 in pregnancy 4.9 per 1000 maternities (95%CI 4.5-5.4). The median gestation at symptom onset was 34 weeks (IQR 29-38). Black or other minority ethnicity (aOR 4.49, 95%CI 3.37-6.00), older maternal age (aOR 1.35, 95%CI 1.01-1.81 comparing women aged 35+ with those aged 30-34), overweight and obesity (aORs 1.91, 95%CI 1.37-2.68 and 2.20, 95%CI 1.56-3.10 respectively compared to women with a BMI<25kg/m2) and pre-existing comorbidities (aOR 1.52, 95%CI 1.12-2.06) were associated with admission with SARS-CoV-2 during pregnancy. 247 women (58%) gave birth or had a pregnancy loss; 180 (73%) gave birth at term. 40 (9%) hospitalised women required respiratory support. Twelve infants (5%) tested positive for SARS-CoV-2 RNA, six of these infants within the first 12 hours after birth.ConclusionsThe majority of pregnant women hospitalised with SARS-CoV-2 were in the late second or third trimester, supporting guidance for continued social distancing measures in later pregnancy. Most had good outcomes and transmission of SARS-CoV-2 to infants was uncommon. The strong association between admission with infection and black or minority ethnicity requires urgent investigation and explanation.Study RegistrationISRCTN 40092247

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Impact of SARS-CoV-2 variant on the severity of maternal infection and perinatal outcomes: Data from the UK Obstetric Surveillance System national cohort.

10.1101/2021.07.22.21261000 ◽

2021 ◽

Author(s):

Nicola Vousden ◽

Rema Ramakrishnan ◽

Kathryn Bunch ◽

Edward Morris ◽

Nigel Simpson ◽

...

Keyword(s):

Pregnant Women ◽

Perinatal Outcomes ◽

Severe Infection ◽

Maternal Infection ◽

Increased Risk ◽

National Guidance ◽

National Cohort ◽

Alpha Variant ◽

The Uk ◽

The Impact

Background In the UK, the Alpha variant of SARS-CoV-2 became dominant in late 2020, rapidly succeeded by the Delta variant in May 2021. The aim of this study was to compare the impact of these variants on severity of maternal infection and perinatal outcomes within the time-periods in which they predominated. Methods This national, prospective cohort study collated data on hospitalised pregnant women with symptoms of confirmed SARS-CoV-2 infection and compared the severity of infection and perinatal outcomes across the Wildtype (01/03/20-30/11/20), Alpha (01/12/20-15/05/21) and Delta dominant periods (16/05/21-11/07/21), using multivariable logistic regression. Findings Of 3371 pregnant women, the proportion that experienced moderate to severe infection significantly increased between Wildtype and Alpha periods (24.4% vs. 35.8%; aOR1.75 95%CI 1.48-2.06), and between Alpha and Delta periods (35.8% vs. 45.0%; aOR1.53, 95%CI 1.07-2.17). Compared to the Wildtype period, symptomatic women admitted in the Alpha period were more likely to require respiratory support (27.2% vs. 20.3%, aOR1.39, 95%CI 1.13-1.78), have pneumonia (27.5% vs. 19.1%, aOR1.65, 95%CI 1.38-1.98) and be admitted to intensive care (11.3% vs. 7.7%, aOR1.61, 95%CI 1.24-2.10). Women admitted during the Delta period had further increased risk of pneumonia (36.8% vs. 27.5%, aOR1.64 95%CI 1.14-2.35). No fully vaccinated pregnant women were admitted between 01/02/2021 when vaccination data collection commenced and 11/07/2021. The proportion of women receiving pharmacological therapies for SARS-CoV-2 management was low, even in those critically ill. Interpretation SARS-CoV-2 infection during Alpha and Delta dominant periods was associated with more severe infection and worse pregnancy outcomes compared to the Wildtype infection, which itself increased risk compared to women without SARS-CoV-2 infection.1 Clinicians need to be aware and implement COVID-specific therapies in keeping with national guidance. Urgent action to tackle vaccine misinformation and policy change to prioritise uptake in pregnancy is essential. Funding National Institute for Health Research HS&DR Programme (11/46/12).

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Effect of pregnancy induced hypertension on adverse perinatal outcomes in Tigray regional state, Ethiopia: a prospective cohort study

10.21203/rs.2.14708/v2 ◽

2019 ◽

Author(s):

Abadi Kidanemariam Berhe ◽

Abiodun O. ILESANMI ◽

Christopher O. AIMAKHU ◽

Afework Mulugeta

Keyword(s):

Cohort Study ◽

Pregnant Women ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Perinatal Outcomes ◽

Pregnancy Induced Hypertension ◽

Care Providers ◽

Regional State ◽

Induced Hypertension ◽

Adverse Perinatal Outcomes

Abstract Background: Pregnancy-induced hypertension is the development of new hypertension with or without proteinuria after 20 weeks of pregnancy. The prevalence of pregnancy-induced hypertension in Ethiopia ranges from 2.2 to 18.3%. Similarly, a study conducted in Tigray regional state indicated a higher prevalence of pregnancy-induced hypertension. However, so far little is known about the adverse perinatal outcomes of pregnancy-induced hypertension in Tigray Regional State, Ethiopia. Therefore the objective of this study was to assess the effect of pregnancy-induced hypertension on adverse perinatal outcomes in Tigray Regional State, Ethiopia. Methods: a prospective cohort study was conducted on a total sample of 782 pregnant women attending antenatal care in hospitals of Tigray regional state, Ethiopia. Data were collected using interviewer-administered questionnaire and review of their medical records from February 1, 2018, to February 30, 2019. Maternal age, wealth status, educational status, residence, gravidity, type of pregnancy, mode of delivery, anemia status and maternal undernutrition variables were controlled in the statistical models. A modified Poisson regression model with robust standard errors was used to analyze Relative risk. Results: In this study, the overall incidence of adverse perinatal outcome was higher among women with pregnancy-induced hypertension than normotensive women (66.4% vs 22.2%). After adjusted for confounders women with pregnancy-induced hypertension were born babies with a higher risk of low birth weight (adjusted RR(95%CI)= 5.1(3.4,7.8)), birth asphyxia (aRR=2.6(1.9,3.8)), small for gestational age (aRR=3.3(2.3,4.6)), preterm delivery (aRR=5.2(3.4,7.9)), stillbirth (aRR=3.46(1.40,8.54)), admission to neonatal intensive care unit (aRR=5.1(3.1,8.4)) and perinatal death (aRR=3.6(1.8,7.4)) compared to normotensive pregnant women. Conclusions: Higher incidences of adverse perinatal outcomes were occurred among women pregnancy-induced hypertension in Tigray regional state, Ethiopia. Hence health care providers should strengthen prevention, early diagnosis and prompt management of pregnancy-induced hypertension to reduce adverse perinatal outcomes of pregnancy-induced hypertension. Keywords: Adverse perinatal outcomes, pregnancy-induced hypertension, Tigray, Ethiopia

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