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

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Oscar Martinez-Perez ◽  
◽  
Pilar Prats Rodriguez ◽  
Marta Muner Hernandez ◽  
Maria Begoña Encinas Pardilla ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Prospective Study ◽  
Preterm Delivery ◽  
Neonatal Intensive Care ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Obstetric Morbidity ◽  
In Pregnancy

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 in pregnancy based on a universal antenatal screening program for SARS-CoV-2 infection. Throughout Spain 45 hospitals tested all women at admission on delivery ward using polymerase-chain-reaction (PCR) for COVID-19 since late March 2020. The cohort of positive mothers and the concurrent sample of negative mothers was followed up until 6-weeks post-partum. Multivariable logistic regression analysis, adjusting for known confounding variables, determined the adjusted odds ratio (aOR) with 95% confidence intervals (95% CI) of the association of SARS-CoV-2 infection and obstetric outcomes. Main outcome measures: Preterm delivery (primary), premature rupture of membranes and neonatal intensive care unit admissions. Results Among 1009 screened pregnancies, 246 were SARS-CoV-2 positive. Compared to negative mothers (763 cases), SARS-CoV-2 infection increased the odds of preterm birth (34 vs 51, 13.8% vs 6.7%, aOR 2.12, 95% CI 1.32–3.36, p = 0.002); iatrogenic preterm delivery was more frequent in infected women (4.9% vs 1.3%, p = 0.001), while the occurrence of spontaneous preterm deliveries was statistically similar (6.1% vs 4.7%). An increased risk of premature rupture of membranes at term (39 vs 75, 15.8% vs 9.8%, aOR 1.70, 95% CI 1.11–2.57, p = 0.013) and neonatal intensive care unit admissions (23 vs 18, 9.3% vs 2.4%, aOR 4.62, 95% CI 2.43–8.94, p <  0.001) was also observed in positive mothers. Conclusion This prospective multicentre study demonstrated that pregnant women infected with SARS-CoV-2 have more infection-related obstetric morbidity. This hypothesis merits evaluation of a causal association in further research.

scholarly journals The association between COVID-19 and preterm delivery: A cohort study with a multivariate analysis

2020 ◽  
Author(s):  
◽  
Oscar Martinez Perez ◽  
Pilar Prats Rodriguez ◽  
Marta Muner Hernandez ◽  
Maria Begona Encinas Pardilla ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cohort Study ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Pregnant Women ◽  
Preterm Delivery ◽  
Neonatal Intensive Care ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Obstetric Morbidity

Structured abstract Objective: 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. Design and setting: Throughout Spain, 45 hospitals took part in the universal screening of pregnant women going into labour using polymerase chain reaction (PCR) for COVID 19 since late March 2020. Methods: The cohort of exposed and unexposed pregnancies was followed up until 6 weeks postpartum. Multivariate logistic regression analysis, adjusting for known confounding variables, determined the adjusted odds ratio (aOR) with 95% confidence intervals (95% CI) of the association of COVID 19 exposure, compared to non exposure, with infection related obstetric outcomes. Main outcome measures: Preterm delivery (primary), premature rupture of membranes and neonatal intensive care unit admissions. Results: In the cohort of 1,009 screened pregnancies, 246 were COVID 19 positive. Compared to non exposure, COVID 19 exposure increased the odds of preterm birth (34 vs 51, 13.8% vs 6.7%, aOR 2.12, 95% CI 1.32 3.36, p=0.002), premature rupture of membranes at term (39 vs 75, % vs 9.8%, aOR 1.70, 95% CI 1.11 2.57, p=0.013) and neonatal intensive care unit admissions (23 vs 18, 9.3% vs 2.4%, aOR 4.62, 95% CI 2.43 8.94, p<0.001). Conclusion: This first prospective cohort study demonstrated that pregnant women infected with SARS CoV 2 have more infection related obstetric morbidity. This hypothesis merits evaluation of a causal association in further research.

scholarly journals Epidemiological characteristics of neonatal admissions in a public maternity / Características epidemiológicas das internações neonatais em uma maternidade pública / Características epidemiológicas de admisión neonatal en una maternidad..

2018 ◽  
Vol 6 (4) ◽  
pp. 28
Author(s):  
Danubia Jacomo Da Silva Cardoso ◽  
Beatriz Schumacher
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Medical Records ◽  
Preterm Labor ◽  
Neonatal Intensive Care ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Maternal Complications ◽  
Epidemiological Characteristics

Descriptive retrospective Research with quantitative approach. Aims: Meet the epidemiological characteristics of hospitalization in Neonatal intensive care unit, relating them to the possible maternal factors, in a public maternity in southern Brazil. Performed with newborns that they put in the NICU, forwarded with the clinical summary to the Municipal program precious baby. The data were collected, with the following variables: maternal age, type of birth, number of pre-natal consultations, complications in pregnancy, and number of days of hospitalization in neonatal intensive care unit, in the period from January to December 2013. Were analyzed medical records 72, prematurity was the most prevalent with 61% of the babies, and their consequences such as the use of mechanical ventilation and apneas 55.5% were repeated and 52.7% respectively. Among the most frequent maternal complications was observed the Preterm Labor (31.3%) and premature rupture of membranes (23.8%). Thus the identification of the factors that lead to preterm labor and premature rupture of membranes, could meet the maternal background and consequently reduce the prematurity and low birth weight.

scholarly journals Mild thrombocytopenia indicating maternal organ damage in pre‐eclampsia: a cross‐sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Michinori Mayama ◽  
Mamoru Morikawa ◽  
Takashi Yamada ◽  
Takeshi Umazume ◽  
Kiwamu Noshiro ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Platelet Count ◽  
Intensive Care Unit Admission ◽  
Neonatal Intensive Care Unit ◽  
Preterm Delivery ◽  
Neonatal Intensive Care ◽  
Organ Damage ◽  
Severe Thrombocytopenia ◽  
Relative Risks

Abstract Background Currently, there is a disagreement between guidelines regarding platelet count cut-off values as a sign of maternal organ damage in pre-eclampsia; the American College of Obstetricians and Gynecologists guidelines state a cut-off value of < 100 × 109/L; however, the International Society for the Study of Hypertension in Pregnancy guidelines specify a cut-off of < 150 × 109/L. We evaluated the effect of mild thrombocytopenia: platelet count < 150 × 109/L and ≥ 100 × 109/L on clinical features of pre-eclampsia to examine whether mild thrombocytopenia reflects maternal organ damage in pre-eclampsia. Methods A total of 264 women were enrolled in this study. Participants were divided into three groups based on platelet count levels at delivery: normal, ≥ 150 × 109/L; mild thrombocytopenia, < 150 × 109/L and ≥ 100 × 109/L; and severe thrombocytopenia, < 100 × 109/L. Risk of severe hypertension, utero-placental dysfunction, maternal organ damage, preterm delivery, and neonatal intensive care unit admission were analyzed based on platelet count levels. Estimated relative risk was calculated with a Poisson regression analysis with a robust error. Results Platelet counts indicated normal levels in 189 patients, mild thrombocytopenia in 51 patients, and severe thrombocytopenia in 24 patients. The estimated relative risks of severe thrombocytopenia were 4.46 [95 % confidence interval, 2.59–7.68] for maternal organ damage except for thrombocytopenia, 1.61 [1.06–2.45] for preterm delivery < 34 gestational weeks, and 1.35 [1.06–1.73] for neonatal intensive care unit admission. On the other hand, the estimated relative risks of mild thrombocytopenia were 0.97 [0.41–2.26] for maternal organ damage except for thrombocytopenia, 0.91 [0.62–1.35] for preterm delivery < 34 gestational weeks, and 0.97 [0.76–1.24] for neonatal intensive care unit admission. Conclusions Mild thrombocytopenia was not associated with severe features of pre-eclampsia and would not be suitable as a sign of maternal organ damage.

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