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.
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..
