Name:
Publisher version
View Source
Access full-text PDFOpen Access
View Source
Check access options
Check access options
Affiliation
Imperial College Healthcare NHS Trust; Imperial College London; Cardiff University; Sandwell and West Birmingham NHS Trust; et al.Publication date
2022-07-19Subject
Obstetrics. Midwifery
Metadata
Show full item recordAbstract
Objective: To assess perinatal outcomes for pregnancies affected by suspected or confirmed SARS-CoV-2 infection. Methods: Prospective, web-based registry. Pregnant women were invited to participate if they had suspected or confirmed SARS-CoV-2 infection between 1st January 2020 and 31st March 2021 to assess the impact of infection on maternal and perinatal outcomes including miscarriage, stillbirth, fetal growth restriction, pre-term birth and transmission to the infant. Results: Between April 2020 and March 2021, the study recruited 8239 participants who had suspected or confirmed SARs-CoV-2 infection episodes in pregnancy between January 2020 and March 2021. Maternal death affected 14/8197 (0.2%) participants, 176/8187 (2.2%) of participants required ventilatory support. Pre-eclampsia affected 389/8189 (4.8%) participants, eclampsia was reported in 40/ 8024 (0.5%) of all participants. Stillbirth affected 35/8187 (0.4 %) participants. In participants delivering within 2 weeks of delivery 21/2686 (0.8 %) were affected by stillbirth compared with 8/4596 (0.2 %) delivering ≥ 2 weeks after infection (95 % CI 0.3-1.0). SGA affected 744/7696 (9.3 %) of livebirths, FGR affected 360/8175 (4.4 %) of all pregnancies. Pre-term birth occurred in 922/8066 (11.5%), the majority of these were indicated pre-term births, 220/7987 (2.8%) participants experienced spontaneous pre-term births. Early neonatal deaths affected 11/8050 livebirths. Of all neonates, 80/7993 (1.0%) tested positive for SARS-CoV-2. Conclusions: Infection was associated with indicated pre-term birth, most commonly for fetal compromise. The overall proportions of women affected by SGA and FGR were not higher than expected, however there was the proportion affected by stillbirth in participants delivering within 2 weeks of infection was significantly higher than those delivering ≥ 2 weeks after infection. We suggest that clinicians' threshold for delivery should be low if there are concerns with fetal movements or fetal heart rate monitoring in the time around infection. The proportion affected by pre-eclampsia amongst participants was not higher than would be expected, although we report a higher than expected proportion affected by eclampsia. There appears to be no effect on birthweight or congenital malformations in women affected by SARS-CoV-2 infection in pregnancy and neonatal infection is uncommon. This study reflects a population with a range of infection severity for SARS-COV-2 in pregnancy, generalisable to whole obstetric populations.Citation
Mullins E, Perry A, Banerjee J, Townson J, Grozeva D, Milton R, Kirby N, Playle R, Bourne T, Lees C; PAN-COVID Investigators. Pregnancy and neonatal outcomes of COVID-19: The PAN-COVID study. Eur J Obstet Gynecol Reprod Biol. 2022 Sep;276:161-167. doi: 10.1016/j.ejogrb.2022.07.010Type
ArticlePMID
35914420Publisher
Elsevierae974a485f413a2113503eed53cd6c53
10.1016/j.ejogrb.2022.07.010