Dataset Information

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

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.

SUBMITTER: Martinez-Perez O

PROVIDER: S-EPMC8016158 | biostudies-literature | 2021 Apr

REPOSITORIES: biostudies-literature

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Publications

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

Martinez-Perez Oscar O Prats Rodriguez Pilar P Muner Hernandez Marta M Encinas Pardilla Maria Begoña MB Perez Perez Noelia N Vila Hernandez Maria Rosa MR Villalba Yarza Ana A Nieto Velasco Olga O Del Barrio Fernandez Pablo Guillermo PG Forcen Acebal Laura L Orizales Lago Carmen Maria CM Martinez Varea Alicia A Muñoz Abellana Begoña B Suarez Arana Maria M Fuentes Ricoy Laura L Martinez Diago Clara C Janeiro Freire Maria Jesus MJ Alférez Alvarez-Mallo Macarena M Casanova Pedraz Cristina C Alomar Mateu Onofre O Lesmes Heredia Cristina C Wizner de Alva Juan Carlos JC Bernardo Vega Rut R Macia Badia Montserrat M Alvarez Colomo Cristina C Sanchez Muñoz Antonio A Pratcorona Alicart Laia L Alonso Saiz Ruben R Lopez Rodriguez Monica M Del Carmen Barbancho Lopez Maria M Meca Casbas Marta Ruth MR Vaquerizo Ruiz Oscar O Moran Antolin Eva E Nuñez Valera Maria Jose MJ Fernandez Fernandez Camino C Tubau Navarra Albert A Cano Garcia Alejandra Maria AM Baena Luque Carmen C Soldevilla Perez Susana S Gastaca Abasolo Irene I Adanez Garcia Jose J Teulon Gonzalez Maria M Puertas Prieto Alberto A Ostos Serna Rosa R Del Pilar Guadix Martin Maria M Catalina Coello Monica M Ferriols Perez Elena E Caño Aguilar Africa A De la Cruz Conty Maria Luisa ML Sainz Bueno Jose Antonio JA

BMC pregnancy and childbirth 20210401 1

<h4>Background</h4>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.<h4>Methods</h4>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 ...[more]

PMID: 33794829

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Project description:BackgroundRecent data in nonpregnant individuals suggest a protective effect of influenza vaccination against SARS-CoV-2 infection and its severity.ObjectivesOur primary objective was to evaluate whether influenza vaccination was associated with COVID-19 severity and pregnancy and neonatal outcomes among those infected with SARS-CoV-2. The secondary objective was to examine the association between influenza vaccination and SARS-CoV-2 infection.Study designSecondary analysis of a multicenter retrospective cohort of pregnant people who tested positive for SARS-CoV-2 between March and August 2020, and a cohort of random deliveries during the same time period. The associations between 2019 influenza vaccination and the primary outcome of moderate-to-critical COVID-19 as well as maternal and perinatal outcomes were examined among all people who tested positive for SARS-CoV-2 between March and August 2020. The association between 2019 influenza vaccination and having a positive SARS-CoV-2 test was examined among a cohort of individuals who delivered on randomly selected dates between March and August 2020. Univariable and multivariable analyses were performed.ResultsOf 2325 people who tested positive for SARS-CoV-2, 1068 (45.9%) were vaccinated against influenza in 2019. Those who received the influenza vaccine were older, leaner, more likely to have private insurance, and identify as White or Hispanic. They were less likely to smoke tobacco and identify as Black. Overall, 419 (18.0%) had moderate, 193 (8.3%) severe, and 52 (2.2%) critical COVID-19. There was no association between influenza vaccination and moderate-to-critical COVID-19 (29.2% vs. 28.0%, adjusted OR 1.10, 95% CI 0.90-1.34) or adverse maternal and perinatal outcomes among those who tested positive. Of 8152 people who delivered in 2020, 4658 (57.1%) received the influenza vaccine. Prior vaccination was not associated with a difference in the odds of SARS-CoV-2 infection (3.8% vs. 4.2%, adjusted OR 0.94, 95% CI 0.74-1.19).ConclusionPrior influenza vaccination was not associated with decreased severity of COVID-19 or lower odds of SARS-CoV-2 infection in pregnancy.

Project description:IntroductionThe lifetime prevalence of human papillomavirus infection (HPV) is estimated to be around 80% and it is the most common sexually transmitted infection. Despite being well known for its oncologic relevance, it has been associated with adverse pregnancy outcomes, though available evidence is contradicting. Previous meta-analyses involved articles which based HPV infection on Pap smear results, leading to a significant source of bias. Therefore, we aimed to assess the burden of genetically proven HPV infection on adverse pregnancy outcomes.Material and methodsIn our meta-analysis, pregnant women tested for HPV DNA were only considered eligible. We conducted a systematic search in three major databases (PubMed, Embase, and CENTRAL) on September 22, 2023. Cohort, cross-sectional, and case-control studies were eligible for the analysis. The exposed group consisted of HPV-infected patients. We assessed the odds ratios (OR) with a confidence interval (CI) of 95%. In order to reduce the heterogeneity, we performed subgroup analyses based on different strains (high risk HPV, HPV 16/18, study design). The study was prospectively registered on PROSPERO (CRD42022370228).ResultsOur study involved 14 articles with 7008 women. A significant association was found between preterm delivery and HPV infection (OR: 1.94, CI: 1.31-2.87). No significant association was found when separately examining high-risk HPV-infected women (OR: 1.94, CI: 0.82-4.59), and HPV 16 or 18-infected women (OR: 2.08, CI: 0.50-8.63) in terms of preterm delivery. No significant association was found between spontaneous abortion and HPV infection (OR: 1.02, CI: 0.16-6.31).ConclusionsOur analysis indicates an association between HPV infection and preterm delivery. It is imperative that future studies consider confounding variables more comprehensively. Additionally, the global implementation of HPV vaccination programs holds significance not only in oncology but also in obstetrics.

Dataset Information

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

Background

Methods

Main outcome measures

Results

Conclusion

Publications

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

Similar Datasets

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