Dataset Information

Is pregnancy a risk factor for in-hospital mortality in reproductive-aged women with SARS-CoV-2 infection? A nationwide retrospective observational cohort study.

ABSTRACT:

Objective

To examine the effect of pregnancy on coronavirus disease 2019 (COVID-19) -related in-hospital mortality in women of reproductive age (between 15 and 45 years), with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection confirmed with polymerase chain reaction tests, adjusted for factors such as co-infection and intervention that were not considered in existing literature.

Methods

Data gathered from a nationwide database in Brazil were analyzed using multivariate logistic regression and multivariate Cox regression. Adjusted odds ratios and hazard ratios of independent factors associated with in-hospital death were calculated.

Results

A total of 97 712 women were included in the study. After the adjustment for sociodemographic factors, epidemiologic characteristics, pre-existing medical conditions, and intervention, pregnant women were found to be associated with lower risk for in-hospital mortality as well as longer survival time compared with non-pregnant women. When covariates of intervention were omitted from the analysis, pregnancy did not appear to be a significant factor associated with mortality.

Conclusion

With the adjustment for intervention that was shown to be an independent factor associated with mortality, pregnancy appeared to have a favorable effect on SARS-CoV-2 infection. Given the immunosuppressed state of pregnancy, this finding is in line with the hypothetical protective role of a weaker immune response that inhibits the production of proinflammatory cytokine.

SUBMITTER: Leung C

PROVIDER: S-EPMC9087772 | biostudies-literature | 2022 Apr

REPOSITORIES: biostudies-literature

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Publications

Is pregnancy a risk factor for in-hospital mortality in reproductive-aged women with SARS-CoV-2 infection? A nationwide retrospective observational cohort study.

Leung Char C de Paiva Karina Mary KM

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 20211223 1

<h4>Objective</h4>To examine the effect of pregnancy on coronavirus disease 2019 (COVID-19) -related in-hospital mortality in women of reproductive age (between 15 and 45 years), with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection confirmed with polymerase chain reaction tests, adjusted for factors such as co-infection and intervention that were not considered in existing literature.<h4>Methods</h4>Data gathered from a nationwide database in Brazil were analyzed using mul ...[more]

PMID: 34888871

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Project description:BackgroundMultiple studies have described increased risk of severe coronavirus disease (COVID-19) among pregnant women compared to nonpregnant women. The risk in middle-income countries where the distributions of age groups and preexisting conditions may differ is less known.ObjectivesTo determine whether pregnant women with SARS-CoV-2 infection are at increased risk for severe COVID-19 compared to nonpregnant women in Colombia.MethodsWe analysed national surveillance data from Colombia, of women aged 15-44 years with laboratory-confirmed infection with SARS-CoV-2 by molecular or antigen testing, from 6 March 2020 to 12 December 2020. An enhanced follow-up of pregnant women with COVID-19 was established to monitor pregnancy and birth outcomes.ResultsOf 371,363 women aged 15-44 years with laboratory-confirmed SARS-CoV-2 infection, 1.5% (n = 5614) were reported as pregnant; among those, 2610 (46.5%) were considered a complete pregnancy for reporting purposes at the time of analysis. Hospitalisation (23.9%) and death (1.3%) occurred more frequently among pregnant symptomatic women compared to nonpregnant symptomatic women (2.9% and 0.3%, respectively). Compared to nonpregnant symptomatic women, pregnant symptomatic women were at increased risk of hospitalisation (adjusted risk ratio [RR] 2.19, 95% confidence interval [CI] 2.07, 2.32) and death (RR 1.82, 95% CI 1.60, 2.07), after adjusting for age, type of health insurance and presence of certain underlying medical conditions. Among complete pregnancies, 55 (2.1%) were pregnancy losses, 72 (2.8%) resulted in term low birthweight infants and 375 (14.4%) were preterm deliveries.ConclusionsAlthough pregnant women were infrequently reported with laboratory-confirmed SARS-CoV-2 infection, pregnant symptomatic women with COVID-19 were at increased risk for hospitalisation and death compared to nonpregnant symptomatic women. Almost all infections we reported on were third-trimester infections; ongoing follow-up is needed to determine pregnancy outcomes among women infected earlier in pregnancy. Healthcare providers should counsel pregnant women about preventive measures to protect from SARS-CoV-2 infection and when to seek care.

Project description:ObjectivesThis study aims to determine hospital variation and intensive care unit characteristics associated with failure to rescue after abdominal surgery in Norway.DesignA nationwide retrospective observational study.SettingAll 52 hospitals in Norway performing elective and acute abdominal surgery.ParticipantsAll 598 736 patients undergoing emergency and elective abdominal surgery from 2011 to 2021.Primary outcome measurePrimary outcome was failure to rescue within 30 days (FTR30), defined as in-hospital or out-of-hospital death within 30 days of a surgical patient who developed at least one complication within 30 days of the surgery (FTR30). Other outcome variables were surgical complications and hospital FTR30 variation. Statistical analysis was conducted separately for general surgery and abdominal surgery.ResultsThe 30-day postoperative complication rate was 30.7 (183 560 of 598 736 surgeries). Of general surgical complications (n=25 775), circulatory collapse (n=6127, 23%), cardiac arrhythmia (n=5646, 21%) and surgical infections (n=4334, 16 %) were most common and 1507 (5.8 %) patients were reoperated within 30 days. One thousand seven hundred and forty patients had FTR30 (6.7 %). The severity of complications was strongly associated with FTR30. In multivariate analysis of general surgery, adjusted for patient characteristics, only the year of surgery was associated with FTR30, with an estimated linear trend of -0.31 percentage units per year (95% CI (-0.48 to -0.15)). The driving distance from local hospitals to the nearest referral intensive care unit was not associated with FTR30. Over the last decade, FTR30 rates have varied significantly among similar hospitals.ConclusionsHospital factors cannot explain Norwegian hospitals' significant FTR variance when adjusting for patient characteristics. The national FTR30 measure has dropped around 30% without a corresponding fall in surgical complications. No association was seen between rural hospital location and FTR30. Policy-makers must address microsystem issues causing high FTR30 in hospitals.

Dataset Information

Is pregnancy a risk factor for in-hospital mortality in reproductive-aged women with SARS-CoV-2 infection? A nationwide retrospective observational cohort study.

Objective

Methods

Results

Conclusion

Publications

Is pregnancy a risk factor for in-hospital mortality in reproductive-aged women with SARS-CoV-2 infection? A nationwide retrospective observational cohort study.

Similar Datasets

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