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The association of COVID-19 infection in pregnancy with preterm birth: A retrospective cohort study in California.
Karasek, Deborah; Baer, Rebecca J; McLemore, Monica R; Bell, April J; Blebu, Bridgette E; Casey, Joan A; Coleman-Phox, Kimberly; Costello, Jean M; Felder, Jennifer N; Flowers, Elena; Fuchs, Jonathan D; Gomez, Anu Manchikanti; Karvonen, Kayla; Kuppermann, Miriam; Liang, Liang; McKenzie-Sampson, Safyer; McCulloch, Charles E; Oltman, Scott P; Pantell, Matthew S; Piao, Xianhua; Prather, Aric A; Schmidt, Rebecca J; Scott, Karen A; Spellen, Solaire; Stookey, Jodi D; Tesfalul, Martha; Rand, Larry; Jelliffe-Pawlowski, Laura L.
  • Karasek D; Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco 490 Illinois Street, Flr 9 Box 2930, San Francisco, CA 94143, USA.
  • Baer RJ; California Preterm Birth Initiative, University of California, San Francisco, 490 Illinois Street, Flr 9 Box 2930, San Francisco, CA 94143, USA.
  • McLemore MR; California Preterm Birth Initiative, University of California, San Francisco, 490 Illinois Street, Flr 9 Box 2930, San Francisco, CA 94143, USA.
  • Bell AJ; Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, California 92093, USA.
  • Blebu BE; Department of Family Health Care Nursing, 2 Koret Way, San Francisco CA 94143, USA.
  • Casey JA; Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco 490 Illinois Street, Flr 9 Box 2930, San Francisco, CA 94143, USA.
  • Coleman-Phox K; California Preterm Birth Initiative, University of California, San Francisco, 490 Illinois Street, Flr 9 Box 2930, San Francisco, CA 94143, USA.
  • Costello JM; Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco 490 Illinois Street, Flr 9 Box 2930, San Francisco, CA 94143, USA.
  • Felder JN; California Preterm Birth Initiative, University of California, San Francisco, 490 Illinois Street, Flr 9 Box 2930, San Francisco, CA 94143, USA.
  • Flowers E; Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, 722 West 168th St. NY, NY 10032, USA.
  • Fuchs JD; Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco 490 Illinois Street, Flr 9 Box 2930, San Francisco, CA 94143, USA.
  • Gomez AM; California Preterm Birth Initiative, University of California, San Francisco, 490 Illinois Street, Flr 9 Box 2930, San Francisco, CA 94143, USA.
  • Karvonen K; California Preterm Birth Initiative, University of California, San Francisco, 490 Illinois Street, Flr 9 Box 2930, San Francisco, CA 94143, USA.
  • Kuppermann M; Department of Biological and Medical Informatics, University of California San Francisco, 550 16th Street, Flr 3, San Francisco, CA, 94158, USA.
  • Liang L; Osher Center for Integrative Medicine, University of California, San Francisco, 1545 Divisadero St, San Francisco, CA 94115, USA.
  • McKenzie-Sampson S; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 3333 California Street, San Francisco CA 94118, USA.
  • McCulloch CE; Department of Physiological Nursing, University of California, San Francisco, Koret Way, San Francisco, CA 94143, USA.
  • Oltman SP; California Preterm Birth Initiative, University of California, San Francisco, 490 Illinois Street, Flr 9 Box 2930, San Francisco, CA 94143, USA.
  • Pantell MS; Center for Learning & Innovation, San Francisco Department of Public Health 25 Van Ness, Suite 500, San Francisco, CA, 94102, USA.
  • Piao X; School of Social Welfare, Sexual Health and Reproductive Equity Program, University of California, Berkeley, 110 Haviland Hall MC 7400, Berkeley, CA 94720-7400, USA.
  • Prather AA; Department of Pediatrics, University of California San Francisco, 550 16th Street, Box 0110, San Francisco, CA 94143, USA.
  • Schmidt RJ; Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco 490 Illinois Street, Flr 9 Box 2930, San Francisco, CA 94143, USA.
  • Scott KA; California Preterm Birth Initiative, University of California, San Francisco, 490 Illinois Street, Flr 9 Box 2930, San Francisco, CA 94143, USA.
  • Spellen S; Department of Genetics, Stanford University School of Medicine, 291 Campus Drive, Stanford, CA 94305, USA.
  • Stookey JD; Department of Epidemiology and Biostatistics, University of California, San Francisco, 550 16th Street, Flr 3, San Francisco, CA, 94158, USA.
  • Tesfalul M; Department of Epidemiology and Biostatistics, University of California, San Francisco, 550 16th Street, Flr 3, San Francisco, CA, 94158, USA.
  • Rand L; California Preterm Birth Initiative, University of California, San Francisco, 490 Illinois Street, Flr 9 Box 2930, San Francisco, CA 94143, USA.
  • Jelliffe-Pawlowski LL; Department of Epidemiology and Biostatistics, University of California, San Francisco, 550 16th Street, Flr 3, San Francisco, CA, 94158, USA.
Lancet Reg Health Am ; 2: 100027, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1331027
ABSTRACT

INTRODUCTION:

Our understanding of the association between coronavirus disease 19 (COVID-19) and preterm or early term birth among racially and ethnically diverse populations and people with chronic medical conditions is limited.

METHODS:

We determined the association between COVID-19 and preterm (PTB) birth among live births documented by California Vital Statistics birth certificates between July 2020 and January 2021 (n=240,147). We used best obstetric estimate of gestational age to classify births as very preterm (VPTB, <32 weeks), PTB (< 37 weeks), early term (37 and 38 weeks), and term (39-44 weeks), as each confer independent risks to infant health and development. Separately, we calculated the joint effects of COVID-19 diagnosis, hypertension, diabetes, and obesity on PTB and VPTB.

FINDINGS:

COVID-19 diagnoses on birth certificates increased for all racial/ethnic groups between July 2020 and January 2021 and were highest for American Indian/Alaska Native (12.9%), Native Hawaiian/Pacific Islander (11.4%), and Latinx (10.3%) birthing people. COVID-19 diagnosis was associated with an increased risk of VPTB (aRR 1.6, 95% CI [1.4, 1.9]), PTB (aRR 1.4, 95% CI [1.3, 1.4]), and early term birth (aRR 1.1, 95% CI [1.1, 1.2]). There was no effect modification of the overall association by race/ethnicity or insurance status. COVID-19 diagnosis was associated with elevated risk of PTB in people with hypertension, diabetes, and/or obesity.

INTERPRETATION:

In a large population-based study, COVID-19 diagnosis increased the risk of VPTB, PTB, and early term birth, particularly among people with medical comorbidities. Considering increased circulation of COVID-19 variants, preventative measures, including vaccination, should be prioritized for birthing persons.

FUNDING:

UCSF-Kaiser Department of Research Building Interdisciplinary Research Careers in Women's Health Program (BIRCWH) National Institute of Child Health and Human Development (NICHD) and the Office of Research on Women's Health (ORWH) [K12 HD052163] and the California Preterm Birth Initiative, funded by Marc and Lynn Benioff.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Vaccines / Variants Language: English Journal: Lancet Reg Health Am Year: 2021 Document Type: Article Affiliation country: J.lana.2021.100027

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Vaccines / Variants Language: English Journal: Lancet Reg Health Am Year: 2021 Document Type: Article Affiliation country: J.lana.2021.100027