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SARS-CoV-2 Infection During Pregnancy and Associated Perinatal Health Outcomes: A National US Cohort Study.
Regan, Annette K; Arah, Onyebuchi A; Fell, Deshayne B; Sullivan, Sheena G.
  • Regan AK; School of Nursing and Health Professions, University of San Francisco, Orange, California, USA.
  • Arah OA; Fielding School of Public Health, University of California Los Angeles, Los Angeles, California, USA.
  • Fell DB; OptumLabs, Eden Prairie, Minnesota, USA.
  • Sullivan SG; Fielding School of Public Health, University of California Los Angeles, Los Angeles, California, USA.
J Infect Dis ; 225(5): 759-767, 2022 03 02.
Article in English | MEDLINE | ID: covidwho-1597371
ABSTRACT

BACKGROUND:

Although severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been associated with increased risk of adverse perinatal health outcomes, few large-scale, community-based epidemiological studies have been conducted.

METHODS:

We conducted a national cohort study using deidentified administrative claims data for 78 283 pregnancies with estimated conception before 30 April 2020 and pregnancy end after 11 March 2020. We identified SARS-CoV-2 infections using diagnostic and laboratory testing data, and compared the risk of pregnancy outcomes using Cox proportional hazard models treating coronavirus disease 2019 (COVID-19) as a time-varying exposure and adjusting for baseline covariates.

RESULTS:

Of the pregnancies, 2655 (3.4%) had a documented SARS-CoV-2 infection. COVID-19 during pregnancy was not associated with risk of miscarriage, antepartum hemorrhage, or stillbirth, but was associated with 2-3 fold higher risk of induced abortion (adjusted hazard ratio [aHR], 2.60; 95% confidence interval [CI], 1.17-5.78), cesarean delivery (aHR, 1.99; 95% CI, 1.71-2.31), clinician-initiated preterm birth (aHR, 2.88; 95% CI, 1.93-4.30), spontaneous preterm birth (aHR, 1.79; 95% CI, 1.37-2.34), and fetal growth restriction (aHR, 2.04; 95% CI, 1.72-2.43).

CONCLUSIONS:

Prenatal SARS-CoV-2 infection was associated with increased risk of adverse pregnancy outcomes. Prevention could have fetal health benefits.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pregnancy Complications, Infectious / Pregnancy Outcome / Infectious Disease Transmission, Vertical / Premature Birth / COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Limits: Adult / Female / Humans / Infant, Newborn / Pregnancy Language: English Journal: J Infect Dis Year: 2022 Document Type: Article Affiliation country: Infdis

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pregnancy Complications, Infectious / Pregnancy Outcome / Infectious Disease Transmission, Vertical / Premature Birth / COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Limits: Adult / Female / Humans / Infant, Newborn / Pregnancy Language: English Journal: J Infect Dis Year: 2022 Document Type: Article Affiliation country: Infdis