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Severe COVID-19 during pregnancy in Sweden, Norway, and Denmark.
Örtqvist, Anne K; Magnus, Maria C; Aabakke, Anna J M; Urhoj, Stine Kjaer; Vinkel Hansen, Anne; Nybo Andersen, Anne-Marie; Krebs, Lone; Pettersson, Karin; Håberg, Siri E; Stephansson, Olof.
  • Örtqvist AK; Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
  • Magnus MC; Department of Obstetrics and Gynecology, Visby County Hospital, Visby, Sweden.
  • Aabakke AJM; Center for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway.
  • Urhoj SK; Department of Obstetrics and Gynecology, Copenhagen University Hospital-Holbaek, Holbaek, Denmark.
  • Vinkel Hansen A; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
  • Nybo Andersen AM; Department of Obstetrics and Gynecology, Copenhagen University Hospital-Northzealand-Hillerød, Hillerød, Denmark.
  • Krebs L; Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
  • Pettersson K; Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
  • Håberg SE; Statistics Denmark, Copenhagen, Denmark.
  • Stephansson O; Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Acta Obstet Gynecol Scand ; 102(6): 681-689, 2023 06.
Article in English | MEDLINE | ID: covidwho-2275097
ABSTRACT

INTRODUCTION:

Pregnancy is a risk factor for severe coronavirus disease 2019 (COVID-19) and adverse pregnancy outcomes. We aimed to explore maternal characteristics, pregnancy outcomes, vaccination status, and virus variants among pregnant women admitted to intensive care units (ICU) with severe COVID-19. MATERIAL AND

METHODS:

We identified pregnant women admitted to ICU in Sweden (n = 96), Norway (n = 31), and Denmark (n = 16) because of severe COVID-19, from national registers and clinical databases between March 2020 and February 2022 (Denmark), August 2022 (Sweden), or December 2022 (Norway). Their background characteristics, pregnancy outcome, and vaccination status were compared with all birthing women and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test-positive pregnant women during the same time period. We calculated the number admitted to ICU per 10 000 birthing and per 1000 SARS-CoV-2 test-positive women during the Index, Alpha, Delta, and Omicron periods.

RESULTS:

Women admitted to ICU had a higher mean body mass index, were more often of non-Scandinavian origin, had on average lower education and income levels, had a higher proportion of chronic and pregnancy-related conditions, delivered preterm, had neonates with low Apgar scores, and had more infants admitted to neonatal care, compared with all birthing and test-positive pregnant women. Of those admitted to ICU, only 7% had been vaccinated before admission. Overall, the highest proportion of women admitted to ICU per birthing was during the Delta period (4.1 per 10 000 birthing women). In Norway, the highest proportion admitted to ICU per test-positive pregnant women was during the Delta period (17.8 per 1000 test-positive), whereas the highest proportion of admitted per test-positive in Sweden and Denmark was seen during the Index period (15.4 and 8.9 per 1000 test-positive, respectively).

CONCLUSIONS:

Admission to ICU because of COVID-19 in pregnancy was a rare event in the Scandinavian countries, but women who were unvaccinated, of non-Scandinavian origin, and with lower socio-economic status were at higher risk of admission to ICU. In addition, women admitted to ICU for COVID-19 had higher risk of adverse pregnancy outcomes.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pregnancy Complications, Infectious / COVID-19 Type of study: Diagnostic study / Observational study / Prognostic study Topics: Vaccines / Variants Limits: Female / Humans / Infant, Newborn / Pregnancy Country/Region as subject: Europa Language: English Journal: Acta Obstet Gynecol Scand Year: 2023 Document Type: Article Affiliation country: Aogs.14552

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pregnancy Complications, Infectious / COVID-19 Type of study: Diagnostic study / Observational study / Prognostic study Topics: Vaccines / Variants Limits: Female / Humans / Infant, Newborn / Pregnancy Country/Region as subject: Europa Language: English Journal: Acta Obstet Gynecol Scand Year: 2023 Document Type: Article Affiliation country: Aogs.14552