Late miscarriage and stillbirth in asymptomatic and symptomatic hospitalised pregnant women in Belgium during the first and second waves of COVID-19: a prospective nationwide population-based study.
BMC Pregnancy Childbirth
; 23(1): 356, 2023 May 16.
Article
Dans Anglais
| MEDLINE | ID: covidwho-2326871
ABSTRACT
BACKGROUND:
Stillbirth has been recognized as a possible complication of a SARS-CoV-2 infection during pregnancy, probably due to destructive placental lesions (SARS-CoV-2 placentitis). The aim of this work is to analyse stillbirth and late miscarriage cases in unvaccinated pregnant women infected with SARS-CoV-2 during the first two waves (wild-type period) in Belgium.METHODS:
Stillbirths and late miscarriages in our prospective observational nationwide registry of SARS-CoV-2 infected pregnant women (n = 982) were classified by three authors using a modified WHO-UMC classification system for standardized case causality assessment.RESULTS:
Our cohort included 982 hospitalised pregnant women infected with SARS-CoV-2, with 23 fetal demises (10 late miscarriages from 12 to 22 weeks of gestational age and 13 stillbirths). The stillbirth rate was 9.5 for singleton pregnancies and 83.3 for multiple pregnancies, which seems higher than for the background population (respectively 5.6 and 13.8). The agreement between assessors about the causal relationship with SARS-Cov-2 infection was fair (global weighted kappa value of 0.66). Among these demises, 17.4% (4/23) were "certainly" attributable to SARS-CoV-2 infection, 13.0% (3/23) "probably" and 30.4% (7/23) "possibly". Better agreement in the rating was noticed when pathological examination of the placenta and identification of the virus were available, underlining the importance of a thorough investigation in case of intra-uterine fetal demise.CONCLUSIONS:
SARS-CoV-2 causality assessment of late miscarriage and stillbirth cases in our Belgian nationwide case series has shown that half of the fetal losses could be attributable to SARS-CoV-2. We must consider in future epidemic emergencies to rigorously investigate cases of intra-uterine fetal demise and to store placental tissue and other material for future analyses.Mots clés
Texte intégral:
Disponible
Collection:
Bases de données internationales
Base de données:
MEDLINE
Sujet Principal:
Complications infectieuses de la grossesse
/
Avortement spontané
/
Mortinatalité
/
COVID-19
Type d'étude:
Étude de cohorte
/
Étude observationnelle
/
Étude pronostique
Les sujets:
Covid long
Limites du sujet:
Adolescent
/
Adulte
/
Femelle
/
Humains
/
Grossesse
Pays comme sujet:
Europe
langue:
Anglais
Revue:
BMC Pregnancy Childbirth
Thème du journal:
Obstétrique
Année:
2023
Type de document:
Article
Pays d'affiliation:
S12884-023-05624-3
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