A practical approach for the management of obstetric and infertile women during the phase two of the novel coronavirus disease 2019 (COVID ‐19) pandemic

Carbone, Ilma Floriana; Conforti, Alessandro; Farina, Antonio; Alviggi, Carlo

doi:10.1016/j.ejogrb.2020.06.006

Cited by 8 publications

(8 citation statements)

References 4 publications

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“…COVID-19 may predispose the general population to a thrombotic condition, both in the venous and arterial circulations, due to inflammation, platelet activation, endothelial dysfunction, and stasis [27,28]. This COVID-19 related hypercoagulability state might intuitively assume an important role in pregnancy due to its inherent prothrombotic state, and might represent a possible cause of the small increase of the rate of stillbirths compared with the baseline population [29][30][31][32].…”

Section: Implications For Clinical Practice and Researchmentioning

confidence: 99%

Risk factors associated with adverse fetal outcomes in pregnancies affected by Coronavirus disease 2019 (COVID-19): a secondary analysis of the WAPM study on COVID-19

Mascio

Şen

Saccone

et al. 2020

Journal of Perinatal Medicine

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126

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ObjectivesTo evaluate the strength of association between maternal and pregnancy characteristics and the risk of adverse perinatal outcomes in pregnancies with laboratory confirmed COVID-19.MethodsSecondary analysis of a multinational, cohort study on all consecutive pregnant women with laboratory-confirmed COVID-19 from February 1, 2020 to April 30, 2020 from 73 centers from 22 different countries. A confirmed case of COVID-19 was defined as a positive result on real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay of nasal and pharyngeal swab specimens. The primary outcome was a composite adverse fetal outcome, defined as the presence of either abortion (pregnancy loss before 22 weeks of gestations), stillbirth (intrauterine fetal death after 22 weeks of gestation), neonatal death (death of a live-born infant within the first 28 days of life), and perinatal death (either stillbirth or neonatal death). Logistic regression analysis was performed to evaluate parameters independently associated with the primary outcome. Logistic regression was reported as odds ratio (OR) with 95% confidence interval (CI).ResultsMean gestational age at diagnosis was 30.6±9.5 weeks, with 8.0% of women being diagnosed in the first, 22.2% in the second and 69.8% in the third trimester of pregnancy. There were six miscarriage (2.3%), six intrauterine device (IUD) (2.3) and 5 (2.0%) neonatal deaths, with an overall rate of perinatal death of 4.2% (11/265), thus resulting into 17 cases experiencing and 226 not experiencing composite adverse fetal outcome. Neither stillbirths nor neonatal deaths had congenital anomalies found at antenatal or postnatal evaluation. Furthermore, none of the cases experiencing IUD had signs of impending demise at arterial or venous Doppler. Neonatal deaths were all considered as prematurity-related adverse events. Of the 250 live-born neonates, one (0.4%) was found positive at RT-PCR pharyngeal swabs performed after delivery. The mother was tested positive during the third trimester of pregnancy. The newborn was asymptomatic and had negative RT-PCR test after 14 days of life. At logistic regression analysis, gestational age at diagnosis (OR: 0.85, 95% CI 0.8–0.9 per week increase; p<0.001), birthweight (OR: 1.17, 95% CI 1.09–1.12.7 per 100 g decrease; p=0.012) and maternal ventilatory support, including either need for oxygen or CPAP (OR: 4.12, 95% CI 2.3–7.9; p=0.001) were independently associated with composite adverse fetal outcome.ConclusionsEarly gestational age at infection, maternal ventilatory supports and low birthweight are the main determinants of adverse perinatal outcomes in fetuses with maternal COVID-19 infection. Conversely, the risk of vertical transmission seems negligible.

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Section: Implications For Clinical Practice and Researchmentioning

confidence: 99%

Risk factors associated with adverse fetal outcomes in pregnancies affected by Coronavirus disease 2019 (COVID-19): a secondary analysis of the WAPM study on COVID-19

Mascio

Şen

Saccone

et al. 2020

Journal of Perinatal Medicine

Self Cite

126

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“…[1] Italy was the one of the first European countries to be severely hit by the spread of the pandemic. There, evidence and guidance on how to manage obstetrics and gynecology patients during this period have been soon released and taken as example by other nations [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] . Notably, pregnant women were soon considered a population at increased risk for complications and more severe COVID-19 course [16] , [17] , [18] , [19] , [20] , [21] , [22] .…”

Section: Introductionmentioning

confidence: 99%

Worldwide beliefs among pregnant women on SARS-CoV-2 vaccine: a systematic review

Carbone

Girolamo

Mappa

et al. 2022

European Journal of Obstetrics & Gynecology and Reproductiv

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Background SARS-CoV-2 vaccine has been recommended to pregnant women, but survey studies showed contrasting findings worldwide in relation to the willingness to accept vaccination during pregnancy. Objective To evaluate the evidence from the literature regarding the acceptance rate of the SARS-CoV-2 vaccine in pregnant and breastfeeding women. Study design: We performed a systematic review on the main databases (MEDLINE (PubMed), Scopus, ISI Web of Science) searching for all the peer-reviewed survey studies analyzing the eventual acceptance rate of the SARS-CoV-2 vaccine among pregnant and breastfeeding women. To combine data meta-analyses of proportions and pooled proportions with their 95% confidence intervals (CI) were calculated. Results 15 studies including 25839 women were included in the analysis. The proportion of women actually willing to be vaccinated during pregnancy is 49.1% (95% CI, 42.3-56.0), and the proportion of breastfeeding women is 61.6% (95% CI, 50.0-75.0). Conclusion The cumulative SARS-CoV-2 vaccine acceptance rate among pregnant women appear still low. Vaccinal campaign are urgently needed to drive more confidence into the vaccine to help reducing the spread of the infection and the possible consequences during pregnancy.

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“…COVID-19 pandemic has determined an incredible burden on national healthcare systems worldwide. In Obstetrics and Gynecology practice, all non-urgent clinical and surgical activities have been postponed during the most critical phases, also raising the debate on which conditions should be considered as urgent and how to reorganize obstetrical, gynecological and reproductive medicine units [1][2][3][4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Pregnant women's perspectives on severe acute respiratory syndrome coronavirus 2 vaccine

Carbone

Mappa

Sirico

et al. 2021

American Journal of Obstetrics & Gynecology MFM

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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A practical approach for the management of obstetric and infertile women during the phase two of the novel coronavirus disease 2019 (COVID ‐19) pandemic

Abstract: A practical approach for the management of obstetric and infertile women during the phase two of the novel coronavirus disease 2019 (COVID-19) pandemic Dear Editor,

Cited by 8 publications

References 4 publications

Risk factors associated with adverse fetal outcomes in pregnancies affected by Coronavirus disease 2019 (COVID-19): a secondary analysis of the WAPM study on COVID-19

Risk factors associated with adverse fetal outcomes in pregnancies affected by Coronavirus disease 2019 (COVID-19): a secondary analysis of the WAPM study on COVID-19

Worldwide beliefs among pregnant women on SARS-CoV-2 vaccine: a systematic review

Pregnant women's perspectives on severe acute respiratory syndrome coronavirus 2 vaccine

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