High rates of stillbirth and preterm delivery in women with covid-19 and the efficacy of ECMO in pregnancy

Kingston, Elizabeth V

doi:10.1136/bmj.m2921

Cited by 7 publications

(7 citation statements)

References 6 publications

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“…Women with COVID-19 infection are at a higher risk of delivering preterm. 9 In the present study, the rate of preterm delivery was almost 8-fold higher for MGP than for singleton pregnancies. However, the incidence of preterm delivery among women with MGP and COVID-19 during the 5-month study period was marginally lower than that among uninfected women with MGP during the months preceding the pandemic (60% vs. 73%).…”

Section: Discussionsupporting

confidence: 41%

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Impact of SARS‐CoV‐2 on multiple gestation pregnancy

Mahajan

Ansari

Gaikwad

et al. 2020

Intl J Gynecology & Obste

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The incidence of multiple pregnancies varies in different populations and countries. Twinning rates in India are reported to be below 9 per 1000 births. 1 As of October 20, 2020 SARS-CoV-2 (COVID-19) had affected approximately 40 million individuals globally and caused more than 1 million deaths, 2 including many pregnant women with twin gestation. Multiple gestational pregnancies (MGP) are associated with a high risk of both fetal and maternal complications and require

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Section: Discussionsupporting

confidence: 41%

“…Women with Covid-19 infection are at a higher risk of delivering preterm [9]. In the present study, the rate of preterm delivery was almost 8-fold higher for MGP than for singleton pregnancies.…”

Section: Accepted Articlesupporting

confidence: 40%

Impact of SARS‐CoV‐2 on multiple gestation pregnancy

Mahajan

Ansari

Gaikwad

et al. 2020

Intl J Gynecology & Obste

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“…This finding differs from other published studies showing possible associations between SARS-CoV-2 infection and preterm delivery, stillbirth, unplanned cesarean delivery, and/or preeclampsia. 6,[25][26][27] This difference is likely multifactorial. While 61 patients in our study population were infected with SARS-CoV-2 during their pregnancy, only two of these patients experienced severe disease requiring ICU admission.…”

Section: Commentmentioning

confidence: 99%

SARS-CoV-2 Infection during Pregnancy in a Rural Midwest All-delivery Cohort and Associated Maternal and Neonatal Outcomes

et al. 2021

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Objective This study aimed to estimate the prevalence of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) among pregnant patients at the time of delivery in a rural Midwest tertiary care hospital and to examine demographics, clinical factors, and maternal and neonatal outcomes associated with SARS-CoV-2 infection during pregnancy. Study Design This prospective cohort study included all delivering patients between May 1 and September 22, 2020 at the University of Iowa Hospitals and Clinics. Plasma SARS-CoV-2 antibody testing was performed. SARS-CoV-2 viral reverse-transcription polymerase chain reaction (RT-PCR) results and maternal and neonatal outcomes were collected from the electronic medical record. Data were analyzed using univariate statistical methods with clustering for multiple births. Results In total, 1,000 patients delivered between May 1 and September 22, 2020. Fifty-eight (5.8%) were SARS-CoV-2 antibody positive. Twenty-three also tested viral positive during pregnancy. Three of 1,000 (0.3%) were viral positive on admission but antibody negative. The median age was 30 years (interquartile range [IQR]: 26–33 years) and body mass index was 31.75 kg/m2 (IQR 27.7–37.5 kg/m2). The cesarean delivery rate was 34.0%. The study population was primarily white (71.6%); however, 41.0% of SARS-CoV-2 infected patients identified as Black, 18.0% as Hispanic/Latino, 3.3% as Native Hawaiian/Pacific Islander, and only 27.9% as White (p < 0.0001). SARS-CoV-2 infection was more likely in patients without private insurance (p = 0.0243). Adverse maternal and/or neonatal outcomes were not more likely in patients with evidence of infection during pregnancy. Two SARS-CoV-2 infected patients were admitted to the intensive care unit. There were no maternal deaths during the study period. Conclusion In this largely rural Midwest population, 6.1% of delivering patients had evidence of past or current SARS-CoV-2 infection. Rates of SARS-CoV-2 during pregnancy were higher among racial and ethnic minorities and patients without private insurance. The SARS-CoV-2 infected patients and their neonates were not found to be at increased risk for adverse outcomes. Key Points

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“…In obstetrics, scientific evidence of the potential adverse effects of the virus on maternal and perinatal outcomes were published (43). One of the potential explanations of this evidence is the fear of pregnant women to continue their normal follow-up programmes in a period of social distancing imposed by governments.…”

Section: The Impacts Of the Sars-cov-2 Pandemic On Other Essential Gynaecological And Obstetrical Care Servicesmentioning

confidence: 99%

Future medico-legal implications on Obstetrics and Gynaecology practice in the SARS-CoV-2 pandemic

Oliva

2021

It Journ Gyn Obs

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Since February 2020, the Italian National Healthcare System had to mitigate the possibility of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) transmission to vulnerable patients. Healthcare professionals rapidly reviewed their workflow to maintain a safe and high standard treatment, but weak scientific evidences and organizational limits resulted in the adoption of heterogeneous measures. Adherence to screening protocols and follow-up programs pregnant women and oncological patients has not been always guaranteed: this scenario could evolve in an enormous number of medico-legal actions. This context, showing the weakness of the Italian law No. 24/2017, imposes an urgent reorganization of the legal framework to homogenize the judgements to "protect" healthcare professionals involved in this epochal emergency. SOMMARIODa febbraio 2020, il Sistema Sanitario Italiano ha dovuto arginare il rischio di trasmissione della malattia da Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-Cov-2) a pazienti vulnerabili. Gli operatori sanitari hanno rapidamente rivisto il loro flusso di lavoro per mantenere uno standard di cure adeguato, ma prove scientifiche deboli e limiti organizzativi hanno portato all'adozione di misure eterogenee. L'adesione ai protocolli di screening e ai programmi di follow-up delle donne gravide e delle pazienti oncologiche non è sempre stata garantita: questo scenario potrebbe evolvere in un numero enorme di azioni medico-legali. Tale contesto, che mostra la debolezza della legge italiana n. 24/2017, impone un'urgente riorganizzazione del quadro giuridico per "tutelare" gli operatori sanitari coinvolti in questa emergenza epocale.

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High rates of stillbirth and preterm delivery in women with covid-19 and the efficacy of ECMO in pregnancy

Cited by 7 publications

References 6 publications

Impact of SARS‐CoV‐2 on multiple gestation pregnancy

Impact of SARS‐CoV‐2 on multiple gestation pregnancy

SARS-CoV-2 Infection during Pregnancy in a Rural Midwest All-delivery Cohort and Associated Maternal and Neonatal Outcomes

Future medico-legal implications on Obstetrics and Gynaecology practice in the SARS-CoV-2 pandemic

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