Preterm birth and severe maternal morbidity associated with SARS-CoV-2 infection during the Omicron wave

Gulersen, Moti; ALVAREZ, Alejandro; Rochelson, Burton; Blitz, Matthew J.

doi:10.1016/j.ajogmf.2022.100712

Cited by 7 publications

(7 citation statements)

References 5 publications

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“…Specifically, adjusting for maternal age, race-ethnicity, parity, history of PTB, body mass index, marital status, medical co-morbidities, month of delivery, and pandemic wave, it was seen that patients with symptomatic COVID-19 at the time of delivery had a higher risk of PTB (19.0%) compared to women with asymptomatic infection (8.8%) or no infection (7.1%). [25] Finally, in the article by Gulersen et al [26] it was seen that, during the Omicron wave, SARS-CoV-2 infection in pregnancy has been associated with an increased risk of PTB compared to uninfected cases. This risk has not been changed by vaccination or the status of the SARS-CoV-2 antibodies in subgroup analyses.…”

Section: Resultsmentioning

confidence: 99%

Covid19 and Pregnancy: Infected Mothers and Premature Babies?

Franco,

Perelli,

Gallitelli

et al. 2024

Preprint

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Introduction: The emergency of the SARS-CoV-2 virus spread and its subsequent global pan-demic have raised significant concerns regarding its impact on pregnancy outcomes. This review aims to summarize the emerging data on the risk of preterm delivery in pregnant women infected with SARS-CoV-2. Materials and Methods: A systematic search was conducted from March 2020 to December 2023 using PubMed, following PRISMA guidelines. Studies correlating maternal COVID-19 infection with preterm birth were included. Results: Thirteen studies were analyzed, indicating a higher incidence of preterm birth in SARS-CoV-2 positive pregnant women compared to controls. The average incidence rate of pre-term birth in infected patients was 18.5%, with a median of 12.75%, while non infected women showed an average incidence of preterm birth of 10% with a median of 8.2%. Discussion: Studies suggest an association between SARS-CoV-2 infection during pregnancy and increased risk of preterm birth and cesarean section. Severity of symptoms and underlying comorbidities further elevate this risk. Notably, infections during the third trimester pose the highest risk of preterm birth. Conclusion: Preventing SARS-CoV-2 infection during pregnancy is crucial to mitigate adverse obstetric outcomes. Close monitoring and tailored interventions for infected pregnant women, particularly those in later trimesters and with comorbidities, are imperative to reduce the risk of preterm birth and improve maternal-fetal outcomes.

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Section: Resultsmentioning

confidence: 99%

Covid19 and Pregnancy: Infected Mothers and Premature Babies?

Franco,

Perelli,

Gallitelli

et al. 2024

Preprint

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“…In the United States, few studies have assessed the severity of COVID-19 during Omicron predominance; studies available are limited by sample sizes (Gulersen et al, 2022;Seasely et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

COVID-19-related Health Outcomes during Delivery Hospitalization During Pre-delta, Delta, and Omicron Periods

Carlson,

Simeone,

Ellington

et al. 2023

Preprint

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Background SARS-CoV-2 infection during pregnancy has been associated with several adverse maternal health and pregnancy outcomes; however, few studies have included pregnancies occurring during the time period of Omicron variant predominance (January 2022–present) in the evaluation of pregnancy outcomes. We examined the relationship between COVID-19 diagnosis at delivery and adverse maternal and pregnancy outcomes for each variant period, with a focus on Omicron. Methods Data on delivery hospitalizations from the Premier Healthcare Database during February 2020 –August 2023 were analyzed as a cross-sectional observational study. Adjusted prevalence ratios (aPR) were calculated to compare the risks of adverse outcomes between women with and without a COVID-19 diagnosis at the time of delivery for each variant period. Results Among 2,990,973 women with a delivery hospitalization, 1.9% (n = 56,618) had a COVID-19 diagnosis noted on discharge, including 26,053 during the Omicron period. In adjusted models, COVID-19 during the Omicron period was associated with a significant increased risk for maternal sepsis (COVID-19: 0.4% vs No COVID-19: 0.1%) (aPR: 3.32 [95%CI: 2.70, 4.08]), acute respiratory distress syndrome (0.6% vs 0.1%) (6.19 [5.26, 7.29]), shock (0.2% vs 0.1%) (2.14 [1.62, 2.84]), renal failure (0.5% vs 0.2%) (2.08 [1.73, 2.49]), ICU admission (2.7% vs 1.7%) (1.64 [1.53, 1.77]), mechanical ventilation (0.3% vs 0.1%) (3.15 [2.52, 3.93]), in-hospital death (0.0% vs 0.0%)(5.00 [2.30, 10.90]), stillbirth (0.7% vs 0.6%) (1.17 [1.01, 1.36]), and preterm birth (12.3% vs 9.6%) (1.34 [1.27, 1.42]). Conclusions During the Omicron variant period, risks of adverse outcomes associated with COVID-19 diagnosis at delivery remain elevated, despite the possibility of some level of immunity due to previous SARS-COV-2 infection or vaccination. It remains important for pregnant people, and those planning pregnancy, to stay up to date with COVID-19 vaccination to reduce the risk of adverse outcomes.

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“…The impact of Covid-19 on severe maternal morbidity is poorly understood because prior research has focused on demonstrating that newer SARS-CoV-2 variants are not as dangerous as earlier variants in pregnant women [ 6 – 9 ]. Studies have successfully shown that infections with wildtype, alpha, beta, gamma, and delta are all more harmful than omicron [ 6 – 9 ]. As the attention was on comparing variants, efforts at identifying the specific life-threatening morbidities in SARS-CoV-2 infected women have been rare.…”

Section: Introductionmentioning

confidence: 99%

Impact of Covid-19 on risk of severe maternal morbidity

Auger,

Ukah,

Wei

et al. 2023

Crit Care

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Background We examined the risk of severe life-threatening morbidity in pregnant patients with Covid-19 infection. Methods We conducted a population-based study of 162,576 pregnancies between March 2020 and March 2022 in Quebec, Canada. The main exposure was Covid-19 infection, including the severity, period of infection (antepartum, peripartum), and circulating variant (wildtype, alpha, delta, omicron). The outcome was severe maternal morbidity during pregnancy up to 42 days postpartum. We estimated risk ratios (RR) and 95% confidence intervals (CI) for the association between Covid-19 infection and severe maternal morbidity using adjusted log-binomial regression models. Results Covid-19 infection was associated with twice the risk of severe maternal morbidity compared with no infection (RR 2.02, 95% CI 1.76–2.31). Risks were elevated for acute renal failure (RR 3.01, 95% CI 1.79–5.06), embolism, shock, sepsis, and disseminated intravascular coagulation (RR 1.35, 95% CI 0.95–1.93), and severe hemorrhage (RR 1.49, 95% CI 1.09–2.04). Severe antepartum (RR 13.60, 95% CI 10.72–17.26) and peripartum infections (RR 20.93, 95% CI 17.11–25.60) were strongly associated with severe maternal morbidity. Mild antepartum infections also increased the risk, but to a lesser magnitude (RR 3.43, 95% CI 2.42–4.86). Risk of severe maternal morbidity was around 3 times greater during circulation of wildtype and the alpha and delta variants, but only 1.2 times greater during omicron. Conclusions Covid-19 infection during pregnancy increases risk of life-threatening maternal morbidity, including renal, embolic, and hemorrhagic complications. Severe Covid-19 infection with any variant in the antepartum or peripartum periods all increase the risk of severe maternal morbidity.

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Preterm birth and severe maternal morbidity associated with SARS-CoV-2 infection during the Omicron wave

Cited by 7 publications

References 5 publications

Covid19 and Pregnancy: Infected Mothers and Premature Babies?

Covid19 and Pregnancy: Infected Mothers and Premature Babies?

COVID-19-related Health Outcomes during Delivery Hospitalization During Pre-delta, Delta, and Omicron Periods

Impact of Covid-19 on risk of severe maternal morbidity

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