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Maternal and perinatal outcomes in high compared to low risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection (phase 2): the World Association of Perinatal Medicine working group on coronavirus disease 2019

F. D'Antonio, C. Sen, DD. Mascio, A. Galindo, C. Villalain, I. Herraiz, R. Arisoy, A. Ovayolu, H. Eroğlu, MG. Canales, S. Ladella, L. Cojocaru, O. Turan, S. Turan, E. Hadar, NA. Brzezinski-Sinai, S. Dollinger, O. Uyaniklar, SR. Ocakouglu, Z....

. 2021 ; 3 (4) : 100329. [pub] 20210220

Language English Country United States

Document type Journal Article, Multicenter Study

BACKGROUND: It has still to be ascertained whether severe acute respiratory syndrome coronavirus 2 infection in pregnancy is associated with worse maternal and fetal outcomes compared to low risk gestations. OBJECTIVE: This study aimed to evaluate maternal and perinatal outcomes in high- and low-risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection. STUDY DESIGN: This was a multinational retrospective cohort study involving women with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection from 76 centers from 25 countries in Europe, the United States, South America, Asia, and Australia from April 4, 2020, to October 28, 2020. The primary outcome was a composite measure of maternal mortality and morbidity, including admission to the intensive care unit, use of mechanical ventilation, or death. The secondary outcome was a composite measure of adverse perinatal outcome, including miscarriage, fetal loss, neonatal and perinatal death, and admission to the neonatal intensive care unit. All outcomes were assessed in high- and low-risk pregnancies. Pregnancies were considered high risk in case of either preexisting chronic medical conditions in pregnancy or obstetrical disorders occurring in pregnancy. The Fisher exact test and logistic regression analysis were used to analyze the data. RESULTS: A total of 887 singleton pregnancies who tested positive for severe acute respiratory syndrome coronavirus 2 infection using reverse transcription-polymerase chain reaction of nasal and pharyngeal swab specimens were included in the study. The risk of composite adverse maternal outcomes was higher in high-risk pregnancies than in low-risk pregnancies (odds ratio, 1.52; 95% confidence interval, 1.03-2.24; P=.035). In addition, women carrying high-risk pregnancies were at higher risk of hospital admission (odds ratio, 1.48; 95% confidence interval, 1.07-2.04; P=.002), presence of severe respiratory symptoms (odds ratio, 2.13; 95% confidence interval, 0.41-3.21; P=.001), admission to the intensive care unit (odds ratio, 2.63; 95% confidence interval, 1.42-4.88), and invasive mechanical ventilation (odds ratio, 2.65; 95% confidence interval, 1.19-5.94; P=.002). When exploring perinatal outcomes, high-risk pregnancies were at high risk of adverse perinatal outcomes (odds ratio, 1.78; 95% confidence interval, 0.15-2.72; P=.009). However, such association was mainly because of the higher incidence of miscarriage in high-risk pregnancies compared with that in low-risk pregnancies (5.3% vs 1.6%, P=.008); furthermore, there was no difference in other explored outcomes between the 2 study groups. At logistic regression analysis, maternal age (odds ratio, 1.12; 95% confidence interval, 1.02-1.22; P=.023) and high-risk pregnancy (odds ratio, 4.21; 95% confidence interval, 3.90-5.11; P<.001) were independently associated with adverse maternal outcomes. CONCLUSION: High-risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection were at higher risk of adverse maternal outcomes than low-risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection.

ABC Medical Center Mexico City Mexico

Academic Division of Obstetrics and Gynecology Mauriziano Umberto 1 Hospital University of Turin Turin Italy

Academic Unit of Obstetrics and Gynaecology Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino Genova Italy

Alexandra Hospital National and Kapodistrian University of Athens Athens Greece

Alvaro Cunqueiro University Hospital of Vigo Vigo Spain

Assistência Obstétrica do Grupo Perinatal Rio de Janeiro Brazil

Batman Maternity and Child Health Hospital Batman Turkey

Bursa City Hospital Bursa Turkey

Campus Bio Medico University of Rome Rome Italy

Cengiz Gokcek Women's and Children's Hospital Gaziantep Turkey

Centre for High Risk Pregnancy and Fetal Care Department of Obstetrics and Gynecology University of Chieti Chieti Italy

Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno Buenos Aires Argentina

Clínica del Country Bogotá Colombia

Community Medical Centers University of California San Francisco Fresno Fresno CA

Departamento de Ginecologia e Obstetrícia Hospital Universitário Polydoro Ernani Santiago Brazil

Departamento De Ginecologia Y Obstetricia Centro Medico La Paz De Bata Bata Guinea Ecuatorial

Department Gynecology and Obstetrics Fornaroli Hospital Magenta Italy

Department of Anaesthesia Lyell McEwin Hospital Adelaide Australia

Department of Maternal and Child Health and Urological Sciences Sapienza University of Rome Rome Italy

Department of Neonatology Obstetrics and Gynecology University Hospital Sofia Bulgaria

Department of Neuroscience Reproductive Sciences and Dentistry School of Medicine University of Naples Federico 2 Naples Italy

Department of Obstetrics and Gynaecology Fondazione Policlinico Universitario A Gemelli IRCCS Università Cattolica del Sacro Cuore Rome Italy

Department of Obstetrics and Gynecology Centre for High Risk Pregnancy and Fetal Care University of Chieti Chieti Italy

Department of Obstetrics and Gynecology Filippo Del Ponte Hospital University of Insubria Varese Italy

Department of Obstetrics and Gynecology Hasanuddin University Makassar Indonesia

Department of Obstetrics and Gynecology Hospital Erasme Cliniques Universitaires de Bruxells Brussels Belgium

Department of Obstetrics and Gynecology Istanbul University Cerrahpasa Medical School Istanbul Turkey

Department of Obstetrics and Gynecology Neonatology and Intensive Care Helsinki University Hospital and University of Helsinki Helsinki Finland

Department of Obstetrics and Gynecology Saint John Hospital Carol Davila University of Medicine and Pharmacy Romania

Department of Obstetrics and Gynecology Sanko University School of Medicine Gaziantep Turkey

Department of Obstetrics and Gynecology Sant'Anna Hospital University of Turin Turin Italy

Department of Obstetrics and Gynecology Sant'Orsola Malpighi University Hospital University of Bologna Bologna Italy

Department of Obstetrics and Gynecology University of Dicle Diyarbakır Turkey

Department of Obstetrics and Gynecology University of Parma Parma Italy

Department of Obstetrics Gynecology and Reproductive Sciences University of Maryland Medical Center Baltimore MD

Department of Perinatal Medicine Memorial Hospital Istanbul Turkey

Department of Woman Child and General and Specialized Surgery University of Campania Luigi Vanvitelli Naples Italy

División Obstetricia Hospital de Clínicas José de San Martín Buenos Aires Argentina

Division of Neonatology Department of Obstetrics and Gynecology General Hospital Prague and 1st Faculty of Medicine Charles University Prague Czech Republic

Division of Neonatology Hospital Clínico San Carlos Madrid Spain

Düzce University Medicine Faculty Department of Perinatology Düzce Turkey

Fetal Medicine Unit Di Venere Hospital Bari Italy

Fetal Medicine Unit Maternal and Child Health and Development Network Department of Obstetrics and Gynecology University Hospital 12 de Octubre Complutense University of Madrid Madrid Spain

Hisar Intercontinental Hospital Instanbul Turkey

Hospital Angeles Lomas Mexico City Mexico

Hospital Clinico San Jose Chile Santiago Chile

Hospital Juan A Fernandez Buenos Argentina

Hospital Raul F Larcade Buenos Aires Argentina

Hospital Regional Universitario de Málaga Malaga Spain

Hospital Universitari Germans Trias i Pujol Barcelona Spain

Hospital Universitario de Móstoles Mostoles Spain

Hospital Virgen De La Luz Cuenca Spain

Instituto de MedFetal e Diagnóstico por Imagem do Amazonas Manausi Brazil

Instituto Nacional Materno Perinatal Lima Peru

Karaman Public Hospital Karaman Turkey

KBC Dr Dragisa Misovic Dedinje Belgrade Serbia

Medical Faculty Department of Perinatology University Medical Center University of Ljubljana Ljubljana Slovenia

National Medical Research Center for Obstetrics Gynecology and Perinatology Moscow Russia

Ospedale Generale Regionale F Miulli Acquaviva delle Fonti Italy

Ostetricia e Ginecologia Universitaria Ospedale S Anna e S Sebastiano Caserta Italy

Perinatal Medicine Foundation Department of Perinatal Medicine Memorial Hospital Istanbul Turkey

Petach Tikva and Sackler Faculty of Medicine Rabin Medical Center Helen Schneider Hospital for Women Tel Aviv University Tel Aviv Israel

Regional Hospital Gjakova Kosovo Republic of Kosovo

Sakarya University Education and Research Hospital Sakarya Turkey

Section of Obstetrics and Gynecology Department of Medical Sciences Azienda Ospedaliera Universitaria Sant' Anna University of Ferrara Ferrara Italy

Servicio de Obstetricia y Ginecología Hospital Universitario y Politécnico La Fe Valencia Spain

Sulochana clinic Kolkata India

Unit of Obstetrics and Gynecology Ospedale Maggiore Bologna Italy

Universitatea de Medicină și Farmacie Grigore T Popa Iași Iasi Romania

University Clinic Hospital of Valladolid Valladolid Spain

University Clinic of Obstetrics and Gynecology Skopje North Macedonia

University Hospital of Obstetrics and Gynecology Sofia Bulgaria

University Of Health Sciences Umraniye Training And Research Hospital Turkey Istanbul

University of Milan Milan Italy

References provided by Crossref.org

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$a Maternal and perinatal outcomes in high compared to low risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection (phase 2): the World Association of Perinatal Medicine working group on coronavirus disease 2019 / $c F. D'Antonio, C. Sen, DD. Mascio, A. Galindo, C. Villalain, I. Herraiz, R. Arisoy, A. Ovayolu, H. Eroğlu, MG. Canales, S. Ladella, L. Cojocaru, O. Turan, S. Turan, E. Hadar, NA. Brzezinski-Sinai, S. Dollinger, O. Uyaniklar, SR. Ocakouglu, Z. Atak, T. Premru-Srsen, L. Kornhauser-Cerar, M. Druškovič, L. Ples, R. Gündüz, E. Ağaçayak, JA. Schvartzman, MN. Malbran, M. Liberati, FD. Sebastiano, L. Oronzi, C. Cerra, D. Buca, A. Cagnacci, A. Ramone, F. Barra, A. Carosso, C. Benedetto, S. Cosma, A. Pintiaux, C. Daelemans, E. Costa, A. Özel, M. Muhçu, JSJ. Lopez, C. Alvarado, AL. Piqueras, DE. Oliva, GBL. Schera, N. Volpe, T. Frusca, I. Samardjiski, S. Simeonova, IA. Papestiev, J. Hojman, I. Turkcuoglu, A. Cromi, AS. Laganà, F. Ghezzi, A. Sirico, A. Familiari, G. Scambia, ZKGT. Sukhikh, KA. Gorina, RAM. de Sa, M. Vaz, OHM. Feuerschuette, AND. Gatta, A. Youssef, GD. Donna, A. Martinez-Varea, G. Loscalzo, J. Morales Roselló, V. Stefanovic, I. Nupponen, K. Nelskylä, R. Ayala, RG. Molpeceres, AP. Vázquez, F. Sandri, I. Cataneo, M. Lenzi, ET. Haberal, E. Huertas, A. Sanchez, P. Arango, A. Bermejo, MMG. Alcantara, G. Göynümer, E. Okuyan, C. Madalina, AC. Guisan, AM. Schulte, V. Esposito, V. De Robertis, S. Zdjelar, M. Lackovic, S. Mihajlovic, N. Jekova, G. Saccone, MM. Aslan, MCD. Dedda, M. Chalid, JEM. Canache, G. Daskalakis, P. Antsaklis, EC. Vega, E. Cueto, C. Taccaliti, Y. Aykanat, Ş. Özlem Genç, B. Froessler, PA. Radulova, D. Morano, B. Bianchi, MGL. Marino, G. Meccariello, B. Rohatgi, A. Schiattarella, M. Morlando, N. Colacurci, A. Villasco, N. Biglia, ALS. Marques, A. Gatti, D. Luvero, R. Angioli, A. Pittaro, A. Lila, B. Zlatohlávková, On the behalf of the World Association of Perinatal Medicine working group on coronavirus disease 2019
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$a BACKGROUND: It has still to be ascertained whether severe acute respiratory syndrome coronavirus 2 infection in pregnancy is associated with worse maternal and fetal outcomes compared to low risk gestations. OBJECTIVE: This study aimed to evaluate maternal and perinatal outcomes in high- and low-risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection. STUDY DESIGN: This was a multinational retrospective cohort study involving women with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection from 76 centers from 25 countries in Europe, the United States, South America, Asia, and Australia from April 4, 2020, to October 28, 2020. The primary outcome was a composite measure of maternal mortality and morbidity, including admission to the intensive care unit, use of mechanical ventilation, or death. The secondary outcome was a composite measure of adverse perinatal outcome, including miscarriage, fetal loss, neonatal and perinatal death, and admission to the neonatal intensive care unit. All outcomes were assessed in high- and low-risk pregnancies. Pregnancies were considered high risk in case of either preexisting chronic medical conditions in pregnancy or obstetrical disorders occurring in pregnancy. The Fisher exact test and logistic regression analysis were used to analyze the data. RESULTS: A total of 887 singleton pregnancies who tested positive for severe acute respiratory syndrome coronavirus 2 infection using reverse transcription-polymerase chain reaction of nasal and pharyngeal swab specimens were included in the study. The risk of composite adverse maternal outcomes was higher in high-risk pregnancies than in low-risk pregnancies (odds ratio, 1.52; 95% confidence interval, 1.03-2.24; P=.035). In addition, women carrying high-risk pregnancies were at higher risk of hospital admission (odds ratio, 1.48; 95% confidence interval, 1.07-2.04; P=.002), presence of severe respiratory symptoms (odds ratio, 2.13; 95% confidence interval, 0.41-3.21; P=.001), admission to the intensive care unit (odds ratio, 2.63; 95% confidence interval, 1.42-4.88), and invasive mechanical ventilation (odds ratio, 2.65; 95% confidence interval, 1.19-5.94; P=.002). When exploring perinatal outcomes, high-risk pregnancies were at high risk of adverse perinatal outcomes (odds ratio, 1.78; 95% confidence interval, 0.15-2.72; P=.009). However, such association was mainly because of the higher incidence of miscarriage in high-risk pregnancies compared with that in low-risk pregnancies (5.3% vs 1.6%, P=.008); furthermore, there was no difference in other explored outcomes between the 2 study groups. At logistic regression analysis, maternal age (odds ratio, 1.12; 95% confidence interval, 1.02-1.22; P=.023) and high-risk pregnancy (odds ratio, 4.21; 95% confidence interval, 3.90-5.11; P<.001) were independently associated with adverse maternal outcomes. CONCLUSION: High-risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection were at higher risk of adverse maternal outcomes than low-risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection.
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$a Sen, Cihat $u Perinatal Medicine Foundation, Department of Perinatal Medicine, Memorial Hospital, Istanbul, Turkey (Dr Sen)
700    1_
$a Mascio, Daniele Di $u Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Rome, Italy (Dr Mascio)
700    1_
$a Galindo, Alberto $u Fetal Medicine Unit, Maternal and Child Health and Development Network, Department of Obstetrics and Gynecology, University Hospital 12 de Octubre, Complutense University of Madrid, Madrid, Spain (Dr Galindo, Dr Villalain, and Dr Herraiz)
700    1_
$a Villalain, Cecilia $u Fetal Medicine Unit, Maternal and Child Health and Development Network, Department of Obstetrics and Gynecology, University Hospital 12 de Octubre, Complutense University of Madrid, Madrid, Spain (Dr Galindo, Dr Villalain, and Dr Herraiz)
700    1_
$a Herraiz, Ignacio $u Fetal Medicine Unit, Maternal and Child Health and Development Network, Department of Obstetrics and Gynecology, University Hospital 12 de Octubre, Complutense University of Madrid, Madrid, Spain (Dr Galindo, Dr Villalain, and Dr Herraiz)
700    1_
$a Arisoy, Resul $u Department of Perinatal Medicine, Memorial Hospital, Istanbul, Turkey (Dr Arisoy)
700    1_
$a Ovayolu, Ali $u Cengiz Gokcek Women's and Children's Hospital, Gaziantep, Turkey (Dr Ovayolu and Dr Eroğlu)
700    1_
$a Eroğlu, Hasan $u Cengiz Gokcek Women's and Children's Hospital, Gaziantep, Turkey (Dr Ovayolu and Dr Eroğlu)
700    1_
$a Canales, Manuel Guerra $u Hospital Clinico San Jose, Chile Santiago, Chile (Dr Canales)
700    1_
$a Ladella, Subhashini $u Community Medical Centers, University of California, San Francisco Fresno, Fresno, CA (Dr Ladella)
700    1_
$a Cojocaru, Liviu $u Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland Medical Center, Baltimore, MD (Dr Cojocaru, Dr O Turan, and Dr S Turan)
700    1_
$a Turan, Ozhan $u Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland Medical Center, Baltimore, MD (Dr Cojocaru, Dr O Turan, and Dr S Turan)
700    1_
$a Turan, Sifa $u Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland Medical Center, Baltimore, MD (Dr Cojocaru, Dr O Turan, and Dr S Turan)
700    1_
$a Hadar, Eran $u Petach-Tikva and Sackler Faculty of Medicine, Rabin Medical Center, Helen Schneider Hospital for Women, Tel-Aviv University, Tel-Aviv, Israel (Dr Hadar, Dr Brzezinski-Sinai, and Dr Dollinger)
700    1_
$a Brzezinski-Sinai, Noa A $u Petach-Tikva and Sackler Faculty of Medicine, Rabin Medical Center, Helen Schneider Hospital for Women, Tel-Aviv University, Tel-Aviv, Israel (Dr Hadar, Dr Brzezinski-Sinai, and Dr Dollinger)
700    1_
$a Dollinger, Sarah $u Petach-Tikva and Sackler Faculty of Medicine, Rabin Medical Center, Helen Schneider Hospital for Women, Tel-Aviv University, Tel-Aviv, Israel (Dr Hadar, Dr Brzezinski-Sinai, and Dr Dollinger)
700    1_
$a Uyaniklar, Ozlem $u Bursa City Hospital, Bursa, Turkey (Dr Uyaniklar, Dr Ocakouglu, and Dr Atak)
700    1_
$a Ocakouglu, Sakine Rahimli $u Bursa City Hospital, Bursa, Turkey (Dr Uyaniklar, Dr Ocakouglu, and Dr Atak)
700    1_
$a Atak, Zeliha $u Bursa City Hospital, Bursa, Turkey (Dr Uyaniklar, Dr Ocakouglu, and Dr Atak)
700    1_
$a Premru-Srsen, Tanja $u Medical Faculty, Department of Perinatology, University Medical Center, University of Ljubljana, Ljubljana, Slovenia (Dr Premru-Srsen, Dr Kornhauser-Cerar, and Dr Druškovič)
700    1_
$a Kornhauser-Cerar, Lilijana $u Medical Faculty, Department of Perinatology, University Medical Center, University of Ljubljana, Ljubljana, Slovenia (Dr Premru-Srsen, Dr Kornhauser-Cerar, and Dr Druškovič)
700    1_
$a Druškovič, Mirjam $u Medical Faculty, Department of Perinatology, University Medical Center, University of Ljubljana, Ljubljana, Slovenia (Dr Premru-Srsen, Dr Kornhauser-Cerar, and Dr Druškovič)
700    1_
$a Ples, Liana $u Department of Obstetrics and Gynecology, Saint John Hospital, Carol Davila University of Medicine and Pharmacy, Romania (Dr Ples)
700    1_
$a Gündüz, Reyhan $u Department of Obstetrics and Gynecology, University of Dicle, Diyarbakır, Turkey (Dr Gündüz and Dr Ağaçayak)
700    1_
$a Ağaçayak, Elif $u Department of Obstetrics and Gynecology, University of Dicle, Diyarbakır, Turkey (Dr Gündüz and Dr Ağaçayak)
700    1_
$a Schvartzman, Javier Alfonso $u Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno," Buenos Aires, Argentina (Dr Schvartzman and Dr Malbran)
700    1_
$a Malbran, Mercedes Negri $u Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno," Buenos Aires, Argentina (Dr Schvartzman and Dr Malbran)
700    1_
$a Liberati, Marco $u Department of Obstetrics and Gynecology, Centre for High-Risk Pregnancy and Fetal Care, University of Chieti, Chieti, Italy (Dr Liberati, Dr Sebastiano, Dr Oronzi, Dr Cerra, and Dr Buca)
700    1_
$a Sebastiano, Francesca Di $u Department of Obstetrics and Gynecology, Centre for High-Risk Pregnancy and Fetal Care, University of Chieti, Chieti, Italy (Dr Liberati, Dr Sebastiano, Dr Oronzi, Dr Cerra, and Dr Buca)
700    1_
$a Oronzi, Ludovica $u Department of Obstetrics and Gynecology, Centre for High-Risk Pregnancy and Fetal Care, University of Chieti, Chieti, Italy (Dr Liberati, Dr Sebastiano, Dr Oronzi, Dr Cerra, and Dr Buca)
700    1_
$a Cerra, Chiara $u Department of Obstetrics and Gynecology, Centre for High-Risk Pregnancy and Fetal Care, University of Chieti, Chieti, Italy (Dr Liberati, Dr Sebastiano, Dr Oronzi, Dr Cerra, and Dr Buca)
700    1_
$a Buca, Danilo $u Department of Obstetrics and Gynecology, Centre for High-Risk Pregnancy and Fetal Care, University of Chieti, Chieti, Italy (Dr Liberati, Dr Sebastiano, Dr Oronzi, Dr Cerra, and Dr Buca)
700    1_
$a Cagnacci, Angelo $u Academic Unit of Obstetrics and Gynaecology, Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, Genova, Italy (Dr Cagnacci, Dr Ramone, and Dr Barra)
700    1_
$a Ramone, Arianna $u Academic Unit of Obstetrics and Gynaecology, Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, Genova, Italy (Dr Cagnacci, Dr Ramone, and Dr Barra)
700    1_
$a Barra, Fabio $u Academic Unit of Obstetrics and Gynaecology, Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, Genova, Italy (Dr Cagnacci, Dr Ramone, and Dr Barra)
700    1_
$a Carosso, Andrea $u Department of Obstetrics and Gynecology, Sant'Anna Hospital, University of Turin, Turin, Italy (Dr Carosso, Dr Benedetto, and Dr Cosma)
700    1_
$a Benedetto, Chiara $u Department of Obstetrics and Gynecology, Sant'Anna Hospital, University of Turin, Turin, Italy (Dr Carosso, Dr Benedetto, and Dr Cosma)
700    1_
$a Cosma, Stefano $u Department of Obstetrics and Gynecology, Sant'Anna Hospital, University of Turin, Turin, Italy (Dr Carosso, Dr Benedetto, and Dr Cosma)
700    1_
$a Pintiaux, Axelle $u Department of Obstetrics and Gynecology, Hospital Erasme, Cliniques Universitaires de Bruxells, Brussels, Belgium (Dr Pintiaux, Dr Daelemans, and Dr Costa)
700    1_
$a Daelemans, Caroline $u Department of Obstetrics and Gynecology, Hospital Erasme, Cliniques Universitaires de Bruxells, Brussels, Belgium (Dr Pintiaux, Dr Daelemans, and Dr Costa)
700    1_
$a Costa, Elena $u Department of Obstetrics and Gynecology, Hospital Erasme, Cliniques Universitaires de Bruxells, Brussels, Belgium (Dr Pintiaux, Dr Daelemans, and Dr Costa)
700    1_
$a Özel, Ayşegül $u University Of Health Sciences, Umraniye Training And Research Hospital, Turkey, Istanbul (Dr Özel and Dr Muhçu)
700    1_
$a Muhçu, Murat $u University Of Health Sciences, Umraniye Training And Research Hospital, Turkey, Istanbul (Dr Özel and Dr Muhçu)
700    1_
$a Lopez, Jesús S Jimenez $u Hospital Regional Universitario de Málaga, Malaga, Spain (Dr Lopez)
700    1_
$a Alvarado, Clara $u Clínica del Country, Bogotá, Colombia (Dr Alvarado)
700    1_
$a Piqueras, Anna Luengo $u Hospital Universitari Germans Trias i Pujol, Barcelona, Spain (Dr Piqueras and Dr Oliva)
700    1_
$a Oliva, Dolores Esteban $u Hospital Universitari Germans Trias i Pujol, Barcelona, Spain (Dr Piqueras and Dr Oliva)
700    1_
$a Schera, Giovanni Battista Luca $u Department of Obstetrics and Gynecology, University of Parma, Parma, Italy (Dr Schera, Dr Volpe, and Dr Frusca)
700    1_
$a Volpe, Nicola $u Department of Obstetrics and Gynecology, University of Parma, Parma, Italy (Dr Schera, Dr Volpe, and Dr Frusca)
700    1_
$a Frusca, Tiziana $u Department of Obstetrics and Gynecology, University of Parma, Parma, Italy (Dr Schera, Dr Volpe, and Dr Frusca)
700    1_
$a Samardjiski, Igor $u University Clinic of Obstetrics and Gynecology, Skopje, North Macedonia (Dr Samardjiski, Dr Simeonava, and Dr Papestiev)
700    1_
$a Simeonova, Slagjana $u University Clinic of Obstetrics and Gynecology, Skopje, North Macedonia (Dr Samardjiski, Dr Simeonava, and Dr Papestiev)
700    1_
$a Papestiev, Irena Aleksioska $u University Clinic of Obstetrics and Gynecology, Skopje, North Macedonia (Dr Samardjiski, Dr Simeonava, and Dr Papestiev)
700    1_
$a Hojman, Javier $u División Obstetricia/Hospital de Clínicas "José de San Martín," Buenos Aires, Argentina (Dr Hojman)
700    1_
$a Turkcuoglu, Ilgin $u Department of Obstetrics and Gynecology, Sanko University School of Medicine, Gaziantep, Turkey (Dr Turkcuoglu)
700    1_
$a Cromi, Antonella $u Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy (Dr Cromi, Dr Laganà, and Dr Ghezzi)
700    1_
$a Laganà, Antonio Simone $u Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy (Dr Cromi, Dr Laganà, and Dr Ghezzi)
700    1_
$a Ghezzi, Fabio $u Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy (Dr Cromi, Dr Laganà, and Dr Ghezzi)
700    1_
$a Sirico, Angelo $u Department of Obstetrics and Gynaecology, Fondazione Policlinico Universitario A Gemelli IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy (Dr Sirico, Dr Familiari, and Dr Scambia)
700    1_
$a Familiari, Alessandra $u Department of Obstetrics and Gynaecology, Fondazione Policlinico Universitario A Gemelli IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy (Dr Sirico, Dr Familiari, and Dr Scambia)
700    1_
$a Scambia, Giovanni $u Department of Obstetrics and Gynaecology, Fondazione Policlinico Universitario A Gemelli IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy (Dr Sirico, Dr Familiari, and Dr Scambia)
700    1_
$a Sukhikh, Zulfiya Khodjaeva Gennady T $u National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russia (Dr Sukhikh and Dr Gorina)
700    1_
$a Gorina, Ksenia A $u National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russia (Dr Sukhikh and Dr Gorina)
700    1_
$a de Sa, Renato Augusto Moreira $u Assistência Obstétrica do Grupo Perinatal, Rio de Janeiro, Brazil (Dr de Sa and Dr Vaz)
700    1_
$a Vaz, Mariana $u Assistência Obstétrica do Grupo Perinatal, Rio de Janeiro, Brazil (Dr de Sa and Dr Vaz)
700    1_
$a Feuerschuette, Otto Henrique May $u Departamento de Ginecologia e Obstetrícia, Hospital Universitário Polydoro Ernani, Santiago, Brazil (Dr Feuerschuette)
700    1_
$a Gatta, Anna Nunzia Della $u Department of Obstetrics and Gynecology, Sant'Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy (Dr Gatta, Dr Youssef, and Dr Donna)
700    1_
$a Youssef, Aly $u Department of Obstetrics and Gynecology, Sant'Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy (Dr Gatta, Dr Youssef, and Dr Donna)
700    1_
$a Donna, Gaetana Di $u Department of Obstetrics and Gynecology, Sant'Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy (Dr Gatta, Dr Youssef, and Dr Donna)
700    1_
$a Martinez-Varea, Alicia $u Servicio de Obstetricia y Ginecología, Hospital Universitario y Politécnico La Fe, Valencia, Spain (Dr Martinez-Varea, Dr Loscalzo, and Dr Roselló)
700    1_
$a Loscalzo, Gabriela $u Servicio de Obstetricia y Ginecología, Hospital Universitario y Politécnico La Fe, Valencia, Spain (Dr Martinez-Varea, Dr Loscalzo, and Dr Roselló)
700    1_
$a Morales Roselló, José $u Servicio de Obstetricia y Ginecología, Hospital Universitario y Politécnico La Fe, Valencia, Spain (Dr Martinez-Varea, Dr Loscalzo, and Dr Roselló)
700    1_
$a Stefanovic, Vedran $u Department of Obstetrics and Gynecology, Neonatology and Intensive Care, Helsinki University Hospital and University of Helsinki, Helsinki, Finland (Dr Stefanovic, Dr Nupponen, and Dr Nelskylä)
700    1_
$a Nupponen, Irmeli $u Department of Obstetrics and Gynecology, Neonatology and Intensive Care, Helsinki University Hospital and University of Helsinki, Helsinki, Finland (Dr Stefanovic, Dr Nupponen, and Dr Nelskylä)
700    1_
$a Nelskylä, Kaisa $u Department of Obstetrics and Gynecology, Neonatology and Intensive Care, Helsinki University Hospital and University of Helsinki, Helsinki, Finland (Dr Stefanovic, Dr Nupponen, and Dr Nelskylä)
700    1_
$a Ayala, Rodrigo $u ABC Medical Center, Mexico City, Mexico (Dr Ayala)
700    1_
$a Molpeceres, Rebeca Garrote $u University Clinic Hospital of Valladolid, Valladolid, Spain (Dr Molpeceres and Dr Vázquez)
700    1_
$a Vázquez, Asunción Pino $u University Clinic Hospital of Valladolid, Valladolid, Spain (Dr Molpeceres and Dr Vázquez)
700    1_
$a Sandri, Fabrizio $u Unit of Obstetrics and Gynecology, Ospedale Maggiore, Bologna, Italy (Dr Sandri, Dr Cataneo, and Dr Lenzi)
700    1_
$a Cataneo, Ilaria $u Unit of Obstetrics and Gynecology, Ospedale Maggiore, Bologna, Italy (Dr Sandri, Dr Cataneo, and Dr Lenzi)
700    1_
$a Lenzi, Marinella $u Unit of Obstetrics and Gynecology, Ospedale Maggiore, Bologna, Italy (Dr Sandri, Dr Cataneo, and Dr Lenzi)
700    1_
$a Haberal, Esra Tustas $u Hisar Intercontinental Hospital, Instanbul, Turkey (Dr Haberal)
700    1_
$a Huertas, Erasmo $u Instituto Nacional Materno Perinatal, Lima, Peru (Dr Huertas, Dr Sanchez, and Dr Arango)
700    1_
$a Sanchez, Amadeo $u Instituto Nacional Materno Perinatal, Lima, Peru (Dr Huertas, Dr Sanchez, and Dr Arango)
700    1_
$a Arango, Pedro $u Instituto Nacional Materno Perinatal, Lima, Peru (Dr Huertas, Dr Sanchez, and Dr Arango)
700    1_
$a Bermejo, Amanda $u Hospital Universitario de Móstoles, Mostoles, Spain (Dr Bermejo)
700    1_
$a Alcantara, María Monica Gonzalez $u Hospital Juan A. Fernandez, Buenos, Argentina (Dr Alcantara)
700    1_
$a Göynümer, Gökhan $u Düzce University Medicine Faculty, Department of Perinatology, Düzce, Turkey (Dr Göynümer)
700    1_
$a Okuyan, Erhan $u Batman Maternity and Child Health Hospital, Batman, Turkey (Dr Okuyan)
700    1_
$a Madalina, Ciuhodaru $u Universitatea de Medicină și Farmacie Grigore T. Popa Iași, Iasi, Romania (Dr Madalina)
700    1_
$a Guisan, Ana Concheiro $u Alvaro Cunqueiro University Hospital of Vigo, Vigo, Spain (Dr Guisan)
700    1_
$a Schulte, Alejandra Martínez $u Hospital Angeles Lomas, Mexico City, Mexico (Dr Schulte)
700    1_
$a Esposito, Valentina $u University of Milan, Milan, Italy (Dr Esposito)
700    1_
$a De Robertis, Valentina $u Fetal Medicine Unit, Di Venere Hospital, Bari, Italy (Dr Robertis)
700    1_
$a Zdjelar, Snezana $u KBC Dr Dragisa Misovic Dedinje Belgrade, Serbia (Dr Zdjelar, Dr Lackovic, and Dr Mihajlovic)
700    1_
$a Lackovic, Milan $u KBC Dr Dragisa Misovic Dedinje Belgrade, Serbia (Dr Zdjelar, Dr Lackovic, and Dr Mihajlovic)
700    1_
$a Mihajlovic, Sladjana $u KBC Dr Dragisa Misovic Dedinje Belgrade, Serbia (Dr Zdjelar, Dr Lackovic, and Dr Mihajlovic)
700    1_
$a Jekova, Nelly $u Department of Neonatology, Obstetrics and Gynecology, University Hospital, Sofia, Bulgaria (Dr Jekova)
700    1_
$a Saccone, Gabriele $u Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy (Dr Saccone)
700    1_
$a Aslan, Mehmet Musa $u Sakarya University Education and Research Hospital, Sakarya, Turkey (Dr Aslan)
700    1_
$a Dedda, Maria Carmela Di $u Department Gynecology and Obstetrics, Fornaroli Hospital, Magenta, Italy (Dr Dedda)
700    1_
$a Chalid, Maisuri $u Department of Obstetrics and Gynecology, Hasanuddin University, Makassar, Indonesia (Dr Chalid)
700    1_
$a Canache, Jose Enrique Moros $u Departamento De Ginecologia Y Obstetricia, Centro Medico La Paz De Bata, Bata, Guinea Ecuatorial (Dr Canache)
700    1_
$a Daskalakis, George $u Alexandra Hospital - National and Kapodistrian, University of Athens, Athens, Greece (Dr Daskalakis and Dr Antsaklis)
700    1_
$a Antsaklis, Panos $u Alexandra Hospital - National and Kapodistrian, University of Athens, Athens, Greece (Dr Daskalakis and Dr Antsaklis)
700    1_
$a Vega, Enrique Criado $u Division of Neonatology, Hospital Clínico "San Carlos," Madrid, Spain (Dr Vega)
700    1_
$a Cueto, Elisa $u Hospital Virgen De La Luz, Cuenca, Spain (Dr Cueto)
700    1_
$a Taccaliti, Chiara $u Ospedale Generale Regionale "F. Miulli," Acquaviva delle Fonti, Italy (Dr Taccaliti)
700    1_
$a Aykanat, Yeliz $u Department of Obstetrics and Gynecology, Istanbul University-Cerrahpasa Medical School, Istanbul, Turkey (Dr Aykanat)
700    1_
$a Özlem Genç, Şerife $u Karaman Public Hospital, Karaman, Turkey (Dr Genç)
700    1_
$a Froessler, Bernd $u Department of Anaesthesia, Lyell McEwin Hospital, Adelaide, Australia (Dr Froessler)
700    1_
$a Radulova, Petya Angelova $u University Hospital of Obstetrics and Gynecology, Sofia, Bulgaria (Dr Radulova)
700    1_
$a Morano, Danila $u Section of Obstetrics and Gynecology, Department of Medical Sciences, Azienda Ospedaliera-Universitaria Sant' Anna, University of Ferrara, Ferrara, Italy (Dr Morano, Dr Bianchi, and Dr Marino)
700    1_
$a Bianchi, Beatrice $u Section of Obstetrics and Gynecology, Department of Medical Sciences, Azienda Ospedaliera-Universitaria Sant' Anna, University of Ferrara, Ferrara, Italy (Dr Morano, Dr Bianchi, and Dr Marino)
700    1_
$a Marino, Maria Giulia Lombana $u Section of Obstetrics and Gynecology, Department of Medical Sciences, Azienda Ospedaliera-Universitaria Sant' Anna, University of Ferrara, Ferrara, Italy (Dr Morano, Dr Bianchi, and Dr Marino)
700    1_
$a Meccariello, Gabriella $u Ostetricia e Ginecologia Universitaria - Ospedale S.Anna e S.Sebastiano, Caserta, Italy (Dr Meccariello)
700    1_
$a Rohatgi, Bindu $u Sulochana clinic, Kolkata India (Dr Rohatgi)
700    1_
$a Schiattarella, Antonio $u Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy (Dr Schiattarella, Dr Morlando, and Dr Colacurci)
700    1_
$a Morlando, Maddalena $u Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy (Dr Schiattarella, Dr Morlando, and Dr Colacurci)
700    1_
$a Colacurci, Nicola $u Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy (Dr Schiattarella, Dr Morlando, and Dr Colacurci)
700    1_
$a Villasco, Andrea $u Academic Division of Obstetrics and Gynecology, Mauriziano Umberto I Hospital, University of Turin, Turin, Italy (Dr Villasco and Dr Biglia)
700    1_
$a Biglia, Nicoletta $u Academic Division of Obstetrics and Gynecology, Mauriziano Umberto I Hospital, University of Turin, Turin, Italy (Dr Villasco and Dr Biglia)
700    1_
$a Marques, Ana Luiza Santos $u Instituto de MedFetal e Diagnóstico por Imagem do Amazonas, Manausi, Brazil (Dr Marques)
700    1_
$a Gatti, Alessandra $u Campus Bio Medico, University of Rome, Rome, Italy (Dr Gatti, Dr Luvero, and Dr Angioli)
700    1_
$a Luvero, Daniela $u Campus Bio Medico, University of Rome, Rome, Italy (Dr Gatti, Dr Luvero, and Dr Angioli)
700    1_
$a Angioli, Roberto $u Campus Bio Medico, University of Rome, Rome, Italy (Dr Gatti, Dr Luvero, and Dr Angioli)
700    1_
$a Pittaro, Alejandro $u Hospital Raul F. Larcade, Buenos Aires, Argentina (Dr Pittaro)
700    1_
$a Lila, Albert $u Regional Hospital Gjakova, Kosovo, Republic of Kosovo (Dr Lila)
700    1_
$a Zlatohlávková, Blanka $u Division of Neonatology, Department of Obstetrics and Gynecology, General Hospital in Prague and First Faculty of Medicine, Charles University, Prague, Czech Republic (Dr Zlatohlávková)
710    2_
$a On the behalf of the World Association of Perinatal Medicine working group on coronavirus disease 2019
773    0_
$w MED00208296 $t American journal of obstetrics & gynecology MFM $x 2589-9333 $g Roč. 3, č. 4 (2021), s. 100329
856    41
$u https://pubmed.ncbi.nlm.nih.gov/33621713 $y Pubmed
910    __
$a ABA008 $b sig $c sign $y p $z 0
990    __
$a 20211013 $b ABA008
991    __
$a 20211026133837 $b ABA008
999    __
$a ok $b bmc $g 1714456 $s 1145926
BAS    __
$a 3
BAS    __
$a PreBMC
BMC    __
$a 2021 $b 3 $c 4 $d 100329 $e 20210220 $i 2589-9333 $m American journal of obstetrics & gynecology MFM $n Am J Obstet Gynecol MFM $x MED00208296
LZP    __
$a Pubmed-20211013

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