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
Jazyk angličtina Země Německo Médium print
Typ dokumentu časopisecké články
PubMed
32975205
DOI
10.1515/jpm-2020-0355
PII: jpm-2020-0355
Knihovny.cz E-zdroje
- Klíčová slova
- Coronavirus, perinatal morbidity, perinatal mortality,
- MeSH
- Betacoronavirus * genetika izolace a purifikace MeSH
- COVID-19 MeSH
- gestační stáří MeSH
- infekční komplikace v těhotenství epidemiologie virologie MeSH
- klinické laboratorní techniky MeSH
- kohortové studie MeSH
- koronavirové infekce komplikace diagnóza epidemiologie MeSH
- lidé MeSH
- novorozenec nedonošený MeSH
- novorozenec MeSH
- odumření plodu * MeSH
- pandemie MeSH
- perinatální smrt * MeSH
- polymerázová řetězová reakce s reverzní transkripcí MeSH
- rizikové faktory MeSH
- samovolný potrat epidemiologie MeSH
- SARS-CoV-2 MeSH
- těhotenství MeSH
- testování na COVID-19 MeSH
- vakcíny proti COVID-19 MeSH
- vertikální přenos infekce statistika a číselné údaje MeSH
- virová pneumonie komplikace diagnóza epidemiologie MeSH
- výsledek těhotenství MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Objectives To evaluate the strength of association between maternal and pregnancy characteristics and the risk of adverse perinatal outcomes in pregnancies with laboratory confirmed COVID-19. Methods Secondary 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). Results Mean 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. Conclusions Early 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.
Academic Unit of Obstetrics and Gynaecology IRCCS Ospedale Policlinico San Martino Genova Italy
Alexandra Hospital National and Kapodistrian University of Athens Athens Greece
Alvaro Cunqueiro University Hospital of Vigo Vigo Spain
American Hospital Istanbul Turkey
Asklepios Hospital Barmbek Hamburg Germany
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
Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno Buenos Aires Argentina
Clinic of Obstetrics and Gynaecology University of Udine Udine Italy
Departamento de Ginecologia e Obstetrícia Hospital Universitário Polydoro Ernani Santiago Brazil
Department Gynaecology and Obstetrics Fornaroli Hospital Magenta Italy
Department of Anaesthesia Lyell McEwin Hospital Adelaide Australia
Department of General Surgery and Medical Surgical Specialties University of Catania Catania Italy
Department of Gynaecologic Oncology University of Palermo Palermo Sicilia Italy
Department of Gynaecology and Obstetrics Vivantes Klinikum im Friedrichshain Berlin Germany
Department of Medical Sciences University of Ferrara Ferrara Italy
Department of Obstetrics and Gynaecology AOUI Verona University of Verona Verona Italy
Department of Obstetrics and Gynaecology Centro Hospitalar e Universitário São João Porto Portugal
Department of Obstetrics and Gynaecology Ciudad Real University General Hospital Ciudad Real Spain
Department of Obstetrics and Gynaecology Ospedale AOSG Moscati Avellino Italy
Department of Obstetrics and Gynaecology Ospedale di San Leonardo Castellammare di Stabia Italy
Department of Obstetrics and Gynaecology Saint John Hospital UMF Carol Davila Bucharest Romania
Department of Obstetrics and Gynaecology Sant'Anna Hospital University of Turin Turin Italy
Department of Obstetrics and Gynaecology University of Dicle Diyarbakır Turkey
Department of Obstetrics and Gynaecology University of Messina Messina Italy
Department of Obstetrics and Gynaecology University of Parma Parma Italy
Department of Perinatology and Gynaecology National Cerebral and Cardiovascular Center Osaka Japan
Department of Translational Medicine University of Eastern Piedmont Novara Italy
Department of Woman' and Child's Health University of Padova Padova Italy
Fetal Medicine Unit Di Venere Hospital Bari Italy
Fundación Valle del Lili Tertiary Obstetric Unit Cali Colombia
Hisar Intercontinental Hospital Istanbul Turkey
Hospital Castelli Verbania Italy
Hospital Raul F Larcade Buenos Aires Argentina
Hospital Regional Universitario de Málaga Malaga Spain
Hospital Universitari Germans Trias i Pujol Barcelona Spain
Hospital Universitario Central de Asturias Asturias Spain
Hospital Universitario de Móstoles Mostoles Spain
Hospital Virgen De La Luz Cuenca Spain
Instituto Nacional Materno Perinatal Lima Peru
Istituto di Clinica Ostetrica e Ginecologica Università Cattolica del Sacro Cuore Rome Italy
Karaman Public Hospital Karaman Turkey
Kbc Dr Dragisa Misovic Dedinje Belgrade Beograd Serbia
Maternal and Child Health Department Santa Maria Hospital Terni Italy
National Medical Research Center for Obstetrics Gynaecology and Perinatology Moscow Russia
Neonatal Intensive Care Unit University of Chieti ChietiItaly
Ospedale Generale Regionale F Miulli Acquaviva delle Fonti Italy
Ospedale Maggiore Policlinico Milano Milan Italy
Perinatal Medicine Foundation and Department of Perinatal Medicine Memorial Hospital Istanbul Turkey
Postgraduate Department Universidad Icesi Cali Colombia
Queen Margaret University Institute for Global Health and Development Edinburgh UK
Regional Hospital Gjakova Kosovo Republic of Kosovo
Servicio de Obstetricia y Ginecología Hospital Universitario y Politécnico La Fe Valencia Spain
Unit of Obstetrics and Gynaecology 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 Gynaecology Skopje North Macedonia
University of Castilla La Mancha Ciudad Real Spain
University of Milan Milan Italy
Zobrazit více v PubMed
ISUOG Safety Committee Position Statement on safe performance of obstetric and gynecological scans and equipment cleaning in context of COVID-19. Ultrasound Obstet Gynecol 2020;55:709–12.
Abu-Rustum, RS, Akolekar, R, Sotiriadis, A, Salomon, LJ, Da Silva Costa, F, Wu, Q, et al. ISUOG Consensus Statement on organization of routine and specialist obstetric ultrasound services in the context of COVID-19. Ultrasound Obstet Gynecol 2020;55:863–70. https://doi.org/10.1002/uog.22029.
Mullins, E, Evans, D, Viner, RM, O’Brien, P, Morris, E. Coronavirus in pregnancy and delivery: rapid review. Ultrasound Obstet Gynecol 2020;55:586–92. https://doi.org/10.1002/uog.22014.
Moro, F, Buonsenso, D, Moruzzi, MC, Inchingolo, R, Smargiassi, A, Demi, L, et al. How to perform lung ultrasound in pregnant women with suspected COVID-19. Ultrasound Obstet Gynecol 2020;55:593–8. https://doi.org/10.1002/uog.22028.
Buonsenso, D, Raffaelli, F, Tamburrini, E, Biasucci, DG, Salvi, S, Smargiassi, A, et al. Clinical role of lung ultrasound for the diagnosis and monitoring of COVID-19 pneumonia in pregnant women. Ultrasound Obstet Gynecol 2020;56:106–9 https://doi.org/10.1002/uog.22055.
Kwiatkowski, S, Borowski, D, Kajdy, A, Poon, LC, Rokita, W, Wielgoś, M. Why we should not stop giving aspirin to pregnant women during the COVID-19 pandemic. Ultrasound Obstet Gynecol 2020;55:841–3 https://doi.org/10.1002/uog.22049.
Kalafat, E, Yaprak, E, Cinar, G, Varli, B, Ozisik, S, Uzun, C, Azap, A, Koc, A. Lung ultrasound and computed tomographic findings in pregnant woman with COVID-19. Ultrasound Obstet Gynecol 2020;55:835–7 https://doi.org/10.1002/uog.22034.
Mathilde, G, Rolnik, DL, Hoffman, MK, Panchaud, A, Baud, D. Should we stop aspirin prophylaxis in pregnant women diagnosed with COVID-19? [published online ahead of print, 2020 Apr 29]. Ultrasound Obstet Gynecol 2020 https://doi.org/10.1002/uog.22063.
Boelig, RC, Manuck, T, Oliver, EA, et al. 2020. Labor and delivery guidance for COVID-19. Am J Obstet Gynecol MFM (in press). https://doi.org/10.1111/1471-0528.16335.
Di Mascio, D, Khalil, A, Saccone, G, Rizzo, G, Buca, D, Liberati, M, et al. Outcome of Coronavirus spectrum infections (SARS, MERS, COVID 1-19) during pregnancy: a systematic review and meta-analysis. Am J Obstet Gynecol MFM 2020;2:100107. https://doi.org/10.1016/j.ajogmf.2020.100107.
Coronavirus disease 2019 (COVID-2019): situation report-123. Geneva: World Health Organization; May 2020. Accessed on May 23, 2020.
Saccone, G, Sen, C, Di Mascio, D, Galindo, A, Grünebaum, A, Yoshimatsu, J, et al. Maternal and Perinatal Outcomes of Pregnant Women with SARS-COV 2 infection: The WAPM working Group on COVID-19 [First published online: 14 September 2020]. https://doi.org/10.1002/uog.23107.
World Health Organization. Clinical management of severe acute respiratory infection when novel coronavirus (2019-nCoV) is suspected: interim guidance; 13 March 2020.
Guan, W, Ni, Z, HU, Y, Liang, L, OU, C, He, J, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382:1702–20. https://doi.org/10.1056/NEJMoa2002032.
Huang, C, Wang, Y, Li, X, Ren, L, Zhao, J, Hu, Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497–506. https://doi.org/10.1016/s0140-6736(20)30183-5.
Juan, J, Gil, MM, Rong, Z, Zhang, Y, Yang, H, Poon, LC. Effects of coronavirus disease 2019 (COVID-19) on maternal, perinatal and neonatal outcomes: a systematic review. Ultrasound Obstet Gynecol 2020;55:15–27.
Della Gatta, AN, Rizzo, R, Pilu, G, Simonazzi, G. Coronavirus disease 2019 during pregnancy: a systematic review of reported cases. Am J Obstet Gynecol 2020;223:36–41. https://doi.org/10.1016/j.ajog.2020.04.013.
Huntley, BJF, Huntley, ESD, Di Mascio, D, Chen, T, Berghella, V, Chauhan, S. Pregnancies complicated by coronavirus disease 2019 (COVID-19) in pregnancy: rates of maternal and perinatal mortality, and vertical transmission: a systematic review. Obstet Gynecol 2020;136:303–12. https://doi.org/10.1097/AOG.0000000000004010.
Luteijn, JM, Brown, MJ, Dolk, H. Influenza and congenital anomalies: a systematic review and meta-analysis. Hum Reprod 2014;29:809–23. https://doi.org/10.1093/humrep/det455.
Faure-Bardon, V, Magny, JF, Parodi, M, Couderc, S, Garcia, P, Maillotte, AM, et al. Sequelae of congenital Cytomegalovirus following maternal primary infections are limited to those acquired in the first trimester of pregnancy. Clin Infect Dis 2019;69:1526–32. https://doi.org/10.1093/cid/ciy1128.
Lassen, J, Jensen, AK, Bager, P, Pedersen, CB, Panum, I, Nørgaard-Pedersen, B, et al. Parvovirus B19 infection in the first trimester of pregnancy and risk of fetal loss: a population-based case-control study. Am J Epidemiol 2012;176:803–7. https://doi.org/10.1093/aje/kws177.
Enders, M, Weidner, A, Zoellner, I, Searle, K, Enders, G. Fetal morbidity and mortality after acute human parvovirus B19 infection in pregnancy: prospective evaluation of 1018 cases. Prenat Diagn 2004;24:513–8. https://doi.org/10.1002/pd.940.
Di Mascio, D, Sileo, FG, Khalil, A, Rizzo, G, Persico, N, Brunelli, R, et al. Role of magnetic resonance imaging in fetuses with mild or moderate ventriculomegaly in the era of fetal neurosonography: systematic review and meta-analysis. Ultrasound Obstet Gynecol 2019;54:164–71. https://doi.org/10.1002/uog.20197.
ENSO Working Group. Role of prenatal magnetic resonance imaging in fetuses with isolated mild or moderate ventriculomegaly in the era of neurosonography: a multicenter study. Ultrasound Obstet Gynecol 2020;56:340–7. https://doi.org/10.1002/uog.21974.
Zeng, L, Xia, S, Yuan, W, Yan, K, Xiao, F, Shao, J, et al. Neonatal Early-Onset Infection With SARS-CoV-2 in 33 Neonates Born to Mothers With COVID-19 in Wuhan. China JAMA Pediatrics 2020;174:722–5.
Elshafeey, F, Magdi, R, Hindi, N, Elshebiny, M, Farrag, N, Mahdy, S, et al. A systematic scoping review of COVID-19 during pregnancy and childbirth [published online ahead of print, 2020 Apr 24]. Int J Gynaecol Obstet 2020. https://doi.org/10.1002/ijgo.13182.
Bikdeli, B, Madhavan, MV, Jimenez, D, Chuich, T, Dreyfus, I, Driggin, E, et al. COVID-19 and thrombotic or thromboembolic disease: implications for prevention, antithrombotic therapy, and follow-up. J Am Coll Cardiol 2020 Apr 15; S0735-1097(20)35008-7. https://doi.org/10.1016/j.jacc.2020.04.031.
Connors, JM, Levy, JH. Thromboinflammation and the hypercoagulability of COVID-19 [published online ahead of print, 2020 Apr 17]. J Thromb Haemost 2020. https://doi.org/10.1111/jth.14849.
Boelig, RC, Manuck, T, Oliver, EA, Di Mascio, D, Saccone, G, Bellusi, F, et al. Labor and delivery guidance for COVID-19. Am J Obstet Gynecol MFM 2020;2:100110. https://doi.org/10.1016/j.ajogmf.2020.100110.
Saccone, G, Florio, A, Aiello, F, Bifulco, G, Zullo, F, Venturella, R, et al. Psychological impact of coronavirus disease 2019 in pregnant women. Am J Obstet Gynecol 2020; S0002-9378(20)30527-5. https://doi.org/10.1016/j.ajog.2020.05.003.
Saccone, G, Carbone, FI, Zullo, F. The novel coronavirus (2019-nCoV) in pregnancy: what we need to know. Eur J Obstet Gynecol Reprod Biol 2020;249:92–3. https://doi.org/10.1016/j.ejogrb.2020.04.006.
Carbone, IF, Conforti, A, Farina, A, Alviggi, C. A practical approach for the management of obstetric and infertile women during the phase two of the novel coronavirus disease 2019 (COVID-19) pandemic [published online ahead of print, 2020 Jun 8]. Eur J Obstet Gynecol Reprod Biol 2020; S0301-2115(20)30368-7. https://doi.org/10.1016/j.ejogrb.2020.06.006.
