BMC Pregnancy and Childbirth (Apr 2021)
The association between SARS-CoV-2 infection and preterm delivery: a prospective study with a multivariable analysis
- Oscar Martinez-Perez,
- Pilar Prats Rodriguez,
- Marta Muner Hernandez,
- Maria Begoña Encinas Pardilla,
- Noelia Perez Perez,
- Maria Rosa Vila Hernandez,
- Ana Villalba Yarza,
- Olga Nieto Velasco,
- Pablo Guillermo Del Barrio Fernandez,
- Laura Forcen Acebal,
- Carmen Maria Orizales Lago,
- Alicia Martinez Varea,
- Begoña Muñoz Abellana,
- Maria Suarez Arana,
- Laura Fuentes Ricoy,
- Clara Martinez Diago,
- Maria Jesus Janeiro Freire,
- Macarena Alférez Alvarez-Mallo,
- Cristina Casanova Pedraz,
- Onofre Alomar Mateu,
- Cristina Lesmes Heredia,
- Juan Carlos Wizner de Alva,
- Rut Bernardo Vega,
- Montserrat Macia Badia,
- Cristina Alvarez Colomo,
- Antonio Sanchez Muñoz,
- Laia Pratcorona Alicart,
- Ruben Alonso Saiz,
- Monica Lopez Rodriguez,
- Maria del Carmen Barbancho Lopez,
- Marta Ruth Meca Casbas,
- Oscar Vaquerizo Ruiz,
- Eva Moran Antolin,
- Maria Jose Nuñez Valera,
- Camino Fernandez Fernandez,
- Albert Tubau Navarra,
- Alejandra Maria Cano Garcia,
- Carmen Baena Luque,
- Susana Soldevilla Perez,
- Irene Gastaca Abasolo,
- Jose Adanez Garcia,
- Maria Teulon Gonzalez,
- Alberto Puertas Prieto,
- Rosa Ostos Serna,
- Maria del Pilar Guadix Martin,
- Monica Catalina Coello,
- Elena Ferriols Perez,
- Africa Caño Aguilar,
- Maria Luisa De la Cruz Conty,
- Jose Antonio Sainz Bueno,
- Spanish Obstetric Emergency Group
Affiliations
- Oscar Martinez-Perez
- Department Gynaecology and Obstetrics, Puerta de Hierro University Hospital of Majadahonda
- Pilar Prats Rodriguez
- Department Reproductive Medicine and Gynaecology, Obstetrics, Dexeus University Hospital
- Marta Muner Hernandez
- Department Gynaecology and Obstetrics, La Paz University Hospital. Madrid
- Maria Begoña Encinas Pardilla
- Department Gynaecology and Obstetrics, Puerta de Hierro University Hospital of Majadahonda
- Noelia Perez Perez
- Department Gynaecology and Obstetrics, San Carlos University Hospital. Madrid
- Maria Rosa Vila Hernandez
- Department Gynaecology and Obstetrics, Santa Caterina Hospital
- Ana Villalba Yarza
- Department Gynaecology and Obstetrics, University Hospital of Salamanca
- Olga Nieto Velasco
- Department Obstetrics and Gynaecology, Quironsalud Madrid University Hospital. Madrid
- Pablo Guillermo Del Barrio Fernandez
- Department Gynaecology and Obstetrics, Getafe University Hospital
- Laura Forcen Acebal
- Department Gynaecology and Obstetrics, Doce de Octubre University Hospital
- Carmen Maria Orizales Lago
- Department Gynaecology and Obstetrics, Severo Ochoa University Hospital
- Alicia Martinez Varea
- Department Gynaecology and Obstetrics, La Fe University and Polytechnic Hospital
- Begoña Muñoz Abellana
- Department Obstetrics and Gynaecology, Sant Joan de Reus University Hospital
- Maria Suarez Arana
- Department Gynaecology and Obstetrics, Regional University Hospital of Malaga
- Laura Fuentes Ricoy
- Department Obstetrics and Gynaecology, University Hospital of Ferrol
- Clara Martinez Diago
- Department Gynaecology and Obstetrics, Doctor Josep Trueta University Hospital of Girona
- Maria Jesus Janeiro Freire
- Department Obstetrics and Gynaecology, University Hospital Complex of A Coruña
- Macarena Alférez Alvarez-Mallo
- Department Obstetrics and Gynaecology, HM Hospitals
- Cristina Casanova Pedraz
- Department Gynaecology and Obstetrics, University Hospital of Torrejon
- Onofre Alomar Mateu
- Department Obstetrics and Gynaecology, Regional Hospital of Inca
- Cristina Lesmes Heredia
- Department Obstetrics and Gynaecology, Parc Taulí Hospital
- Juan Carlos Wizner de Alva
- Department Gynaecology and Obstetrics, San Pedro de Alcántara Hospital
- Rut Bernardo Vega
- Department Gynaecology and Obstetrics, Rio Hortega University Hospital
- Montserrat Macia Badia
- Department Gynaecology and Obstetrics, Arnau de Vilanova University Hospital
- Cristina Alvarez Colomo
- Department Gynaecology and Obstetrics, Valladolid University Hospital
- Antonio Sanchez Muñoz
- Department Gynaecology and Obstetrics, General University Hospital of Ciudad Real
- Laia Pratcorona Alicart
- Department Obstetrics and Gynaecology, Germans Trias i Pujol University Hospital
- Ruben Alonso Saiz
- Department Gynaecology and Obstetrics, University Hospital of Burgos
- Monica Lopez Rodriguez
- Department Obstetrics and Gynaecology, Joan XXIII University Hospital of Tarragona
- Maria del Carmen Barbancho Lopez
- Department Gynaecology and Obstetrics, Infanta Sofia University Hospital
- Marta Ruth Meca Casbas
- Department Obstetrics and Gynaecology, Poniente Hospital of Almería
- Oscar Vaquerizo Ruiz
- Department Obstetrics and Gynaecology, University Hospital of Cabueñes
- Eva Moran Antolin
- Department Obstetrics and Gynaecology, Son Espases University Hospital
- Maria Jose Nuñez Valera
- Department Obstetrics and Gynaecology, Virgen de la Luz Hospital
- Camino Fernandez Fernandez
- Department Gynaecology and Obstetrics, University Assistance Complex of Leon
- Albert Tubau Navarra
- Department Obstetrics and Gynaecology, Son Llatzer University Hospital
- Alejandra Maria Cano Garcia
- Department Gynaecology and Obstetrics, University Hospital of El Tajo
- Carmen Baena Luque
- Department Gynaecology and Obstetrics, Infanta Margarita Hospital
- Susana Soldevilla Perez
- Department Obstetrics and Gynaecology, University Hospital of Jerez de la Frontera
- Irene Gastaca Abasolo
- Department Obstetrics and Gynaecology, Txagorritxu University Hospital of Araba
- Jose Adanez Garcia
- Department Obstetrics and Gynaecology, Central University Hospital of Asturias
- Maria Teulon Gonzalez
- Department Gynaecology and Obstetrics, University Hospital of Fuenlabrada
- Alberto Puertas Prieto
- Department Obstetrics and Gynaecology, Virgen de las Nieves University Hospital
- Rosa Ostos Serna
- Department Gynaecology and Obstetrics, Virgen de Valme University Hospital
- Maria del Pilar Guadix Martin
- Department Obstetrics and Gynaecology, Virgen Macarena University Hospital
- Monica Catalina Coello
- Department Gynaecology and Obstetrics, Virgen de la Concha Hospital
- Elena Ferriols Perez
- Department Gynaecology and Obstetrics, Parc de Salut Mar University Hospital
- Africa Caño Aguilar
- Department Obstetrics and Gynaecology, San Cecilio University Hospital of Granada
- Maria Luisa De la Cruz Conty
- Fundación de Investigación Biomédica, Puerta de Hierro University Hospital of Majadahonda
- Jose Antonio Sainz Bueno
- Department Gynaecology and Obstetrics, University of Seville, G. Chacon (Viamed Santa Angela de la Cruz Hospital)
- Spanish Obstetric Emergency Group
- DOI
- https://doi.org/10.1186/s12884-021-03742-4
- Journal volume & issue
-
Vol. 21,
no. 1
pp. 1 – 11
Abstract
Abstract Background To determine whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, the cause of COVID-19 disease) exposure in pregnancy, compared to non-exposure, is associated with infection-related obstetric morbidity. Methods We conducted a multicentre prospective study in pregnancy based on a universal antenatal screening program for SARS-CoV-2 infection. Throughout Spain 45 hospitals tested all women at admission on delivery ward using polymerase-chain-reaction (PCR) for COVID-19 since late March 2020. The cohort of positive mothers and the concurrent sample of negative mothers was followed up until 6-weeks post-partum. Multivariable logistic regression analysis, adjusting for known confounding variables, determined the adjusted odds ratio (aOR) with 95% confidence intervals (95% CI) of the association of SARS-CoV-2 infection and obstetric outcomes. Main outcome measures: Preterm delivery (primary), premature rupture of membranes and neonatal intensive care unit admissions. Results Among 1009 screened pregnancies, 246 were SARS-CoV-2 positive. Compared to negative mothers (763 cases), SARS-CoV-2 infection increased the odds of preterm birth (34 vs 51, 13.8% vs 6.7%, aOR 2.12, 95% CI 1.32–3.36, p = 0.002); iatrogenic preterm delivery was more frequent in infected women (4.9% vs 1.3%, p = 0.001), while the occurrence of spontaneous preterm deliveries was statistically similar (6.1% vs 4.7%). An increased risk of premature rupture of membranes at term (39 vs 75, 15.8% vs 9.8%, aOR 1.70, 95% CI 1.11–2.57, p = 0.013) and neonatal intensive care unit admissions (23 vs 18, 9.3% vs 2.4%, aOR 4.62, 95% CI 2.43–8.94, p < 0.001) was also observed in positive mothers. Conclusion This prospective multicentre study demonstrated that pregnant women infected with SARS-CoV-2 have more infection-related obstetric morbidity. This hypothesis merits evaluation of a causal association in further research.
Keywords
