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Martinez Perez, OscarAutor o CoautorEncinas Pardilla MbAutor o Coautor

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The association between SARS-CoV-2 infection and preterm delivery: a prospective study with a multivariable analysis

Publicado en:BMC Pregnancy and Childbirth. 21 (1): 273-273 - 2021-01-01 21(1), DOI: 10.1186/s12884-021-03742-4

Autores: Martinez-Perez O, Prats Rodriguez P, Muner Hernandez M, Encinas Pardilla MB, Perez Perez N, Vila Hernandez MR, Villalba Yarza A, Nieto Velasco O, Del Barrio Fernandez PG, Forcen Acebal L, Orizales Lago CM, Martinez Varea A, Muñoz Abellana B, Suarez Arana M, Fuentes Ricoy L, Martinez Diago C, Janeiro Freire MJ, Alférez Alvarez-Mallo M, Casanova Pedraz C, Alomar Mateu O, Lesmes Heredia C, Wizner de Alva JC, Bernardo Vega R, Macia Badia M, Alvarez Colomo C, Sanchez Muñoz A, Pratcorona Alicart L, Alonso Saiz R, Lopez Rodriguez M, Del Carmen Barbancho Lopez M, Meca Casbas MR, Vaquerizo Ruiz O, Moran Antolin E, Nuñez Valera MJ, Fernandez Fernandez C, Tubau Navarra A, Cano Garcia AM, Baena Luque C, Soldevilla Perez S, Gastaca Abasolo I, Adanez Garcia J, Teulon Gonzalez M, Puertas Prieto A, Ostos Serna R, Del Pilar Guadix Martin M, Catalina Coello M, Ferriols Perez E, Caño Aguilar A, De la Cruz Conty ML, Sainz Bueno JA, Spanish Obstetric Emergency Group

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Resumen

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.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.Preterm delivery (primary), premature rupture of membranes and neonatal intensive care unit admissions.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.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.

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