Maternal and Perinatal Outcomes of Pregnant Women with SARS-CoV-2 Infection at Birth in the United Kingdom: A National Cohort Study
SARS-CoV-2 infection at birth is associated with a higher incidence of fetal death, preterm birth, preeclampsia and emergency caesarean section. There were no additional adverse neonatal outcomes, except those associated with preterm birth. Pregnant women should be counseled about the risk of SARS-COV-2 infection and should be viewed as a priority for vaccination.
DOI: https : //doi.org/10.1016/j.ajog.2021.05.016
Commentary
This study investigated the association between SARS-CoV-2 infection at birth and maternal and perinatal outcomes, and was a cohort study conducted in the United Kingdom.It covered 31 periods reported between May 2020 and January 2021 and compared pregnant women with and without laboratory-confirmed SARS-CoV-2 infections recorded in birth episodes.
Analysis of the results showed that 342,080 women were included, of whom 3,527 were confirmed to have SARS-CoV-2 infection. The tendency to be infected was characterized by being young, non-white, first born, living in the most disadvantaged areas, and having comorbidities.
Fetal death (aOR, 2.21, 95% CI 1.58-3.11; P <0.001)
Preterm birth (aOR, 2.17, 95% CI 1.96-2.42; P <0.001)
This occurred more frequently in women with SARS-CoV-2 infection and was associated with preeclampsia/preeclampsia (aOR 1.55, 95% CI 1.29-1.85; P <0.001), delivery by emergency caesarean section (aOR 1.63, 95% CI 1.51-1.76; P <0.001), prolonged hospitalization after delivery (aOR 1. 57, 95% CI 1.44-1.72; P <0.001) were reported to be significantly higher in women with SARS-CoV-2 infection than in those without.
The risk of adverse neonatal outcomes, the need for specialized neonatal care, and prolonged postnatal hospitalization were reported to be significantly higher in infants born to mothers with a history of SARS-CoV-2 infection.
When these analyses were restricted to pregnancies delivered at full term (≥37 weeks), there were no significant differences in adverse neonatal outcomes, need for specialized postnatal neonatal care, or neonatal readmission within 4 weeks.
