Preterm birth is not associated with asymptomatic/mild SARS-CoV-2 infection per se: Pre-pregnancy state is what matters

被引:7
作者
Cosma, Stefano [1 ]
Carosso, Andrea Roberto [1 ]
Cusato, Jessica [2 ]
Borella, Fulvio [1 ]
Carosso, Marco [1 ]
Gervasoni, Fiammetta [1 ]
Stura, Ilaria [3 ]
Preti, Mario [1 ]
Ghisetti, Valeria [4 ]
Di Perri, Giovanni [5 ]
Benedetto, Chiara [1 ]
机构
[1] Univ Turin, Gynecol & Obstet 1, St Anna Univ Hosp, Dept Surg Sci,City Hlth & Sci, Turin, Italy
[2] Univ Turin, Amedeo di Savoia Hosp, Dept Med Sci, Lab Clin Pharmacol & Pharmacogenet, Turin, Italy
[3] Univ Turin, Dept Publ Hlth & Paediat Sci, Turin, Italy
[4] Amedeo di Savoia Hosp, Lab Microbiol & Virol, ASL Citta Torino, Turin, Italy
[5] Univ Turin, Amedeo di Savoia Hosp, Dept Med Sci, Infect Dis Unit, Turin, Italy
关键词
PREGNANCY; OUTCOMES; RISK;
D O I
10.1371/journal.pone.0254875
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Evidence for the real impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on preterm birth is unclear, as available series report composite pregnancy outcomes and/or do not stratify patients according to disease severity. The purpose of the research was to determine the real impact of asymptomatic/mild SARS-CoV-2 infection on preterm birth not due to maternal respiratory failure. This case-control study involved women admitted to Sant Anna Hospital, Turin, for delivery between 20 September 2020 and 9 January 2021. The cumulative incidence of Coronavirus disease-19 was compared between preterm birth (case group, n = 102) and full-term delivery (control group, n = 127). Only women with spontaneous or medically-indicated preterm birth because of placental vascular malperfusion (pregnancy-related hypertension and its complications) were included. Current or past SARS-CoV-2 infection was determined by nasopharyngeal swab testing and detection of IgM/IgG antibodies in blood samples. A significant difference in the cumulative incidence of Coronavirus disease-19 between the case (21/102, 20.5%) and the control group (32/127, 25.1%) (P= 0.50) was not observed, although the case group was burdened by a higher prevalence of three known risk factors (body mass index > 24.9, asthma, chronic hypertension) for severe Coronavirus disease-19. Logistic regression analysis showed that asymptomatic/mild SARS-CoV-2 infection was not an independent predictor of spontaneous and medically-indicated preterm birth due to pregnancy-related hypertension and its complications (0.77; 95% confidence interval, 0.41-1.43). Pregnant patients without comorbidities need to be reassured that asymptomatic/mild SARS-CoV-2 infection does not increase the risk of preterm delivery. Preterm birth and severe Coronavirus disease-19 share common risk factors (i.e., body mass index > 24.9, asthma, chronic hypertension), which may explain the high rate of indicated preterm birth due to maternal conditions reported in the literature.
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页数:11
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