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

被引：54

作者：

Martinez-Perez, Oscar ^{[1
]}

Prats Rodriguez, Pilar ^{[2
]}

Muner Hernandez, Marta ^{[3
]}

Encinas Pardilla, Maria Begona ^{[1
]}

Perez Perez, Noelia ^{[4
]}

Vila Hernandez, Maria Rosa ^{[5
]}

Villalba Yarza, Ana ^{[6
]}

Nieto Velasco, Olga ^{[7
]}

Del Barrio Fernandez, Pablo Guillermo ^{[8
]}

Forcen Acebal, Laura ^{[9
]}

Orizales Lago, Carmen Maria ^{[10
]}

Martinez Varea, Alicia ^{[11
]}

Munoz Abellana, Begona ^{[12
]}

Suarez Arana, Maria ^{[13
]}

Fuentes Ricoy, Laura ^{[14
]}

Martinez Diago, Clara ^{[15
]}

Janeiro Freire, Maria Jesus ^{[16
]}

Alferez Alvarez-Mallo, Macarena ^{[17
]}

Casanova Pedraz, Cristina ^{[18
]}

Alomar Mateu, Onofre ^{[19
]}

Lesmes Heredia, Cristina ^{[20
]}

Wizner de Alva, Juan Carlos ^{[21
]}

Bernardo Vega, Rut ^{[22
]}

Macia Badia, Montserrat ^{[23
]}

Alvarez Colomo, Cristina ^{[24
]}

Sanchez Munoz, Antonio ^{[25
]}

Pratcorona Alicart, Laia ^{[26
]}

Alonso Saiz, Ruben ^{[27
]}

Lopez Rodriguez, Monica ^{[28
]}

Barbancho Lopez, Maria del Carmen ^{[29
]}

Meca Casbas, Marta Ruth ^{[30
]}

Vaquerizo Ruiz, Oscar ^{[31
]}

Moran Antolin, Eva ^{[32
]}

Nunez Valera, Maria Jose ^{[33
]}

Fernandez Fernandez, Camino ^{[34
]}

Tubau Navarra, Albert ^{[35
]}

Cano Garcia, Alejandra Maria ^{[36
]}

Baena Luque, Carmen ^{[37
]}

Soldevilla Perez, Susana ^{[38
]}

Gastaca Abasolo, Irene ^{[39
]}

Adanez Garcia, Jose ^{[40
]}

Teulon Gonzalez, Maria ^{[41
]}

Puertas Prieto, Alberto ^{[42
]}

Ostos Serna, Rosa ^{[43
]}

Guadix Martin, Maria del Pilar ^{[44
]}

Catalina Coello, Monica ^{[45
]}

Ferriols Perez, Elena ^{[46
]}

Cano Aguilar, Africa ^{[47
]}

De la Cruz Conty, Maria Luisa ^{[48
]}

Sainz Bueno, Jose Antonio ^{[49
]}

机构：

[1] Puerta Hierro Univ Hosp Majadahonda, Dept Gynaecol & Obstet, Madrid, Spain

[2] Dexeus Univ Hosp, Dept Reprod Med & Gynaecol, Obstet, Barcelona, Catalunya, Spain

[3] La Paz Univ Hosp Madrid, Dept Gynaecol & Obstet, Madrid, Spain

[4] San Carlos Univ Hosp Madrid, Dept Gynaecol & Obstet, Madrid, Spain

[5] Santa Caterina Hosp, Dept Gynaecol & Obstet, Girona, Catalunya, Spain

[6] Univ Hosp Salamanca, Dept Gynaecol & Obstet, Salamanca, Castilla Y Leon, Spain

[7] Quironsalud Madrid Univ Hosp, Dept Obstet & Gynaecol, Madrid, Spain

[8] Getafe Univ Hosp, Dept Gynaecol & Obstet, Madrid, Spain

[9] Doce Octubre Univ Hosp, Dept Gynaecol & Obstet, Madrid, Spain

[10] Severo Ochoa Univ Hosp, Dept Gynaecol & Obstet, Madrid, Spain

[11] La Fe Univ & Polytech Hosp, Dept Gynaecol & Obstet, Valencia, Spain

[12] Sant Joan Reus Univ Hosp, Dept Obstet & Gynaecol, Reus, Catalunya, Spain

[13] Reg Univ Hosp Malaga, Dept Gynaecol & Obstet, Malaga, Andalucia, Spain

[14] Univ Hosp Ferrol, Dept Obstet & Gynaecol, Ferrol, A Coruna, Spain

[15] Doctor Josep Trueta Univ Hosp Girona, Dept Gynaecol & Obstet, Girona, Catalunya, Spain

[16] Univ Hosp Complex A Coruna, Dept Obstet & Gynaecol, La Coruna, Spain

[17] HM Hosp, Dept Obstet & Gynaecol, Madrid, Spain

[18] Univ Hosp Torrejon, Dept Gynaecol & Obstet, Madrid, Spain

[19] Reg Hosp Inca, Dept Obstet & Gynaecol, Inca, Illes Balears, Spain

[20] Parc Tauli Hosp, Dept Obstet & Gynaecol, Barcelona, Catalunya, Spain

[21] San Pedro Alcantara Hosp, Dept Gynaecol & Obstet, Caceres, Extremadura, Spain

[22] Rio Hortega Univ Hosp, Dept Gynaecol & Obstet, Valladolid, Castilla Y Leon, Spain

[23] Arnau Vilanova Univ Hosp, Dept Gynaecol & Obstet, Lleida, Catalunya, Spain

[24] Valladolid Univ Hosp, Dept Gynaecol & Obstet, Valladolid, Castilla Y Leon, Spain

[25] Gen Univ Hosp Ciudad Real, Dept Gynaecol & Obstet, Ciudad Real, Castilla La Man, Spain

[26] Germans Trias & Pujol Univ Hosp, Dept Obstet & Gynaecol, Barcelona, Catalunya, Spain

[27] Univ Hosp Burgos, Dept Gynaecol & Obstet, Burgos, Castilla Y Leon, Spain

[28] Joan XXIII Univ Hosp Tarragona, Dept Obstet & Gynaecol, Tarragona, Catalunya, Spain

[29] Infanta Sofia Univ Hosp, Dept Gynaecol & Obstet, Madrid, Spain

[30] Poniente Hosp Almeria, Dept Obstet & Gynaecol, El Ejido, Andalucia, Spain

[31] Univ Hosp Cabuenes, Dept Obstet & Gynaecol, Gijon, Asturias, Spain

[32] Son Espases Univ Hosp, Dept Obstet & Gynaecol, Palma De Mallorca, Illes Balears, Spain

[33] Virgen Luz Hosp, Dept Obstet & Gynaecol, Cuenca, Castilla La Man, Spain

[34] Univ Assistance Complex Leon, Dept Gynaecol & Obstet, Leon, Castilla Y Leon, Spain

[35] Son Llatzer Univ Hosp, Dept Obstet & Gynaecol, Palma De Mallorca, Illes Balears, Spain

[36] Univ Hosp El Tajo, Dept Gynaecol & Obstet, Madrid, Spain

[37] Infanta Margarita Hosp, Dept Gynaecol & Obstet, Andalucia, Cabra, Spain

[38] Univ Hosp Jerez Frontera, Dept Obstet & Gynaecol, Jerez de la Frontera, Andalucia, Spain

[39] Txagorritxu Univ Hosp Araba, Dept Obstet & Gynaecol, Vitoria, Pais Vasco, Spain

[40] Cent Univ Hosp Asturias, Dept Obstet & Gynaecol, Oviedo, Asturias, Spain

[41] Univ Hosp Fuenlabrada, Dept Gynaecol & Obstet, Madrid, Spain

[42] Virgen Nieves Univ Hosp, Dept Obstet & Gynaecol, Granada, Andalucia, Spain

[43] Virgen Valme Univ Hosp, Dept Gynaecol & Obstet, Seville, Andalucia, Spain

[44] Virgen Macarena Univ Hosp, Dept Obstet & Gynaecol, Seville, Andalucia, Spain

[45] Virgen Concha Hosp, Dept Gynaecol & Obstet, Zamora, Castilla Y Leon, Spain

[46] Parc Salut Mar Univ Hosp, Dept Gynaecol & Obstet, Barcelona, Catalunya, Spain

[47] San Cecilio Univ Hosp Granada, Dept Obstet & Gynaecol, Granada, Andalucia, Spain

[48] Puerta Hierro Univ Hosp Majadahonda, Fdn Invest Biomed, Madrid, Spain

[49] Univ Seville, G Chacon Viamed Santa Angela Cruz Hosp, Dept Gynaecol & Obstet, Seville, Andalucia, Spain

来源：

BMC PREGNANCY AND CHILDBIRTH | 2021年 / 21卷 / 01期

关键词：

SARS-CoV-2; Coronavirus; COVID-19; Pregnancy; Premature birth; Premature rupture of membranes; Intensive care units; neonatal;

D O I：

10.1186/s12884-021-03742-4

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

BackgroundTo 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.MethodsWe 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.ResultsAmong 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.ConclusionThis 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.

引用

页数：11

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