Active Intrapartum SARS-CoV-2 Infection and Pregnancy Outcomes

Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection during pregnancy has been associated with poor pregnancy outcomes. There is, however, not much information on the impact of the timing of SARS-CoV-2 infection on pregnancy outcomes, and studies from low-middle income settings are...

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Bibliographic Details
Published in:American journal of perinatology Vol. 39; no. S 01; p. S42
Main Authors: Nunes, Marta C, Jones, Stephanie, Strehlau, Renate, Baba, Vuyelwa, Ditse, Zanele, da Silva, Kelly, Bothma, Lané, Serafin, Natali, Baillie, Vicky L, Kwatra, Gaurav, Burke, Megan, Wise, Amy, Adam, Mary, Mlandu, Philiswa, Melamu, Mpolokeng, Phelp, Juliette, Fraser, Wendy, Wright, Colleen, Zell, Elizabeth, Adam, Yasmin, Madhi, Shabir A
Format: Journal Article
Language:English
Published: United States 01.12.2022
Subjects:
Chorioamnionitis - pathology
COVID-19
Cross-Sectional Studies
Female
Humans
Infant, Newborn
Infectious Disease Transmission, Vertical
Male
Placenta - pathology
Pregnancy
Pregnancy Complications, Infectious
Pregnancy Outcome
Premature Birth - pathology
SARS-CoV-2
ISSN:1098-8785, 1098-8785
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Summary:Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection during pregnancy has been associated with poor pregnancy outcomes. There is, however, not much information on the impact of the timing of SARS-CoV-2 infection on pregnancy outcomes, and studies from low-middle income settings are also scarce. We conducted a cross-sectional study from April to December 2020, in South Africa, to assess the association of SARS-CoV-2 infection on a nasal swab at the time of labor with fetal death, preterm birth, low birth weight, or pregnancy-induced complications. When possible, maternal blood, cord blood, and placenta were collected. SARS-CoV-2 infection was investigated by a nucleic acid amplification test (NAAT). Overall, 3,117 women were tested for SARS-CoV-2 on a nasal swab, including 1,562 (50%) healthy women with uncomplicated term delivery. A positive NAAT was detected among 132 (4%) women. Adverse birth outcomes or pregnancy-related complications were not associated with SARS-CoV-2 infection at the time of labor. Among SARS-CoV-2-infected women, an NAAT-positive result was also obtained from 6 out of 98 (6%) maternal blood samples, 8 out of 93 (9%) cord-blood samples, 14 out of 54 (26%) placentas, and 3 out of 22 (14%) nasopharyngeal swabs from newborns collected within 72 hours of birth. Histological assessment of placental tissue revealed that women with SARS-CoV-2 nasal infection had a higher odds (3.82, 95% confidence interval: 1.20, 12.19) of chronic chorioamnionitis compared with those without SARS-CoV-2 infection. Our study demonstrates that intrapartum, SARS-CoV-2 infection was not associated with evaluated poor outcomes. In utero fetal and placental infections and possible vertical and/or horizontal viral transfer to the newborn were detected among women with nasal SARS-CoV-2 infection. · Intrapartum SARS-CoV-2 infection was not associated with evaluated poor outcomes.. · In utero fetal and placental infections were detected among women with nasal SARS-CoV-2 infection.. · Women with SARS-CoV-2 nasal infection had a higher odds of chronic chorioamnionitis..
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ISSN:1098-8785
1098-8785
DOI:10.1055/s-0042-1757274