Disease Severity and Perinatal Outcomes of Pregnant Patients With Coronavirus Disease 2019 (COVID-19)

To describe coronavirus disease 2019 (COVID-19) severity in pregnant patients and evaluate the association between disease severity and perinatal outcomes. We conducted an observational cohort study of all pregnant patients with a singleton gestation and a positive test result for severe acute respi...

Celý popis

Uložené v:
Podrobná bibliografia
Vydané v:Obstetrics and gynecology (New York. 1953) Ročník 137; číslo 4; s. 571
Hlavní autori: Metz, Torri D, Clifton, Rebecca G, Hughes, Brenna L, Sandoval, Grecio, Saade, George R, Grobman, William A, Manuck, Tracy A, Miodovnik, Menachem, Sowles, Amber, Clark, Kelly, Gyamfi-Bannerman, Cynthia, Mendez-Figueroa, Hector, Sehdev, Harish M, Rouse, Dwight J, Tita, Alan T N, Bailit, Jennifer, Costantine, Maged M, Simhan, Hyagriv N, Macones, George A
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: United States 01.04.2021
Predmet:
Adult
Asymptomatic Infections
Body Mass Index
Cesarean Section - statistics & numerical data
Cohort Studies
Comorbidity
COVID-19 - complications
COVID-19 - diagnosis
COVID-19 - epidemiology
Female
Humans
Hypertension, Pregnancy-Induced - epidemiology
Infant, Newborn
Maternal Age
Maternal Mortality
Patient Acuity
Perinatal Mortality
Pregnancy
Pregnancy Complications, Infectious - epidemiology
Pregnancy Complications, Infectious - virology
Premature Birth - epidemiology
Risk Factors
SARS-CoV-2
United States - epidemiology
Venous Thromboembolism - epidemiology
Venous Thromboembolism - virology
Young Adult
United States
ISSN:1873-233X, 1873-233X
On-line prístup:Zistit podrobnosti o prístupe
Tagy: Pridať tag
Žiadne tagy, Buďte prvý, kto otaguje tento záznam!
Popis
Shrnutí:To describe coronavirus disease 2019 (COVID-19) severity in pregnant patients and evaluate the association between disease severity and perinatal outcomes. We conducted an observational cohort study of all pregnant patients with a singleton gestation and a positive test result for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who delivered at 1 of 33 U.S. hospitals in 14 states from March 1 to July 31, 2020. Disease severity was classified by National Institutes of Health criteria. Maternal, fetal, and neonatal outcomes were abstracted by centrally trained and certified perinatal research staff. We evaluated trends in maternal characteristics and outcomes across COVID-19 severity classes and associations between severity and outcomes by multivariable modeling. A total of 1,219 patients were included: 47% asymptomatic, 27% mild, 14% moderate, 8% severe, 4% critical. Overall, 53% were Hispanic; there was no trend in race-ethnicity distribution by disease severity. Those with more severe illness had older mean age, higher median body mass index, and pre-existing medical comorbidities. Four maternal deaths (0.3%) were attributed to COVID-19. Frequency of perinatal death or a positive neonatal SARS-CoV-2 test result did not differ by severity. Adverse perinatal outcomes were more frequent among patients with more severe illness, including 6% (95% CI 2-11%) incidence of venous thromboembolism among those with severe-critical illness compared with 0.2% in mild-moderate and 0% in asymptomatic (P<.001 for trend across severity). In adjusted analyses, severe-critical COVID-19 was associated with increased risk of cesarean birth (59.6% vs 34.0%, adjusted relative risk [aRR] 1.57, 95% CI 1.30-1.90), hypertensive disorders of pregnancy (40.4% vs 18.8%, aRR 1.61, 95% CI 1.18-2.20), and preterm birth (41.8% vs 11.9%, aRR 3.53, 95% CI 2.42-5.14) compared with asymptomatic patients. Mild-moderate COVID-19 was not associated with adverse perinatal outcomes compared with asymptomatic patients. Compared with pregnant patients with SARS-CoV-2 infection without symptoms, those with severe-critical COVID-19, but not those with mild-moderate COVID-19, were at increased risk of perinatal complications.
Bibliografia:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ObjectType-Undefined-3
ISSN:1873-233X
1873-233X
DOI:10.1097/AOG.0000000000004339