المؤلفون: Edward F. Bell, Barbara J. Stoll, Nellie I. Hansen, Myra H. Wyckoff, Michele C. Walsh, Pablo J. Sánchez, Matthew A. Rysavy, Jenna H. Gabrio, Stephanie W. Archer, Abhik Das, Rosemary D. Higgins

المصدر: Seminars in perinatology. 46(7)

مصطلحات موضوعية: Infant, Extremely Premature, Pediatrics, Perinatology and Child Health, Infant, Newborn, Obstetrics and Gynecology, Humans, Infant, National Institute of Child Health and Human Development (U.S.), Gestational Age, Infant, Premature, Diseases, Prospective Studies, Child, United States

الوصف: The Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network (NRN) maintains a database of extremely preterm infants known as the Generic Database (GDB). Begun in 1987, this database now includes more than 91,000 infants, most of whom are extremely preterm (29 weeks gestation). The GDB has been the backbone of the NRN, providing high quality, prospectively collected data to study the changing epidemiology of extreme prematurity and its outcomes over time. In addition, GDB data have been used to generate hypotheses for prospective studies and to develop new clinical trials by providing information about the numbers and characteristics of available subjects and the expected event rates for conditions and complications to be studied. Since its inception, the GDB has been the basis of more than 200 publications in peer-reviewed journals, many of which have had a significant impact on the field of neonatology.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::63ca7dd2e4075d227806c7da64e46b6b
https://pubmed.ncbi.nlm.nih.gov/35835615

المؤلفون: Torri D, Metz, Rebecca G, Clifton, Brenna L, Hughes, Grecio J, Sandoval, William A, Grobman, George R, Saade, Tracy A, Manuck, Monica, Longo, Amber, Sowles, Kelly, Clark, Hyagriv N, Simhan, Dwight J, Rouse, Hector, Mendez-Figueroa, Cynthia, Gyamfi-Bannerman, Jennifer L, Bailit, Maged M, Costantine, Harish M, Sehdev, Alan T N, Tita, George A, Macones, Stephanie W, Archer

المصدر: JAMA

مصطلحات موضوعية: Adult, Postpartum Hemorrhage, Postpartum Period, COVID-19, General Medicine, Hypertension, Pregnancy-Induced, United States, Maternal Mortality, Pregnancy, Humans, Female, Pregnancy Complications, Infectious, Retrospective Studies, Original Investigation

الوصف: IMPORTANCE: It remains unknown whether SARS-CoV-2 infection specifically increases the risk of serious obstetric morbidity. OBJECTIVE: To evaluate the association of SARS-CoV-2 infection with serious maternal morbidity or mortality from common obstetric complications. DESIGN, SETTING, AND PARTICIPANTS: Retrospective cohort study of 14 104 pregnant and postpartum patients delivered between March 1, 2020, and December 31, 2020 (with final follow-up to February 11, 2021), at 17 US hospitals participating in the Eunice Kennedy Shriver National Institute of Child Health and Human Development’s Gestational Research Assessments of COVID-19 (GRAVID) Study. All patients with SARS-CoV-2 were included and compared with those without a positive SARS-CoV-2 test result who delivered on randomly selected dates over the same period. EXPOSURES: SARS-CoV-2 infection was based on a positive nucleic acid or antigen test result. Secondary analyses further stratified those with SARS-CoV-2 infection by disease severity. MAIN OUTCOMES AND MEASURES: The primary outcome was a composite of maternal death or serious morbidity related to hypertensive disorders of pregnancy, postpartum hemorrhage, or infection other than SARS-CoV-2. The main secondary outcome was cesarean birth. RESULTS: Of the 14 104 included patients (mean age, 29.7 years), 2352 patients had SARS-CoV-2 infection and 11 752 did not have a positive SARS-CoV-2 test result. Compared with those without a positive SARS-CoV-2 test result, SARS-CoV-2 infection was significantly associated with the primary outcome (13.4% vs 9.2%; difference, 4.2% [95% CI, 2.8%-5.6%]; adjusted relative risk [aRR], 1.41 [95% CI, 1.23-1.61]). All 5 maternal deaths were in the SARS-CoV-2 group. SARS-CoV-2 infection was not significantly associated with cesarean birth (34.7% vs 32.4%; aRR, 1.05 [95% CI, 0.99-1.11]). Compared with those without a positive SARS-CoV-2 test result, moderate or higher COVID-19 severity (n = 586) was significantly associated with the primary outcome (26.1% vs 9.2%; difference, 16.9% [95% CI, 13.3%-20.4%]; aRR, 2.06 [95% CI, 1.73-2.46]) and the major secondary outcome of cesarean birth (45.4% vs 32.4%; difference, 12.8% [95% CI, 8.7%-16.8%]; aRR, 1.17 [95% CI, 1.07-1.28]), but mild or asymptomatic infection (n = 1766) was not significantly associated with the primary outcome (9.2% vs 9.2%; difference, 0% [95% CI, −1.4% to 1.4%]; aRR, 1.11 [95% CI, 0.94-1.32]) or cesarean birth (31.2% vs 32.4%; difference, −1.4% [95% CI, −3.6% to 0.8%]; aRR, 1.00 [95% CI, 0.93-1.07]). CONCLUSIONS AND RELEVANCE: Among pregnant and postpartum individuals at 17 US hospitals, SARS-CoV-2 infection was associated with an increased risk for a composite outcome of maternal mortality or serious morbidity from obstetric complications.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1d946e22bcf4f8bd14292444f3e85e40
https://pubmed.ncbi.nlm.nih.gov/35129581