دورية أكاديمية
Pregnancy and infant outcomes following SARS-CoV-2 infection in pregnancy during delta variant predominance - Surveillance for Emerging Threats to Pregnant People and Infants.
| العنوان: | Pregnancy and infant outcomes following SARS-CoV-2 infection in pregnancy during delta variant predominance - Surveillance for Emerging Threats to Pregnant People and Infants. |
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| المؤلفون: | Reeves EL; Eagle Global Scientific, LLC, Atlanta, GA (Ms Reeves, Dr Carlson, and Ms Fox). Electronic address: setnet@cdc.gov., Neelam V; Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA (Ms Neelam; Drs Olsen, Woodworth, Cohn, and Gilboa; and Ms Tong)., Carlson JM; Eagle Global Scientific, LLC, Atlanta, GA (Ms Reeves, Dr Carlson, and Ms Fox)., Olsen EO; Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA (Ms Neelam; Drs Olsen, Woodworth, Cohn, and Gilboa; and Ms Tong)., Fox CJ; Eagle Global Scientific, LLC, Atlanta, GA (Ms Reeves, Dr Carlson, and Ms Fox)., Woodworth KR; Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA (Ms Neelam; Drs Olsen, Woodworth, Cohn, and Gilboa; and Ms Tong)., Nestoridi E; Massachusetts Department of Public Health, Boston, MA (Dr Nestoridi)., Mobley E; Missouri Department of Health and Senior Services, Jefferson City, MO (Mr Mobley)., Montero Castro S; New Jersey Department of Health, Trenton, NJ (Ms Montero Castro)., Dzimira P; Pennsylvania Department of Health, Pittsburgh, PA (Ms Dzimira)., Sokale A; Philadelphia Department of Public Health, Philadelphia, PA (Ms Sokale)., Sizemore L; Tennessee Department of Health, Nashville, TN (Ms Sizemore)., Hall AJ; Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA (Dr Hall)., Ellington S; Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA (Dr Ellington)., Cohn A; Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA (Ms Neelam; Drs Olsen, Woodworth, Cohn, and Gilboa; and Ms Tong)., Gilboa SM; Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA (Ms Neelam; Drs Olsen, Woodworth, Cohn, and Gilboa; and Ms Tong)., Tong VT; Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA (Ms Neelam; Drs Olsen, Woodworth, Cohn, and Gilboa; and Ms Tong). |
| المصدر: | American journal of obstetrics & gynecology MFM [Am J Obstet Gynecol MFM] 2024 Feb; Vol. 6 (2), pp. 101265. Date of Electronic Publication: 2023 Dec 21. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Inc Country of Publication: United States NLM ID: 101746609 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2589-9333 (Electronic) Linking ISSN: 25899333 NLM ISO Abbreviation: Am J Obstet Gynecol MFM Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: [New York, NY] : Elsevier Inc., [2019]- |
| مواضيع طبية MeSH: | COVID-19*/diagnosis , COVID-19*/epidemiology , COVID-19*/prevention & control , Premature Birth*/epidemiology , Abortion, Spontaneous*/epidemiology , Pregnancy Complications, Infectious*/diagnosis , Pregnancy Complications, Infectious*/epidemiology, Pregnancy ; Infant ; Female ; Infant, Newborn ; Humans ; SARS-CoV-2/genetics ; Stillbirth/epidemiology ; Retrospective Studies ; COVID-19 Vaccines |
| مستخلص: | Background: SARS-CoV-2 infection in pregnancy is associated with an increased risk of adverse birth outcomes such as preterm birth, stillbirth, and maternal and infant complications. Previous research suggests an increased risk of severe COVID-19 illness and stillbirth in pregnant people during delta variant predominance in 2021; however, those studies did not assess timing of infection during pregnancy, and few of them described COVID-19 vaccination status. Objective: Using a large population-based cohort, this study compared pregnancy and infant outcomes and described demographic and clinical characteristics of pregnant people with SARS-CoV-2 infection prior to and during the delta variant period. Study Design: This retrospective cohort analysis included persons with confirmed SARS-CoV-2 infection in pregnancy from 6 US jurisdictions reporting to the Surveillance for Emerging Threats to Pregnant People and Infants Network. Data were collected through case reports of polymerase chain reaction-positive pregnant persons and linkages to birth certificates, fetal death records, and immunization records. We described clinical characteristics and compared frequency of spontaneous abortion (<20 weeks of gestation), stillbirth (≥20 weeks), preterm birth (<37 weeks), small for gestational age, and term infant neonatal intensive care unit admission between the time periods of pre-delta and delta variant predominance. Study time periods were determined by when variants constituted more than 50% of sequences isolated according to regional SARS-CoV-2 genomic surveillance data, with time periods defined for pre-delta (March 3, 2020-June 25, 2021) and Delta (June 26, 2021-December 25, 2021). Adjusted prevalence ratios were estimated for each outcome measure using Poisson regression and were adjusted for continuous maternal age, race and ethnicity, and insurance status at delivery. Results: Among 57,563 pregnancy outcomes, 57,188 (99.3%) were liveborn infants, 65 (0.1%) were spontaneous abortions, and 310 (0.5%) were stillbirths. Most pregnant persons were unvaccinated at the time of SARS-CoV-2 infection, with a higher proportion in pre-delta (99.4%) than in the delta period (78.4%). Of those with infections during delta and who were previously vaccinated, the timing from last vaccination to infection was a median of 183 days. Compared to pre-delta, infections during delta were associated with a higher frequency of stillbirths (0.7% vs 0.4%; adjusted prevalence ratio, 1.55; 95% confidence interval, 1.14-2.09) and preterm births (12.8% vs 11.9%; adjusted prevalence ratio, 1.14; 95% confidence interval, 1.07-1.20). The delta period was associated with a lower frequency of neonatal intensive care unit admission (adjusted prevalence ratio, 0.74; 95% confidence interval, 0.67-0.82) than in the pre-delta period. During the delta period, infection during the third trimester was associated with a higher frequency of preterm birth (adjusted prevalence ratio, 1.41; 95% confidence interval, 1.28-1.56) and neonatal intensive care unit admission (adjusted prevalence ratio, 1.21; 95% confidence interval, 1.01-1.45) compared to the first and second trimester combined. Conclusion: In this US-based cohort of persons with SARS-CoV-2 infection in pregnancy, the majority were unvaccinated, and frequencies of stillbirth and preterm birth were higher during the delta variant predominance period than in the pre-delta period. During the delta period, frequency of preterm birth and neonatal intensive care unit admission was higher among infections occurring in the third trimester vs those earlier in pregnancy. These findings demonstrate population-level increases of adverse fetal and infant outcomes, specifically in the presence of a COVID-19 variant with more severe presentation. (Copyright © 2023 Elsevier Inc. All rights reserved.) |
| References: | Obstet Gynecol Clin North Am. 2023 Jun;50(2):279-297. (PMID: 37149310) Clin Infect Dis. 2022 Oct 3;75(Suppl 2):S317-S325. (PMID: 35717652) MMWR Morb Mortal Wkly Rep. 2021 Nov 26;70(47):1640-1645. (PMID: 34818318) Birth Defects Res. 2023 Jan 15;115(2):145-159. (PMID: 36065896) Clin Infect Dis. 2022 Aug 24;75(1):e1128-e1136. (PMID: 34423834) BMJ. 2022 Feb 11;376:o358. (PMID: 35149516) Nat Med. 2021 Oct;27(10):1693-1695. (PMID: 34493859) BMC Pregnancy Childbirth. 2022 Oct 18;22(1):775. (PMID: 36258186) BMC Pregnancy Childbirth. 2022 Jul 21;22(1):581. (PMID: 35864455) J Infect Dis. 2022 Mar 2;225(5):754-758. (PMID: 35024844) BMJ. 2020 Sep 1;370:m3320. (PMID: 32873575) Clin Infect Dis. 2021 Jul 15;73(Suppl 1):S24-S31. (PMID: 33977298) Obstet Gynecol. 2021 Apr 1;137(4):571-580. (PMID: 33560778) Am J Obstet Gynecol MFM. 2021 Nov;3(6):100468. (PMID: 34425296) Am J Obstet Gynecol. 2018 Feb;218(2S):S630-S640. (PMID: 29422205) MMWR Morb Mortal Wkly Rep. 2021 Jun 11;70(23):846-850. (PMID: 34111060) Am J Obstet Gynecol. 2022 Jan;226(1):149-151. (PMID: 34529957) JAMA Netw Open. 2022 Sep 1;5(9):e2233273. (PMID: 36156146) J Perinatol. 2023 Jun;43(6):766-774. (PMID: 37117394) MMWR Morb Mortal Wkly Rep. 2021 Oct 29;70(43):1513-1519. (PMID: 34710076) Paediatr Perinat Epidemiol. 2016 Mar;30(2):134-40. (PMID: 26860444) MMWR Morb Mortal Wkly Rep. 2022 Feb 11;71(6):206-211. (PMID: 35143464) |
| معلومات مُعتمدة: | CC999999 United States ImCDC Intramural CDC HHS |
| فهرسة مساهمة: | Keywords: COVID-19; SARS-CoV-2; adverse perinatal outcomes; delta variant; fetal death; pregnancy; preterm birth; stillbirth |
| المشرفين على المادة: | 0 (COVID-19 Vaccines) |
| SCR Organism: | SARS-CoV-2 variants |
| تواريخ الأحداث: | Date Created: 20231222 Date Completed: 20240214 Latest Revision: 20240814 |
| رمز التحديث: | 20240815 |
| مُعرف محوري في PubMed: | PMC11264249 |
| DOI: | 10.1016/j.ajogmf.2023.101265 |
| PMID: | 38135220 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 2589-9333 |
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| DOI: | 10.1016/j.ajogmf.2023.101265 |