| Literature DB >> 32975205 |
Daniele Di Mascio1, Cihat Sen2, Gabriele Saccone3, Alberto Galindo4, Amos Grünebaum5, Jun Yoshimatsu6, Milan Stanojevic7, Asım Kurjak7, Frank Chervenak5, María José Rodríguez Suárez8, Zita Maria Gambacorti-Passerini9, María de Los Angeles Anaya Baz9,10, Esther Vanessa Aguilar Galán9,10, Yolanda Cuñarro López11, Juan Antonio De León Luis11, Ignacio Cueto Hernández11, Ignacio Herraiz4, Cecilia Villalain4, Roberta Venturella12, Giuseppe Rizzo13,14, Ilenia Mappa13, Giovanni Gerosolima15, Lars Hellmeyer16, Josefine Königbauer16, Giada Ameli16, Tiziana Frusca17, Nicola Volpe17, Giovanni Battista Luca Schera17, Stefania Fieni17, Eutalia Esposito18, Giuliana Simonazzi19, Gaetana Di Donna19, Aly Youssef19, Anna Nunzia Della Gatta19, Mariano Catello Di Donna20, Vito Chiantera20, Natalina Buono20, Giulio Sozzi20, Pantaleo Greco21, Danila Morano21, Beatrice Bianchi21, Maria Giulia Lombana Marino21, Federica Laraud22, Arianna Ramone22, Angelo Cagnacci22, Fabio Barra22, Claudio Gustavino22, Simone Ferrero22, Fabio Ghezzi23, Antonella Cromi23, Antonio Simone Laganà23, Valentina Laurita Longo24,25,26, Francesca Stollagli25, Angelo Sirico24, Antonio Lanzone24,25, Lorenza Driul27, Fabiana Cecchini D27, Serena Xodo27, Brian Rodriguez28, Felipe Mercado-Olivares28, Deena Elkafrawi28, Giovanni Sisti28, Rosanna Esposito3, Antonio Coviello3, Marco Cerbone3, Maddalena Morlando29, Antonio Schiattarella29, Nicola Colacurci29, Pasquale De Franciscis29, Ilaria Cataneo30, Marinella Lenzi30, Fabrizio Sandri30, Riccardo Buscemi31, Giorgia Gattei31, Francesca Della Sala31, Eleonora Valori31,32, Maria Cristina Rovellotti31, Elisa Done33, Gilles Faron33, Leonardo Gucciardo33, Valentina Esposito34, Flaminia Vena1, Antonella Giancotti1, Roberto Brunelli1, Ludovico Muzii1, Luigi Nappi35, Felice Sorrentino35, Lorenzo Vasciaveo35, Marco Liberati36, Danilo Buca36, Martina Leombroni36, Francesca Di Sebastiano36, Luciano Di Tizio36, Diego Gazzolo37, Massimo Franchi38, Quintino Cesare Ianniciello38, Simone Garzon38, Giuliano Petriglia39, Leonardo Borrello39, Albaro Josè Nieto-Calvache40,41, Juan Manuel Burgos-Luna40,41, Caroline Kadji42, Andrew Carlin42, Elisa Bevilacqua42, Marina Moucho43, Pedro Viana Pinto43, Rita Figueiredo43, José Morales Roselló44, Gabriela Loscalzo44, Alicia Martinez-Varea44, Vincente Diago44, Jesús S Jimenez Lopez45, Alicia Yeliz Aykanat46, Stefano Cosma47, Andrea Carosso47, Chiara Benedetto47, Amanda Bermejo48, Otto Henrique May Feuerschuette49, Ozlem Uyaniklar50, Sakine Rahimli Ocakouglu50, Zeliha Atak50, Reyhan Gündüz51, Esra Tustas Haberal52, Bernd Froessler53, Anupam Parange53, Peter Palm53, Igor Samardjiski54, Chiara Taccaliti55, Erhan Okuyan56, George Daskalakis57, Renato Augusto Moreira de Sa58, Alejandro Pittaro59, Maria Luisa Gonzalez-Duran60, Ana Concheiro Guisan60, Şerife Özlem Genç61, Blanka Zlatohlávková62, Anna Luengo Piqueras63, Dolores Esteban Oliva63, Aylin Pelin Cil64, Olus Api64, Panos Antsaklis57, Liana Ples65, Ioannis Kyvernitakis66, Holger Maul66, Marcel Malan66, Albert Lila67, Roberta Granese68, Alfredo Ercoli68, Giuseppe Zoccali68, Andrea Villasco69, Nicoletta Biglia69, Ciuhodaru Madalina70, Elena Costa71, Caroline Daelemans71, Axelle Pintiaux71, Elisa Cueto72, Eran Hadar73, Sarah Dollinger73, Noa A Brzezinski Sinai73, Erasmo Huertas74, Pedro Arango74, Amadeo Sanchez74, Javier Alfonso Schvartzman75, Liviu Cojocaru76, Sifa Turan76, Ozhan Turan76, Maria Carmela Di Dedda77, Rebeca Garrote Molpeceres78, Snezana Zdjelar79, Tanja Premru-Srsen80, Lilijana Kornhauser Cerar80, Mirjam Druškovič80, Valentina De Robertis81, Vedran Stefanovic82, Irmeli Nupponen82, Kaisa Nelskylä82, Zulfiya Khodjaeva83, Ksenia A Gorina83, Gennady T Sukhikh83, Giuseppe Maria Maruotti3, Silvia Visentin84, Erich Cosmi84, Jacopo Ferrari84, Alessandra Gatti85, Daniela Luvero85, Roberto Angioli85, Ludovica Puri25, Marco Palumbo86, Giusella D'Urso86, Francesco Colaleo86, Agnese Maria Chiara Rapisarda86, Ilma Floriana Carbone87, Antonio Mollo88, Giovanni Nazzaro3, Mariavittoria Locci3, Maurizio Guida3, Attilio Di Spiezio Sardo3, Pierluigi Benedetti Panici1, Vincenzo Berghella89, Maria Elena Flacco90, Lamberto Manzoli90, Giuseppe Bifulco3, Giovanni Scambia24, Fulvio Zullo3, Francesco D'Antonio36.
Abstract
Objectives To evaluate the strength of association between maternal and pregnancy characteristics and the risk of adverse perinatal outcomes in pregnancies with laboratory confirmed COVID-19. Methods Secondary analysis of a multinational, cohort study on all consecutive pregnant women with laboratory-confirmed COVID-19 from February 1, 2020 to April 30, 2020 from 73 centers from 22 different countries. A confirmed case of COVID-19 was defined as a positive result on real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay of nasal and pharyngeal swab specimens. The primary outcome was a composite adverse fetal outcome, defined as the presence of either abortion (pregnancy loss before 22 weeks of gestations), stillbirth (intrauterine fetal death after 22 weeks of gestation), neonatal death (death of a live-born infant within the first 28 days of life), and perinatal death (either stillbirth or neonatal death). Logistic regression analysis was performed to evaluate parameters independently associated with the primary outcome. Logistic regression was reported as odds ratio (OR) with 95% confidence interval (CI). Results Mean gestational age at diagnosis was 30.6±9.5 weeks, with 8.0% of women being diagnosed in the first, 22.2% in the second and 69.8% in the third trimester of pregnancy. There were six miscarriage (2.3%), six intrauterine device (IUD) (2.3) and 5 (2.0%) neonatal deaths, with an overall rate of perinatal death of 4.2% (11/265), thus resulting into 17 cases experiencing and 226 not experiencing composite adverse fetal outcome. Neither stillbirths nor neonatal deaths had congenital anomalies found at antenatal or postnatal evaluation. Furthermore, none of the cases experiencing IUD had signs of impending demise at arterial or venous Doppler. Neonatal deaths were all considered as prematurity-related adverse events. Of the 250 live-born neonates, one (0.4%) was found positive at RT-PCR pharyngeal swabs performed after delivery. The mother was tested positive during the third trimester of pregnancy. The newborn was asymptomatic and had negative RT-PCR test after 14 days of life. At logistic regression analysis, gestational age at diagnosis (OR: 0.85, 95% CI 0.8-0.9 per week increase; p<0.001), birthweight (OR: 1.17, 95% CI 1.09-1.12.7 per 100 g decrease; p=0.012) and maternal ventilatory support, including either need for oxygen or CPAP (OR: 4.12, 95% CI 2.3-7.9; p=0.001) were independently associated with composite adverse fetal outcome. Conclusions Early gestational age at infection, maternal ventilatory supports and low birthweight are the main determinants of adverse perinatal outcomes in fetuses with maternal COVID-19 infection. Conversely, the risk of vertical transmission seems negligible.Entities:
Keywords: Coronavirus; perinatal morbidity; perinatal mortality
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Year: 2020 PMID： 32975205 DOI： 10.1515/jpm-2020-0355
Source DB: PubMed Journal: J Perinat Med ISSN： 0300-5577 Impact factor: 1.901