Elisabeth McClymont1,2, Arianne Y Albert3, Gillian D Alton4,5, Isabelle Boucoiran6,7, Eliana Castillo8, Deshayne B Fell5,9, Verena Kuret8, Vanessa Poliquin10, Tiffany Reeve3, Heather Scott11, Ann E Sprague4,5, George Carson12, Krista Cassell11, Joan Crane13,14, Chelsea Elwood1,3, Chloe Joynt15, Phil Murphy13,14, Lynn Murphy-Kaulbeck16, Sarah Saunders17, Prakesh Shah18, John W Snelgrove19, Julie van Schalkwyk1, Mark H Yudin19, Deborah Money1,3. 1. Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada. 2. Canadian HIV Trials Network, Vancouver, British Columbia, Canada. 3. Women's Health Research Institute, Vancouver, British Columbia, Canada. 4. Better Outcomes Registry and Network (BORN) Ontario, Ottawa, Canada. 5. Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, Canada. 6. Département d'Obstétrique-Gynécologie, Université de Montréal, Montréal, Quebec, Canada. 7. School of Public Health, Université de Montréal, Montréal, Quebec, Canada. 8. Department of Obstetrics and Gynecology, University of Calgary, Calgary, Alberta, Canada. 9. School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada. 10. Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Manitoba, Winnipeg, Canada. 11. Department of Obstetrics and Gynecology, Dalhousie University, Halifax, Nova Scotia, Canada. 12. Department of Obstetrics and Gynecology, University of Saskatchewan, Saskatoon, Canada. 13. Department of Obstetrics and Gynecology, Memorial University of Newfoundland, St John's, Canada. 14. Children's and Women's Health Program, Eastern Health, St John's, Newfoundland and Labrador, Canada. 15. Department of Pediatrics, University of Alberta, Edmonton, Canada. 16. New Brunswick Perinatal Health Program, Fredericton, Canada. 17. Whitehorse General Hospital, Whitehorse, Yukon, Canada. 18. Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada. 19. Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada.
Abstract
Importance: There are limited high-quality, population-level data about the effect of SARS-CoV-2 infection on pregnancy using contemporaneous comparator cohorts. Objectives: To describe maternal and perinatal outcomes associated with SARS-CoV-2 infection in pregnancy and to assess variables associated with severe disease in the pregnant population. Design, Setting, and Participants: CANCOVID-Preg is an observational surveillance program for SARS-CoV-2-affected pregnancies in Canada. This analysis presents exploratory, population-level data from 6 Canadian provinces for the period of March 1, 2020, to October 31, 2021. A total of 6012 pregnant persons with a positive SARS-CoV-2 polymerase chain reaction test result at any time in pregnancy (primarily due to symptomatic presentation) were included and compared with 2 contemporaneous groups including age-matched female individuals with SARS-CoV-2 and unaffected pregnant persons from the pandemic time period. Exposure: SARS-CoV-2 infection during pregnancy. Incident infections in pregnancy were reported to CANCOVID-Preg by participating provinces/territories. Main Outcomes and Measures: Maternal and perinatal outcomes associated with SARS-CoV-2 infection as well as risk factors for severe disease (ie, disease requiring hospitalization, admission to an intensive care unit/critical care unit, and/or oxygen therapy). Results: Among 6012 pregnant individuals with SARS-CoV-2 in Canada (median age, 31 [IQR, 28-35] years), the greatest proportion of cases were diagnosed at 28 to 37 weeks' gestation (35.7%). Non-White individuals were disproportionately represented. Being pregnant was associated with a significantly increased risk of SARS-CoV-2-related hospitalization compared with SARS-CoV-2 cases among all women aged 20 to 49 years in the general population of Canada (7.75% vs 2.93%; relative risk, 2.65 [95% CI, 2.41-2.88]) as well as an increased risk of intensive care unit/critical care unit admission (2.01% vs 0.37%; relative risk, 5.46 [95% CI, 4.50-6.53]). Increasing age, preexisting hypertension, and greater gestational age at diagnosis were significantly associated with worse maternal outcomes. The risk of preterm birth was significantly elevated among SARS-CoV-2-affected pregnancies (11.05% vs 6.76%; relative risk, 1.63 [95% CI, 1.52-1.76]), even in cases of milder disease not requiring hospitalization, compared with unaffected pregnancies during the same time period. Conclusions and Relevance: In this exploratory surveillance study conducted in Canada from March 2020 to October 2021, SARS-CoV-2 infection during pregnancy was significantly associated with increased risk of adverse maternal outcomes and preterm birth.
Importance: There are limited high-quality, population-level data about the effect of SARS-CoV-2 infection on pregnancy using contemporaneous comparator cohorts. Objectives: To describe maternal and perinatal outcomes associated with SARS-CoV-2 infection in pregnancy and to assess variables associated with severe disease in the pregnant population. Design, Setting, and Participants: CANCOVID-Preg is an observational surveillance program for SARS-CoV-2-affected pregnancies in Canada. This analysis presents exploratory, population-level data from 6 Canadian provinces for the period of March 1, 2020, to October 31, 2021. A total of 6012 pregnant persons with a positive SARS-CoV-2 polymerase chain reaction test result at any time in pregnancy (primarily due to symptomatic presentation) were included and compared with 2 contemporaneous groups including age-matched female individuals with SARS-CoV-2 and unaffected pregnant persons from the pandemic time period. Exposure: SARS-CoV-2 infection during pregnancy. Incident infections in pregnancy were reported to CANCOVID-Preg by participating provinces/territories. Main Outcomes and Measures: Maternal and perinatal outcomes associated with SARS-CoV-2 infection as well as risk factors for severe disease (ie, disease requiring hospitalization, admission to an intensive care unit/critical care unit, and/or oxygen therapy). Results: Among 6012 pregnant individuals with SARS-CoV-2 in Canada (median age, 31 [IQR, 28-35] years), the greatest proportion of cases were diagnosed at 28 to 37 weeks' gestation (35.7%). Non-White individuals were disproportionately represented. Being pregnant was associated with a significantly increased risk of SARS-CoV-2-related hospitalization compared with SARS-CoV-2 cases among all women aged 20 to 49 years in the general population of Canada (7.75% vs 2.93%; relative risk, 2.65 [95% CI, 2.41-2.88]) as well as an increased risk of intensive care unit/critical care unit admission (2.01% vs 0.37%; relative risk, 5.46 [95% CI, 4.50-6.53]). Increasing age, preexisting hypertension, and greater gestational age at diagnosis were significantly associated with worse maternal outcomes. The risk of preterm birth was significantly elevated among SARS-CoV-2-affected pregnancies (11.05% vs 6.76%; relative risk, 1.63 [95% CI, 1.52-1.76]), even in cases of milder disease not requiring hospitalization, compared with unaffected pregnancies during the same time period. Conclusions and Relevance: In this exploratory surveillance study conducted in Canada from March 2020 to October 2021, SARS-CoV-2 infection during pregnancy was significantly associated with increased risk of adverse maternal outcomes and preterm birth.
Authors: Yin Ping Wong; Geok Chin Tan; Siti Zarqah Omar; Muaatamarulain Mustangin; Yogesh Singh; Madhuri S Salker; Nor Haslinda Abd Aziz; Mohamad Nasir Shafiee Journal: Int J Environ Res Public Health Date: 2022-08-03 Impact factor: 4.614
Authors: Suzanne M Newton; Emily L Reeves; Emily O'Malley Olsen; Kate R Woodworth; Sherry L Farr; Romeo R Galang; Megan R Reynolds; Elizabeth Harvey; Jing Shi; Eirini Nestoridi; Jerusha Barton; Van P Ngo; Mamie Lush; Nicole D Longcore; Paula Dzimira; Lucille K Im; Ayomide Sokale; Samantha Siebman; Camille Delgado López; Tiffany Chen; Evan L Mobley; Salma Khuwaja; Paul A Romitti; Carolyn Fredette; Esther M Ellis; Kristin Silcox; Aron J Hall; Eduardo Azziz-Baumgartner; Suzanne M Gilboa; Carrie K Shapiro-Mendoza; Van T Tong Journal: J Perinatol Date: 2022-08-04 Impact factor: 3.225
Authors: Alicia M Paul; Clarice Lee; Berhaun Fesshaye; Rachel Gur-Arie; Eleonor Zavala; Prachi Singh; Ruth A Karron; Rupali J Limaye Journal: Int J Environ Res Public Health Date: 2022-08-30 Impact factor: 4.614