Background To determine whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, the cause of COVID-19 disease) exposure in pregnancy, compared to non-exposure, is associated with infection-related obstetric morbidity. Methods We conducted a multicentre prospective study in pregnancy based on a universal antenatal screening program for SARS-CoV-2 infection. Throughout Spain 45 hospitals tested all women at admission on delivery ward using polymerase-chain-reaction (PCR) for COVID-19 since late March 2020. The cohort of positive mothers and the concurrent sample of negative mothers was followed up until 6-weeks post-partum. Multivariable logistic regression analysis, adjusting for known confounding variables, determined the adjusted odds ratio (aOR) with 95% confidence intervals (95% CI) of the association of SARS-CoV-2 infection and obstetric outcomes. Main outcome measures: Preterm delivery (primary), premature rupture of membranes and neonatal intensive care unit admissions. Results Among 1009 screened pregnancies, 246 were SARS-CoV-2 positive. Compared to negative mothers (763 cases), SARS-CoV-2 infection increased the odds of preterm birth (34 vs 51, 13.8% vs 6.7%, aOR 2.12, 95% CI 1.32–3.36, p = 0.002); iatrogenic preterm delivery was more frequent in infected women (4.9% vs 1.3%, p = 0.001), while the occurrence of spontaneous preterm deliveries was statistically similar (6.1% vs 4.7%). An increased risk of premature rupture of membranes at term (39 vs 75, 15.8% vs 9.8%, aOR 1.70, 95% CI 1.11–2.57, p = 0.013) and neonatal intensive care unit admissions (23 vs 18, 9.3% vs 2.4%, aOR 4.62, 95% CI 2.43–8.94, p < 0.001) was also observed in positive mothers. Conclusion This prospective multicentre study demonstrated that pregnant women infected with SARS-CoV-2 have more infection-related obstetric morbidity. This hypothesis merits evaluation of a causal association in further research. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03742-4.
【저자키워드】 COVID-19, SARS-CoV-2, coronavirus, Pregnancy, premature birth, Premature rupture of membranes, Intensive care units, neonatal, 【초록키워드】 intensive care, SARS-COV-2 infection, hospital, Prospective Study, outcome, COVID-19 disease, pregnant women, outcomes, Cohort, Preterm birth, PCR, morbidity, Research, Spain, membrane, Premature, multicentre, women, Admission, mother, association, Hypothesis, Neonatal, Obstetric, Antenatal, preterm delivery, confounding variables, Admissions, acute respiratory syndrome, adjusted odds ratio, Logistic regression analysis, supplementary material, 95% CI, 95% confidence interval, increased risk, positive, pregnancies, rupture, Occurrence, Result, tested, conducted, screened, determine, demonstrated, statistically, iatrogenic, infected with SARS-CoV-2, 【제목키워드】 SARS-COV-2 infection, Prospective Study, association, multivariable analysis,