8. May, 2022
COVID-19 v těhotenství
Association of SARS-CoV-2 Infection During Pregnancy
With Maternal and Perinatal Outcomes
Elisabeth McClymont, PhD; Arianne Y. Albert, PhD; Gillian D. Alton, PhD; Isabelle Boucoiran, MD;Eliana Castillo, MD; Deshayne B. Fell, PhD; Verena Kuret, MD; Vanessa Poliquin, MD; Tiffany Reeve, MSc;Heather Scott, MD; Ann E. Sprague, PhD; George Carson, MD; Krista Cassell, MD; Joan Crane, MD;Chelsea Elwood, MD; Chloe Joynt, MD; Phil Murphy, MS; Lynn Murphy-Kaulbeck, MD; Sarah Saunders, MD;Prakesh Shah, MD; JohnW. Snelgrove, MD; Julie van Schalkwyk, MD; Mark H. Yudin, MD; Deborah Money, MD;for the CANCOVID-Preg Team
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.
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 pretermbirth 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
JAMA. doi:10.1001/jama.2022.5906
Published online May 2, 2022.