| Author | Brendolin, Michelle | |
| Author | Wakimoto, Mayumi Duarte | |
| Author | Oliveira, Raquel de Vasconcellos Carvalhaes de | |
| Author | Mageste, Larissa Rangel | |
| Author | Nielsen-Saines, Karin | |
| Author | Brasil, Patricia | |
| Access date | 2025-04-09T00:01:39Z | |
| Available date | 2025-04-09T00:01:39Z | |
| Document date | 2025 | |
| Citation | BRENDOLIN, Michelle et al. SARS-CoV-2 Infection and Adverse Maternal and Perinatal Outcomes: Time-to-Event Analysis of a Hospital-Based Cohort Study of Pregnant Women in Rio de Janeiro, Brazil. Viruses, v. 17, n. 207, p. 1-16, Jan. 2025. | en_US |
| ISSN | 1999-4915 | en_US |
| URI | https://www.arca.fiocruz.br/handle/icict/69496 | |
| Sponsorship | This research was funded by the Carlos Chagas Foundation for the Advancement of Science of the State of Rio de Janeiro (grant numbers E-26/200.935/2022, E-26/010.146/2020); National Council for Scientific and Technological Development (grant numbers 311562/2021-3, 409108/2022-7); the Simons Foundation Autism Research Initiative (grant number 866410); the UK Medical Research Council (grant number MR/V033530/1); Orchestra (grant number 101016167); and Contagio (grant number 101137283). The funding source(s) had no involvement. | en_US |
| Language | eng | en_US |
| Publisher | MDPI | en_US |
| Rights | open access | en_US |
| Title | SARS-CoV-2 Infection and Adverse Maternal and Perinatal Outcomes: Time-to-Event Analysis of a Hospital-Based Cohort Study of Pregnant Women in Rio de Janeiro, Brazil | en_US |
| Type | Article | en_US |
| DOI | 10.3390/v17020207 | |
| Abstract | Understanding perinatal health outcomes following SARS-CoV-2 infection during pregnancy necessitates large-scale studies of mother-infant dyads. Hospital-based studies of pregnant women and their neonates provide valuable insights within the field of perinatal health research. The aim of this study was to evaluate the effect of SARS-CoV-2 infection on maternal and perinatal outcomes among hospitalized pregnant women in Rio de Janeiro during the COVID-19 pandemic. Methods: The study consisted of a time-to-event analysis of a hospital-based cohort of 1185 pregnant women ≥ 16 years and their infants from May 2020 to March 2022. Pregnant women were classified as infected if they had a SARS CoV-2 positive RT-PCR or a positive rapid antigen test. An exploratory analysis of qualitative variables was conducted with calculation of absolute and relative frequencies and calculation of 95% confidence intervals. Survival functions were estimated by the Kaplan–Meier method, and the Cox proportional hazards model was employed to interpret the effects of SARS-CoV-2 infection on time to adverse maternal and perinatal outcomes, adjusted for vaccination, comorbidity, and gestational trimester. Results: A total of 21% (249/1185) women were infected with SARS-CoV-2, with a median age of 26 (range: 16–47).
Cesarean section deliveries were performed in 57% (135/237) SARS CoV-2+ participants vs. 43% (391/914) of uninfected participants, p < 0.001. Intensive care unit admission and/or death occurred in 68 of 1185 participants (5.7%), 44 of 249 participants (17.7%) infected with SARS CoV-2 vs. 24 of 936 uninfected participants (2.5%). All 21 participants who died were unvaccinated against COVID-19. Women infected with SARS-CoV-2 were at greater risk of adverse maternal outcomes (crude HR: 5.93, 95% CI: 3.58–9.84; adjusted HR: 5.47, 95% CI: 3.16–9.48) than uninfected pregnant women. SARS CoV-2 vertical transmission was observed in 6 of 169 (3.6%) tested neonates. Preterm deliveries occurred more frequently in patients testing positive for SARS-CoV-2 (30.7% vs. 23.6). In the survival analysis, no effect of SARS-CoV-2 infection was observed on prematurity (HR: 0.92, 95% CI: 0.68–1.23) and adverse perinatal outcomes, including fetal distress (HR: 1.29, 95% CI: 0.82–2.05), stillbirth (HR: 1.07, 95% CI: 0.48–2.38), and neonatal death (HR: 0.96, 95% CI: 0.35–2.67), even after adjusting for vaccination, comorbidity, gestational trimester, and periods of time.
Conclusion: The risk of maternal death due to COVID-19 highlights the need for adequate preventive measures, particularly vaccination, during the prenatal and postpartum periods. | en_US |
| Affilliation | Adão Pereira Nunes Hospital. Maternity Department. Duque de Caxias, RJ, Brazil / Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Serviço de Vigilância em Saúde. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Epidemiologia Clínica. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | University of California. David Geffen School of Medicine. Pediatric Infectious Diseases Division. Los Angeles, CA, USA. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em Doenças Febris Agudas. Rio de Janeiro, RJ, Brasil. | en_US |
| Subject | SARS-CoV-2 | en_US |
| Subject | COVID-19 | en_US |
| Subject | Pregnancy | en_US |
| Subject | Perinatal outcomes | en_US |
| Subject | Mortality | en_US |
| Subject | Preterm birth | en_US |
| Subject | Death maternal | en_US |
| Subject | Adverse outcomes | en_US |
| e-ISSN | 1999-4915 | |
