The association between SARS-CoV-2 infection and preterm delivery: a prospective study with a multivariable analysis

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases
• Public Health

Background:

• Pregnancy involves physiological changes that can increase susceptibility to infections.
• Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19, a disease with potential systemic effects.
• The impact of SARS-CoV-2 infection on obstetric outcomes requires thorough investigation.

Purpose of the Study:

• To assess the association between SARS-CoV-2 infection during pregnancy and infection-related obstetric morbidity.
• To compare obstetric outcomes in SARS-CoV-2 positive pregnant individuals versus uninfected controls.

Main Methods:

• A multicenter prospective study was conducted across 45 hospitals in Spain.
• Universal antenatal screening for SARS-CoV-2 using PCR was implemented for all women admitted for delivery.
• A cohort of SARS-CoV-2 positive mothers and a concurrent sample of negative mothers were followed postpartum.

Main Results:

• SARS-CoV-2 infection was associated with a significantly increased risk of preterm birth (aOR 2.12).
• Infected mothers showed higher rates of iatrogenic preterm delivery, premature rupture of membranes, and neonatal intensive care unit admissions.
• While spontaneous preterm deliveries were similar, iatrogenic preterm births were more frequent in SARS-CoV-2 positive women.

Conclusions:

• Pregnant women infected with SARS-CoV-2 experience a higher burden of infection-related obstetric morbidity.
• The findings suggest a need for further research to establish a causal association.
• This study underscores the importance of infection control measures for pregnant populations.