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SARS-CoV-2 Infection During Pregnancy—An Analysis of Clinical Data From Germany and Austria From the CRONOS Registry.

Ulrich Pecks¹, Nadine Mand, Thomas Kolben

¹Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Kiel; Center for Pediatric and Adolescent Medicine, University Hospital Gießen and Marburg GmbH, Philipps University Marburg; Department of Gynecology and Obstetrics, LMU Medical Center, Munich; Neonatology and Pediatric Intensive Care Medicine, Department of Pediatric and Adolescent Medicine, Medical Faculty, Technical University of Dresden; Center for Fetal and Neonatal Health, Technical University of Dresden; Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Johannes Kepler University, Linz, Austria; Department of Obstetrics, University Hospital Jena; Institute for Medical Informatics and Statistics, University Hospital Schleswig-Holstein, Kiel.

Deutsches Arzteblatt International

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Summary

The risk of severe COVID-19 in pregnant women increases with gestational age, but vaccination significantly reduces this risk. This data aids in counseling on protective measures for pregnant individuals during the pandemic.

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Published on: June 5, 2021

Area of Science:

Obstetrics and Gynecology
Infectious Diseases
Public Health

Background:

Assessing COVID-19 complications in pregnancy is crucial for maternal and fetal health.
Understanding risk factors like gestational age and vaccination status is vital for clinical management.

Purpose of the Study:

To evaluate the risk of complicated COVID-19 in pregnant women based on gestational age, vaccination status, and pandemic period.
To provide data for counseling on prophylactic and therapeutic interventions for pregnant individuals with SARS-CoV-2 infection.

Main Methods:

Analysis of data from the German CRONOS registry, a prospective, hospital-based observational study.
Logistic regression models were used to calculate odds ratios for COVID-19-specific events.
Data were acquired across two distinct periods: March 2020–August 2021 and January–June 2022.

Main Results:

The risk of COVID-19 complications rose with increasing gestational age, particularly in the early third trimester.
Hospitalization risk (32 vs. 22 weeks gestation) was 1.4 (95% CI [1.2; 1.7]).
Risk was lower in the second data acquisition period (OR 0.66) and significantly lower for vaccinated women (OR 0.27).

Conclusions:

Vaccination is highly effective in reducing COVID-19 severity in pregnant women, even during the Omicron variant phase.
Findings support the use of prophylactic measures, including monoclonal antibodies, for pregnant individuals.
Gestational age is a significant factor influencing COVID-19 complication risk during pregnancy.