Pregnancy and neonatal outcomes of COVID-19: The PAN-COVID study

Mullins, E., Perry, A., Banerjee, J., Townson, J. ORCID: https://orcid.org/0000-0001-8679-3619, Grozeva, D. ORCID: https://orcid.org/0000-0003-3239-8415, Milton, R., Kirby, N., Playle, R. ORCID: https://orcid.org/0000-0002-2989-1092, Bourne, T., Lees, C., Rand, Abby, Khunda, Aethele, Rozto?il, Ale?, Kermack, Alexandra J, Mackay, Ami, Verma, Amit, Ahmed, Amna, Mahdi, Amy, Fayadh, Anam, Dall'Asta, Andrea, Harrington, Andrea, Gerede, Angeliki, Nejad, Avideah, Sinha, Barkha, Peers, Beth, Hammond, Bev, Ajay, Bini, Dixon, Caroline, Everden, Caroline, Heal, Carrie, Bressington, Catherine, Wyatt, Cheryl, Flood, Chris, Möller-Christensen, Christine, O'Brien, Clare, Glenn-Sansum, Coralie, Huson, Coralie, Rallis, Dimitrios, Perkins, Donna, Southam, Donna, Wixted, Donna, Viner, Alexandra, Asghar, Anila, Nicoll, Antony, Knight, Caroline, McKeown, Gillian, Divakar, Hema, Panagiotis Christofidis, Plastiras, Satodia, Prakash, Liebling, Rachel, Arya, Rita, Kousar, Rukhsana, Gada, Ruta, Narayanan, Sankara, Iliodromiti, Stamatina, Giri, Vibha, Vasu, Vimal, Hassan, Wassim, Woodward, Zoe, Mutema, E., MK Jarvie, Eleanor, Romero, Elena, Collins, Emma, Meadows, Emma, Mills, Emma, Tanton, Emma, Vrapi, Enxhi, Darmawan, Ernawati, Barra, Fabio, Prefumo, Federico, Lee, Fidelma, Martin, Hayley L., Gbinigie, Helen, Millward, Helen, Owen, Hilary, Crawford, Isobel, Tipper, Jacqueline, Jennings, Jacqui, Raven, Jamie-Louise, Cantliffe, Jane, Radford, Jane, Cresswell, Janet, Syson, Jennifer, Brain, Jessie, Mead, Joanna, Mossop, Jude, Goddard, Julie, Grindey, Julie, Cloherty, Karen, Watkins, Karen, Robinson, Kate, Barker, Katie, Elliott, Kerry, Hinshaw, Kim, Revell, Kirsty, Camarasa, Laura, Harris, Laura, Windsor, Laurie, Sherris, Leanne, Chapman, Lianne, Bishop, Linda, Chiu Yee POON, Liona, Frankland, Lisa, Glyn-Jones, Liz, Emmet, Louise, Swaminathan, Louise, Aldika Akbar, M.I, Armstrong, Maggie, Gorti, Mahalakshmi, Black, Mairead, Malarselvi, Mani, Khare, Manjiri, Chester, Mark, Andrasova, Martina, Bray, Maryanne, Parra-Cordero, Mauro, Roland Berger, MD, Anderson, Michelle, Anim-Somuah, Millicent, XIE, Mingxing, Bourke, Miriam, Elbahnasawy, Mohamed, Sobhy Bakry, Mohamed, Shah, Ahmar, RATHER, BA, Churchill, David, Wee, Ling, Kidwai, Salman, Balling, Trevor, Amin, Allison, Essien, Sandra, Sameena Kausar, Ms, Rajeswary, Ms.Jyothi, Javaid, Muglu, Aladangady, Narendra, Shah, Neil, Bale, Nichola, Mason, Nicky, Wu, Pensée, Margarit, Lavinia, Zill-e-Huma, Rabia, Newport, Rachel, Hughes, Robin, Jokhi, Roobin, Mansfield, Roshni, Davies, Ru, Davies, Ruth, Ratcliffe, Sam, Greer, Sandra, Coxon, Sarah, Ekladios, Sarah, Stables, Sarah, McCooty, Shanteela, Gowans, Sharon, Jones, Sharon, Jaleel, Shazia, Higgins, Shelly, Halawa, Sherry, Harrington, Siân C, Robinson, Sophie, Nallapeta, Soum, Grigsby, Stephanie, Blunden, Susara, Tiziana Frusca, SSA, Sukrutha, Veerareddy, Atkinson, Vicki, Murtha, Victoria, Germán Caro, Waldo and Garner, Zoe 2022. Pregnancy and neonatal outcomes of COVID-19: The PAN-COVID study. European Journal of Obstetrics and Gynecology and Reproductive Biology 276 , pp. 161-167. 10.1016/j.ejogrb.2022.07.010

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Abstract

Objective To assess perinatal outcomes for pregnancies affected by suspected or confirmed SARS-CoV-2 infection. Methods Prospective, web-based registry. Pregnant women were invited to participate if they had suspected or confirmed SARS-CoV-2 infection between 1st January 2020 and 31st March 2021 to assess the impact of infection on maternal and perinatal outcomes including miscarriage, stillbirth, fetal growth restriction, pre-term birth and transmission to the infant. Results Between April 2020 and March 2021, the study recruited 8239 participants who had suspected or confirmed SARs-CoV-2 infection episodes in pregnancy between January 2020 and March 2021. Maternal death affected 14/8197 (0.2%) participants, 176/8187 (2.2%) of participants required ventilatory support. Pre-eclampsia affected 389/8189 (4.8%) participants, eclampsia was reported in 40/ 8024 (0.5%) of all participants. Stillbirth affected 35/8187 (0.4 %) participants. In participants delivering within 2 weeks of delivery 21/2686 (0.8 %) were affected by stillbirth compared with 8/4596 (0.2 %) delivering ≥ 2 weeks after infection (95 % CI 0.3–1.0). SGA affected 744/7696 (9.3 %) of livebirths, FGR affected 360/8175 (4.4 %) of all pregnancies. Pre-term birth occurred in 922/8066 (11.5%), the majority of these were indicated pre-term births, 220/7987 (2.8%) participants experienced spontaneous pre-term births. Early neonatal deaths affected 11/8050 livebirths. Of all neonates, 80/7993 (1.0%) tested positive for SARS-CoV-2. Conclusions Infection was associated with indicated pre-term birth, most commonly for fetal compromise. The overall proportions of women affected by SGA and FGR were not higher than expected, however there was the proportion affected by stillbirth in participants delivering within 2 weeks of infection was significantly higher than those delivering ≥ 2 weeks after infection. We suggest that clinicians’ threshold for delivery should be low if there are concerns with fetal movements or fetal heart rate monitoring in the time around infection.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine Centre for Trials Research (CNTRR)
Publisher:	Elsevier
ISSN:	0301-2115
Date of First Compliant Deposit:	5 September 2022
Date of Acceptance:	14 July 2022
Last Modified:	26 May 2023 07:57
URI:	https://orca.cardiff.ac.uk/id/eprint/152340

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