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. 2022 Oct;42(10):1328-1337.
doi: 10.1038/s41372-022-01467-6. Epub 2022 Aug 4.

Preterm birth among pregnant persons with severe acute respiratory syndrome Coronavirus 2 infection

Suzanne M Newton  1 , Emily L Reeves  2 , Emily O'Malley Olsen  2 , Kate R Woodworth  2 , Sherry L Farr  3 , Romeo R Galang  2 , Megan R Reynolds  2 , Elizabeth Harvey  4   5 , Jing Shi  6 , Eirini Nestoridi  7 , Jerusha Barton  8 , Van P Ngo  9 , Mamie Lush  10 , Nicole D Longcore  11 , Paula Dzimira  12 , Lucille K Im  13 , Ayomide Sokale  14 , Samantha Siebman  15 , Camille Delgado López  16 , Tiffany Chen  17 , Evan L Mobley  18 , Salma Khuwaja  19 , Paul A Romitti  20 , Carolyn Fredette  21 , Esther M Ellis  22 , Kristin Silcox  23 , Aron J Hall  2 , Eduardo Azziz-Baumgartner  2 , Suzanne M Gilboa  2 , Carrie K Shapiro-Mendoza  5 , Van T Tong  2
Affiliations

Preterm birth among pregnant persons with severe acute respiratory syndrome Coronavirus 2 infection

Suzanne M Newton et al. J Perinatol. 2022 Oct.

Abstract

Objective: We examined the relationship between trimester of SARS-CoV-2 infection, illness severity, and risk for preterm birth.

Study design: We analyzed data for 6336 pregnant persons with SARS-CoV-2 infection in 2020 in the United States. Risk ratios for preterm birth were calculated for illness severity, trimester of infection, and illness severity stratified by trimester of infection adjusted for age, selected underlying medical conditions, and pregnancy complications.

Result: Pregnant persons with critical COVID-19 or asymptomatic infection, compared to mild COVID-19, in the second or third trimester were at increased risk of preterm birth. Pregnant persons with moderate-to-severe COVID-19 did not show increased risk of preterm birth in any trimester.

Conclusion: Critical COVID-19 in the second or third trimester was associated with increased risk of preterm birth. This finding can be used to guide prevention strategies, including vaccination, and inform clinical practices for pregnant persons.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Flow-chart of pregnant persons with SARS-CoV-2 infection included in the study.
SARS-CoV-2 severe acute respiratory syndrome coronavirus 2, NAAT nucleic acid amplification testing 1To avoid overestimating preterm birth from reporting bias, we limited to pregnancies with at least 47 weeks (43 weeks gestation plus 4 weeks of reporting lag) between calculated LMP and the end of the reporting period (September 3, 2021). 2We weighted records abstracted based on the random sample to account for selection probability and nonresponse such that the sampling weights totaled the number of pregnancies meeting the case definition.
Fig. 2
Fig. 2. Timing from infection to delivery among pregnant persons with SARS-CoV-2 infection by severity of COVID-19 and trimester in which infection occurred.
SARS-CoV-2 severe acute respiratory syndrome coronavirus 2, COVID-19 Coronavirus disease 2019 Dotted lines indicated median time from infection to birth at each level of COVID-19 severity. A SARS-CoV-2 infection occurring in the first trimester. B SARS-CoV-2 infection occurring in the second trimester. C SARS-CoV-2 infection occurring in the third trimester.
See this image and copyright information in PMC

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