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Multicenter Study
. 2025 Jun;169(3):1200-1209.
doi: 10.1002/ijgo.70010. Epub 2025 Feb 14.

Adverse perinatal outcomes of unvaccinated pregnant women with respiratory symptoms during the COVID-19 pandemic: Evidence from a Brazilian multicenter study

Juliana Da-Costa-Santos  1 , Paulo Sergio Dos Reis Junior  1 , Adriana Gomes Luz  1 , Jose Guilherme Cecatti  1 , Renato T Souza  1 , Ricardo P Tedesco  2 , Karayna G Fernandes  2 , Sérgio H A Martins-Costa  3 , Frederico J A Peret  4 , Francisco E Feitosa  5 , Evelyn Traina  6 , Edson V Cunha Filho  7 , Janete Vettorazzi  3   7 , Samira M Haddad  8 , Carla B Andreucci  9 , José P Guida  10 , Mario D Correa Junior  11 , Marcos A B Dias  12 , Leandro G Oliveira  13 , Elias F Melo Junior  14 , Marília G Q Da Luz  15 , Maria Laura Costa  1 ; REBRACO Study Group
Collaborators, Affiliations
Multicenter Study

Adverse perinatal outcomes of unvaccinated pregnant women with respiratory symptoms during the COVID-19 pandemic: Evidence from a Brazilian multicenter study

Juliana Da-Costa-Santos et al. Int J Gynaecol Obstet. 2025 Jun.

Abstract

Objective: The current study aimed to describe risk factors for adverse perinatal outcomes (APOs) among pregnant women nonvaccinated for COVID-19 who had respiratory symptoms.

Methods: A nested case-control study was performed within the REBRACO (in Portuguese, the Brazilian Network of COVID-19 During Pregnancy) initiative. Women were recruited during pregnancy in 15 maternity hospitals in Brazil from February 1, 2020, to February 28, 2021, while seeking medical care for respiratory symptoms, and were followed up until childbirth regardless of confirmation of COVID-19. For this analysis, women were divided into two groups: (1) those with APOs, defined as the occurrence of fetal or neonatal death, preterm delivery, 5-min Apgar score <7, neonatal respiratory distress, neonatal mechanical ventilation, admission to the neonatal intensive care unit, small-for-gestational-age newborn, or any neonatal morbidity; and (2) those without APOs.

Results: The total number of women included in this analysis was 481, with 210 having APOs (43.7%). The characteristics independently associated with APOs were a composite outcome of severe acute respiratory syndrome, maternal admission at the intensive care unit, or maternal death (relative risk [RR], 3.30 [95% confidence interval (CI), 1.38-7.89]), living in the North and Northeastern regions of Brazil (RR, 3.09 [95% CI, 1.13-8.41]), and pre-eclampsia (RR, 2.77 [95% CI, 1.19-6.43]).

Conclusion: Severe maternal illness was strongly associated with APO regardless of COVID-19 confirmation. It is essential to provide sufficient and timely health care for women who have respiratory symptoms compatible with COVID-19.

Keywords: COVID‐19; SARS‐CoV‐2; infectious; perinatal care; pregnancy complications.

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References

REFERENCES

    1. Smith ER, Oakley E, Grandner GW, et al. Adverse maternal, fetal, and newborn outcomes among pregnant women with SARS‐CoV‐2 infection: an individual participant data meta‐analysis. BMJ Glob Health. 2023;8(1):e009495.
    1. Pan American Health O. Maternal and Neonatal Immunization Field Guide for Latin America and the Caribbean—Annex COVID‐19. Technical reports. PAHO; 2023.
    1. Gajbhiye RK, Sawant MS, Kuppusamy P, et al. Differential impact of COVID‐19 in pregnant women from high‐income countries and low‐ to middle‐income countries: a systematic review and meta‐analysis. Int J Gynaecol Obstet. 2021;155(1):48‐56.
    1. Takemoto MLS, Menezes MDO, Andreucci CB, et al. The tragedy of COVID‐19 in Brazil: 124 maternal deaths and counting. Int J Gynaecol Obstet. 2020;151(1):154‐156.
    1. Lai AY, Sit SM, Wu SY, et al. Associations of delay in doctor consultation with COVID‐19 related fear, attention to information, and fact‐checking. Front Public Health. 2021;9:797814.

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