Maternal and Neonatal Morbidity and Mortality Among Pregnant Women With and Without COVID-19 Infection

作者：José Villar, Shabina Ariff, Robert B. Gunier, Ramachandran Thiruvengadam, Stephen Rauch, Kholin A.M. Kholin, Paola Roggero, Federico Prefumo, Marynéa Silva do Vale, Jorge Arturo Cardona–Pérez, Nerea Maíz, Irene Cetin, Valeria Savasi, Philippe Deruelle, Sarah Rae Easter, Joanna Sichitiu, Constanza P. Soto Conti, Ernawati Ernawati, Mohak Mhatre, Jagjit S. Teji, Becky Liu, Carola Capelli, M. Oberto, Laura Salazar, Michael G. Gravett, Paolo Ivo Cavoretto, Vincent Bizor Nachinab, Hadiza Galadanci, D. Orós, Adejumoke Idowu Ayede, Loı̈c Sentilhes, Babagana Bako, Mónica Savorani, Hellas Cena, Perla K. García-May, Saturday Etuk, Roberto Casale, Sherief Abd‐Elsalam, Satoru Ikenoue, Muhammad Baffah Aminu, Carmen Vecciarelli, Eduardo Alfredo Duro, Mustapha Ado Usman, Yetunde O. John-Akinola, Ricardo Nieto, E. Ferrazzi, Zulfiqar A Bhutta, Ana Langer, Stephen Kennedy, Aris T. Papageorghiou · 发表于：Archives of Pediatrics and Adolescent Medicine · 年份：2021 · DOI：10.1001/jamapediatrics.2021.1050 · 被引用次数：1380 · 研究领域：COVID-19 Impact on Reproduction、Gestational Diabetes Research and Management、COVID-19 Clinical Research Studies

Importance: Detailed information about the association of COVID-19 with outcomes in pregnant individuals compared with not-infected pregnant individuals is much needed. Objective: To evaluate the risks associated with COVID-19 in pregnancy on maternal and neonatal outcomes compared with not-infected, concomitant pregnant individuals. Design, Setting, and Participants: In this cohort study that took place from March to October 2020, involving 43 institutions in 18 countries, 2 unmatched, consecutive, not-infected women were concomitantly enrolled immediately after each infected woman was identified, at any stage of pregnancy or delivery, and at the same level of care to minimize bias. Women and neonates were followed up until hospital discharge. Exposures: COVID-19 in pregnancy determined by laboratory confirmation of COVID-19 and/or radiological pulmonary findings or 2 or more predefined COVID-19 symptoms. Main Outcomes and Measures: The primary outcome measures were indices of (maternal and severe neonatal/perinatal) morbidity and mortality; the individual components of these indices were secondary outcomes. Models for these outcomes were adjusted for country, month entering study, maternal age, and history of morbidity. Results: A total of 706 pregnant women with COVID-19 diagnosis and 1424 pregnant women without COVID-19 diagnosis were enrolled, all with broadly similar demographic characteristics (mean [SD] age, 30.2 [6.1] years). Overweight early in pregnancy occurred in...