The incidence, characteristics and outcomes of pregnant women hospitalized with symptomatic and asymptomatic SARS-CoV-2 infection in the UK from March to September 2020: A national cohort study using the UK Obstetric Surveillance System (UKOSS)
There is a lack of population level data on risk factors, incidence and impact of SARS-CoV-2 infection in pregnant women and their babies. The primary aim of this study was to describe the incidence, characteristics and outcomes of hospitalized pregnant women with symptomatic and asymptomatic SARS-C...
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| Veröffentlicht in: | PloS one 2021-05, Vol.16 (5), p.e0251123 |
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| creator | Vousden, Nicola Bunch, Kathryn Morris, Edward Simpson, Nigel Gale, Christopher O'Brien, Patrick Quigley, Maria Brocklehurst, Peter Kurinczuk, Jennifer J Knight, Marian |
| description | There is a lack of population level data on risk factors, incidence and impact of SARS-CoV-2 infection in pregnant women and their babies. The primary aim of this study was to describe the incidence, characteristics and outcomes of hospitalized pregnant women with symptomatic and asymptomatic SARS-CoV-2 in the UK compared to pregnant women without SARS-CoV-2.
We conducted a national, prospective cohort study of all hospitalized pregnant women with confirmed SARS-CoV-2 from 01/03/2020 to 31/08/2020 using the UK Obstetric Surveillance System. Incidence rates were estimated using national maternity data. Overall, 1148 hospitalized women had confirmed SARS-CoV-2 in pregnancy, 63% of which were symptomatic. The estimated incidence of hospitalization with symptomatic SARS-CoV-2 was 2.0 per 1000 maternities (95% CI 1.9-2.2) and for asymptomatic SARS-CoV-2 was 1.2 per 1000 maternities (95% CI 1.1-1.4). Compared to pregnant women without SARS-CoV-2, women hospitalized with symptomatic SARS-CoV-2 were more likely to be overweight or obese (adjusted OR 1.86, (95% CI 1.39-2.48) and aOR 2.07 (1.53-2.29)), to be of Black, Asian or Other minority ethnic group (aOR 6.24, (3.93-9.90), aOR 4.36, (3.19-5.95) and aOR 12.95, (4.93-34.01)), and to have a relevant medical comorbidity (aOR 1.83 (1.32-2.54)). Hospitalized pregnant women with symptomatic SARS-CoV-2 were more likely to be admitted to intensive care (aOR 57.67, (7.80-426.70)) but the absolute risk of poor outcomes was low. Cesarean births and neonatal unit admission were increased regardless of symptom status (symptomatic aOR 2.60, (1.97-3.42) and aOR 3.08, (1.99-4.77); asymptomatic aOR 2.02, (1.52-2.70) and aOR 1.84, (1.12-3.03)). The risks of stillbirth or neonatal death were not significantly increased, regardless of symptom status.
We have identified factors that increase the risk of symptomatic and asymptomatic SARS-CoV-2 in pregnancy. Clinicians can be reassured that the majority of women do not experience severe complications of SARS-CoV-2 in pregnancy. |
| doi_str_mv | 10.1371/journal.pone.0251123 |
| format | Article |
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We conducted a national, prospective cohort study of all hospitalized pregnant women with confirmed SARS-CoV-2 from 01/03/2020 to 31/08/2020 using the UK Obstetric Surveillance System. Incidence rates were estimated using national maternity data. Overall, 1148 hospitalized women had confirmed SARS-CoV-2 in pregnancy, 63% of which were symptomatic. The estimated incidence of hospitalization with symptomatic SARS-CoV-2 was 2.0 per 1000 maternities (95% CI 1.9-2.2) and for asymptomatic SARS-CoV-2 was 1.2 per 1000 maternities (95% CI 1.1-1.4). Compared to pregnant women without SARS-CoV-2, women hospitalized with symptomatic SARS-CoV-2 were more likely to be overweight or obese (adjusted OR 1.86, (95% CI 1.39-2.48) and aOR 2.07 (1.53-2.29)), to be of Black, Asian or Other minority ethnic group (aOR 6.24, (3.93-9.90), aOR 4.36, (3.19-5.95) and aOR 12.95, (4.93-34.01)), and to have a relevant medical comorbidity (aOR 1.83 (1.32-2.54)). Hospitalized pregnant women with symptomatic SARS-CoV-2 were more likely to be admitted to intensive care (aOR 57.67, (7.80-426.70)) but the absolute risk of poor outcomes was low. Cesarean births and neonatal unit admission were increased regardless of symptom status (symptomatic aOR 2.60, (1.97-3.42) and aOR 3.08, (1.99-4.77); asymptomatic aOR 2.02, (1.52-2.70) and aOR 1.84, (1.12-3.03)). The risks of stillbirth or neonatal death were not significantly increased, regardless of symptom status.
We have identified factors that increase the risk of symptomatic and asymptomatic SARS-CoV-2 in pregnancy. Clinicians can be reassured that the majority of women do not experience severe complications of SARS-CoV-2 in pregnancy.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0251123</identifier><identifier>PMID: 33951100</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Asymptomatic ; Babies ; Biology and life sciences ; Body mass index ; Carrier State - diagnosis ; Carrier State - epidemiology ; Carrier State - virology ; Cesarean Section ; Clinical trials ; Cohort analysis ; Cohort Studies ; Coronaviruses ; COVID-19 ; COVID-19 - complications ; COVID-19 - diagnosis ; COVID-19 - epidemiology ; COVID-19 - virology ; Data collection ; Databases, Factual ; Editing ; Environmental science ; Environmental sciences ; Epidemiology ; Female ; Funding ; Gynecology ; Health aspects ; Health risks ; Health surveillance ; Hospitalization ; Hospitals ; Humans ; Incidence ; Infections ; Influenza ; Intensive care ; Intensive Care Units ; Medical research ; Medicine ; Medicine and health sciences ; Methodology ; Minority & ethnic groups ; Minority Groups - statistics & numerical data ; Neonates ; Newborn babies ; Obesity - complications ; Obstetrics ; Odds Ratio ; Pandemics ; People and Places ; Pneumonia ; Population ; Pregnancy ; Pregnancy Outcome ; Pregnant Women ; Premature birth ; Prospective Studies ; Public health ; Reviews ; Risk analysis ; Risk factors ; SARS-CoV-2 - isolation & purification ; Severe acute respiratory syndrome ; Severe acute respiratory syndrome coronavirus 2 ; Surveillance ; Systematic review ; United Kingdom - epidemiology ; Viral diseases ; Womens health ; Young Adult</subject><ispartof>PloS one, 2021-05, Vol.16 (5), p.e0251123</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Vousden et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Vousden et al 2021 Vousden et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-1243ed5ba1fd4c95c7b485a681441ef1308d1e943b6e0b40af4aa716c16e4e2a3</citedby><cites>FETCH-LOGICAL-c692t-1243ed5ba1fd4c95c7b485a681441ef1308d1e943b6e0b40af4aa716c16e4e2a3</cites><orcidid>0000-0001-5216-8268 ; 0000-0002-1984-4575</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8099130/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8099130/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33951100$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vousden, Nicola</creatorcontrib><creatorcontrib>Bunch, Kathryn</creatorcontrib><creatorcontrib>Morris, Edward</creatorcontrib><creatorcontrib>Simpson, Nigel</creatorcontrib><creatorcontrib>Gale, Christopher</creatorcontrib><creatorcontrib>O'Brien, Patrick</creatorcontrib><creatorcontrib>Quigley, Maria</creatorcontrib><creatorcontrib>Brocklehurst, Peter</creatorcontrib><creatorcontrib>Kurinczuk, Jennifer J</creatorcontrib><creatorcontrib>Knight, Marian</creatorcontrib><title>The incidence, characteristics and outcomes of pregnant women hospitalized with symptomatic and asymptomatic SARS-CoV-2 infection in the UK from March to September 2020: A national cohort study using the UK Obstetric Surveillance System (UKOSS)</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>There is a lack of population level data on risk factors, incidence and impact of SARS-CoV-2 infection in pregnant women and their babies. The primary aim of this study was to describe the incidence, characteristics and outcomes of hospitalized pregnant women with symptomatic and asymptomatic SARS-CoV-2 in the UK compared to pregnant women without SARS-CoV-2.
We conducted a national, prospective cohort study of all hospitalized pregnant women with confirmed SARS-CoV-2 from 01/03/2020 to 31/08/2020 using the UK Obstetric Surveillance System. Incidence rates were estimated using national maternity data. Overall, 1148 hospitalized women had confirmed SARS-CoV-2 in pregnancy, 63% of which were symptomatic. The estimated incidence of hospitalization with symptomatic SARS-CoV-2 was 2.0 per 1000 maternities (95% CI 1.9-2.2) and for asymptomatic SARS-CoV-2 was 1.2 per 1000 maternities (95% CI 1.1-1.4). Compared to pregnant women without SARS-CoV-2, women hospitalized with symptomatic SARS-CoV-2 were more likely to be overweight or obese (adjusted OR 1.86, (95% CI 1.39-2.48) and aOR 2.07 (1.53-2.29)), to be of Black, Asian or Other minority ethnic group (aOR 6.24, (3.93-9.90), aOR 4.36, (3.19-5.95) and aOR 12.95, (4.93-34.01)), and to have a relevant medical comorbidity (aOR 1.83 (1.32-2.54)). Hospitalized pregnant women with symptomatic SARS-CoV-2 were more likely to be admitted to intensive care (aOR 57.67, (7.80-426.70)) but the absolute risk of poor outcomes was low. Cesarean births and neonatal unit admission were increased regardless of symptom status (symptomatic aOR 2.60, (1.97-3.42) and aOR 3.08, (1.99-4.77); asymptomatic aOR 2.02, (1.52-2.70) and aOR 1.84, (1.12-3.03)). The risks of stillbirth or neonatal death were not significantly increased, regardless of symptom status.
We have identified factors that increase the risk of symptomatic and asymptomatic SARS-CoV-2 in pregnancy. Clinicians can be reassured that the majority of women do not experience severe complications of SARS-CoV-2 in pregnancy.</description><subject>Adult</subject><subject>Asymptomatic</subject><subject>Babies</subject><subject>Biology and life sciences</subject><subject>Body mass index</subject><subject>Carrier State - diagnosis</subject><subject>Carrier State - epidemiology</subject><subject>Carrier State - virology</subject><subject>Cesarean Section</subject><subject>Clinical trials</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 - complications</subject><subject>COVID-19 - diagnosis</subject><subject>COVID-19 - epidemiology</subject><subject>COVID-19 - virology</subject><subject>Data collection</subject><subject>Databases, Factual</subject><subject>Editing</subject><subject>Environmental science</subject><subject>Environmental sciences</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Funding</subject><subject>Gynecology</subject><subject>Health aspects</subject><subject>Health risks</subject><subject>Health surveillance</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infections</subject><subject>Influenza</subject><subject>Intensive care</subject><subject>Intensive Care Units</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine and health sciences</subject><subject>Methodology</subject><subject>Minority & ethnic groups</subject><subject>Minority Groups - statistics & numerical data</subject><subject>Neonates</subject><subject>Newborn babies</subject><subject>Obesity - complications</subject><subject>Obstetrics</subject><subject>Odds Ratio</subject><subject>Pandemics</subject><subject>People and Places</subject><subject>Pneumonia</subject><subject>Population</subject><subject>Pregnancy</subject><subject>Pregnancy Outcome</subject><subject>Pregnant Women</subject><subject>Premature birth</subject><subject>Prospective Studies</subject><subject>Public health</subject><subject>Reviews</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>SARS-CoV-2 - isolation & purification</subject><subject>Severe acute respiratory syndrome</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Surveillance</subject><subject>Systematic review</subject><subject>United Kingdom - epidemiology</subject><subject>Viral diseases</subject><subject>Womens health</subject><subject>Young 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incidence, characteristics and outcomes of pregnant women hospitalized with symptomatic and asymptomatic SARS-CoV-2 infection in the UK from March to September 2020: A national cohort study using the UK Obstetric Surveillance System (UKOSS)</title><author>Vousden, Nicola ; Bunch, Kathryn ; Morris, Edward ; Simpson, Nigel ; Gale, Christopher ; O'Brien, Patrick ; Quigley, Maria ; Brocklehurst, Peter ; Kurinczuk, Jennifer J ; Knight, Marian</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-1243ed5ba1fd4c95c7b485a681441ef1308d1e943b6e0b40af4aa716c16e4e2a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Asymptomatic</topic><topic>Babies</topic><topic>Biology and life sciences</topic><topic>Body mass index</topic><topic>Carrier State - diagnosis</topic><topic>Carrier State - epidemiology</topic><topic>Carrier State - virology</topic><topic>Cesarean 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& Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vousden, Nicola</au><au>Bunch, Kathryn</au><au>Morris, Edward</au><au>Simpson, Nigel</au><au>Gale, Christopher</au><au>O'Brien, Patrick</au><au>Quigley, Maria</au><au>Brocklehurst, Peter</au><au>Kurinczuk, Jennifer J</au><au>Knight, Marian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The incidence, characteristics and outcomes of pregnant women hospitalized with symptomatic and asymptomatic SARS-CoV-2 infection in the UK from March to September 2020: A national cohort study using the UK Obstetric Surveillance System (UKOSS)</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2021-05-05</date><risdate>2021</risdate><volume>16</volume><issue>5</issue><spage>e0251123</spage><pages>e0251123-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>There is a lack of population level data on risk factors, incidence and impact of SARS-CoV-2 infection in pregnant women and their babies. The primary aim of this study was to describe the incidence, characteristics and outcomes of hospitalized pregnant women with symptomatic and asymptomatic SARS-CoV-2 in the UK compared to pregnant women without SARS-CoV-2.
We conducted a national, prospective cohort study of all hospitalized pregnant women with confirmed SARS-CoV-2 from 01/03/2020 to 31/08/2020 using the UK Obstetric Surveillance System. Incidence rates were estimated using national maternity data. Overall, 1148 hospitalized women had confirmed SARS-CoV-2 in pregnancy, 63% of which were symptomatic. The estimated incidence of hospitalization with symptomatic SARS-CoV-2 was 2.0 per 1000 maternities (95% CI 1.9-2.2) and for asymptomatic SARS-CoV-2 was 1.2 per 1000 maternities (95% CI 1.1-1.4). Compared to pregnant women without SARS-CoV-2, women hospitalized with symptomatic SARS-CoV-2 were more likely to be overweight or obese (adjusted OR 1.86, (95% CI 1.39-2.48) and aOR 2.07 (1.53-2.29)), to be of Black, Asian or Other minority ethnic group (aOR 6.24, (3.93-9.90), aOR 4.36, (3.19-5.95) and aOR 12.95, (4.93-34.01)), and to have a relevant medical comorbidity (aOR 1.83 (1.32-2.54)). Hospitalized pregnant women with symptomatic SARS-CoV-2 were more likely to be admitted to intensive care (aOR 57.67, (7.80-426.70)) but the absolute risk of poor outcomes was low. Cesarean births and neonatal unit admission were increased regardless of symptom status (symptomatic aOR 2.60, (1.97-3.42) and aOR 3.08, (1.99-4.77); asymptomatic aOR 2.02, (1.52-2.70) and aOR 1.84, (1.12-3.03)). The risks of stillbirth or neonatal death were not significantly increased, regardless of symptom status.
We have identified factors that increase the risk of symptomatic and asymptomatic SARS-CoV-2 in pregnancy. Clinicians can be reassured that the majority of women do not experience severe complications of SARS-CoV-2 in pregnancy.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>33951100</pmid><doi>10.1371/journal.pone.0251123</doi><tpages>e0251123</tpages><orcidid>https://orcid.org/0000-0001-5216-8268</orcidid><orcidid>https://orcid.org/0000-0002-1984-4575</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2021-05, Vol.16 (5), p.e0251123 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2522383715 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Adult Asymptomatic Babies Biology and life sciences Body mass index Carrier State - diagnosis Carrier State - epidemiology Carrier State - virology Cesarean Section Clinical trials Cohort analysis Cohort Studies Coronaviruses COVID-19 COVID-19 - complications COVID-19 - diagnosis COVID-19 - epidemiology COVID-19 - virology Data collection Databases, Factual Editing Environmental science Environmental sciences Epidemiology Female Funding Gynecology Health aspects Health risks Health surveillance Hospitalization Hospitals Humans Incidence Infections Influenza Intensive care Intensive Care Units Medical research Medicine Medicine and health sciences Methodology Minority & ethnic groups Minority Groups - statistics & numerical data Neonates Newborn babies Obesity - complications Obstetrics Odds Ratio Pandemics People and Places Pneumonia Population Pregnancy Pregnancy Outcome Pregnant Women Premature birth Prospective Studies Public health Reviews Risk analysis Risk factors SARS-CoV-2 - isolation & purification Severe acute respiratory syndrome Severe acute respiratory syndrome coronavirus 2 Surveillance Systematic review United Kingdom - epidemiology Viral diseases Womens health Young Adult |
| title | The incidence, characteristics and outcomes of pregnant women hospitalized with symptomatic and asymptomatic SARS-CoV-2 infection in the UK from March to September 2020: A national cohort study using the UK Obstetric Surveillance System (UKOSS) |
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