OP02.05: COVID‐19 during pregnancy as a potential risk factor of preterm delivery in Chile: results from Gestacovid multicentre study

Le résumé fourni par la source

To characterise the maternal and perinatal outcomes of pregnant women with confirmed COVID-19 in Chile. We conducted a national multicentre (38 institutions) prospective study of confirmed COVID-19 before the vaccination uptake. Patients were recruited at any stage during pregnancy or puerperium. Participants were divided in three groups according to severity: Asymptomatic (Group 1), symptomatic with ambulatory management (Group 2) and symptomatic that requires hospitalisation (Group 3). Preterm delivery was determined as global and by cause (spontaneous [s-PTD] or indicated [i-PTD]). Categorical variables were compared with chi2 test and expressed as rates. The association between COVID-19 and preterm delivery in all groups was compared using a survival analysis and Cox-regression. Trend analysis was performed with Jonckheere-Terpstra test. 1,162 women were included and divided in Group 1 (n = 580), Group 2 (n = 390) and Group 3 (n = 192). After excluding miscarriages and fetal deaths (n = 31; 2.7%), global preterm delivery was observed in 192 (17.2%) livebirths, with a significant increase in Group 3 (14.4%, 15.2% and 29.7% for Groups 1 to 3; p < 0.0001). Of 192 preterm deliveries, 47% were spontaneous and 53% indicated. Groups 1 and 2 showed a similar rate of s-PTD (8.3% and 8.7%, respectively) compared to Group 3 (4.8%), p < 0.001. Group 3 demonstrated higher rates of i-PTD (24.5%) versus Groups 1 and 2 (5.7% and 6.3%), p < 0.001. The main contributor for i-PTD were placental related diseases (40.2%) followed by COVID-19 (34%). Global pre-eclampsia (PE) was observed in 6.6% of participants (6.0%, 6.1% and 9.6%; p = 0.2, for Groups 1 to 3) with severe PE in 3.6% (3.0%, 3.4% and 5.9%; p = 0.4, for Groups 1 to 3). This study demonstrated that COVID-19 infection is associated with higher rates of s-PTD and i-PTD, compared to pre-pandemic national rates. Asymptomatic and mild COVID-19 cases presented a similar distribution of PTD causes, in an opposite manner compared to severe cases with hospitalised management.

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