Maternal and perinatal outcomes following pre-Delta, Delta, and Omicron SARS-CoV-2 variants infection among unvaccinated pregnant women in France and Switzerland: a prospective cohort study using the COVI-PREG registry. - Université de Lille Accéder directement au contenu
Article Dans Une Revue The Lancet Regional Health - Europe Année : 2023

Maternal and perinatal outcomes following pre-Delta, Delta, and Omicron SARS-CoV-2 variants infection among unvaccinated pregnant women in France and Switzerland: a prospective cohort study using the COVI-PREG registry.

Leonhard Schäffer
  • Fonction : Auteur
Cora Alexandra Voekt
  • Fonction : Auteur
Béatrice Eggel-Hort
  • Fonction : Auteur
Silke Johann
  • Fonction : Auteur
Sophie Defert
  • Fonction : Auteur
Brigitte Weber
  • Fonction : Auteur
Steffi Leu
  • Fonction : Auteur

Résumé

Background SARS-CoV-2 positive pregnant women are at higher risk of adverse outcomes, but little evidence is available on how variants impact that risk. We aim to evaluate maternal and perinatal outcomes among unvaccinated pregnant women that tested positive for SARS-CoV-2, stratified by pre-Delta, Delta, and Omicron periods. Methods This prospective study enrolled women from March 2020 to September 2022. Exposure to the different SARS-CoV-2 variants was defined by their periods of predominance. The primary outcome was severe maternal adverse outcome defined as either intensive care unit admission, acute respiratory distress syndrome, advanced oxygen supplementation, or maternal death. The secondary outcomes were preterm birth and other perinatal outcomes. Findings Overall, 1402, 262, and 391 SARS-CoV-2 positive pregnant women were enrolled during the pre-Delta, Delta, and Omicron periods respectively. Severe maternal adverse outcome was reported in 3.4% (n = 947/1402; 95% confidence intervals (95%CI) 2.5–4.5), 6.5% (n = 7/262; 95%CI 3.8–10.2), and 1.0% (n = 4/391; 95%CI 0.3–2.6) of women during the pre-Delta, Delta, and Omicron periods. The risk of severe maternal adverse outcome was higher during the Delta vs pre-Delta period (adjusted risk ratio (aRR) = 1.8; 95%CI 1.1–3.2) and lower during the Omicron vs pre-Delta period (aRR = 0.3; 95%CI, 0.1–0.8). The risks of hospitalization for COVID-19 were 12.6% (n = 176/1402; 95%CI 10.9–14.4), 17.2% (n = 45/262; 95%CI 12.8–22.3), and 12.5% (n = 49/391; 95%CI 9.4–16.2), during the pre-Delta, Delta, and Omicron period, respectively. Pregnancy complications occurred after SARS-CoV-2 exposure in 30.0% (n = 363/1212; 95%CI 27.4–32.6), 35.2% (n = 83/236; 95%CI 29.1–41.6), and 30.3% (n = 105/347; 95%CI 25.5–35.4) of patients during the pre-Delta, Delta, and Omicron periods, respectively. Stillbirths were reported in 0.5% (n = 6/1159; 95%CI 0.2–1.1), 2.8% (n = 6/210; 95%CI 1.0–6.0), and 0.9% (n = 2/213; 95%CI 0.1–3.4) or patients during the pre-Delta, Delta, and Omicron periods respectively. Interpretation The Delta period was associated with a higher risk of severe maternal adverse outcome and the Omicron period with a lower risk of severe adverse outcome compared to pre-Delta era. The reported risk of hospitalization was high during the Omicron period and should not be trivialized. Funding Swiss Federal Office of Public Health, Fondation CHUV.

Dates et versions

hal-04550944 , version 1 (18-04-2024)

Identifiants

Citer

Guillaume Favre, E. Maisonneuve, Léo Pomar, Charlotte Daire, Christophe Poncelet, et al.. Maternal and perinatal outcomes following pre-Delta, Delta, and Omicron SARS-CoV-2 variants infection among unvaccinated pregnant women in France and Switzerland: a prospective cohort study using the COVI-PREG registry.. The Lancet Regional Health - Europe, 2023, The Lancet Regional Health - Europe, pp.100569. ⟨10.1016/j.lanepe.2022.100569⟩. ⟨hal-04550944⟩

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