Variations across Europe in hospitalization and management of pregnant women with SARS-CoV-2 during the initial phase of the pandemic: Multi-national population-based cohort study using the International Network of Obstetric Survey Systems (INOSS)

Association between chronic health conditions and severe acute respiratory syndrome in pregnant women: an exploratory study

OBJECTIVE

To analyze the association between chronic health conditions and severe acute respiratory syndrome in pregnant women.

METHOD

Retrospective, exploratory study conducted with 1,152 pregnant women from all 27 states of Brazil who sought hospital treatment and were diagnosed with severe acute respiratory syndrome between 2020 and 2022. Public data from the Influenza Epidemiological Surveillance Information System (SIVEP-Gripe) of the Brazilian Ministry of Health were used. Nonparametric tests were performed in data interpretation.

RESULTS

The mortality rate of pregnant women due to severe acute respiratory syndrome in Brazil was 7%. Severe acute respiratory syndrome was statistically associated with the previous presence of diabetes (p = 0.023), neurological disease (p = 0.001), and drug use (p = 0.001). The epidemiological investigation of respiratory syndrome cases took longer in Black pregnant women (p = 0.012), unvaccinated women (p < 0.001) and women living in the north and south of the country (p = 0.011).

CONCLUSION

Severe acute respiratory syndrome was more common in pregnant women with diabetes, neurological disease and drug users. However, these conditions did not lead to an increase in the number of deaths.

Seroprevalence and placental transfer of SARS-CoV-2 antibodies in unvaccinated pregnant women

PURPOSE

Pregnant women are at risk of severe SARS-CoV-2 infection, potentially leading to obstetric and neonatal complications. Placental transfer of antibodies directed to SARS-CoV-2 may be protective against neonatal COVID-19, but this remains to be studied. We aimed to determine the seroprevalence of SARS-CoV-2 antibodies in a population of unvaccinated pregnant women and to determine the placental transfer of these antibodies.

METHODOLOGY

A total of 1197 unvaccinated women with mostly unknown pre-study SARS-CoV-2 infection status, were tested at delivery for SARS-CoV-2 spike protein IgG antibodies during the first year of the pandemic. Umbilical cord samples were collected and assessed for seropositivity if the mother was seropositive. Maternal characteristics, pregnancy and neonatal outcomes and data on SARS-CoV-2 infection were extracted from medical records.

RESULTS

Specific IgG were detected in 258 women (21.6%). A significant placental transfer to the newborn was observed in 81.3% of cases. The earlier in the 2nd and 3rd trimesters that the mother had contracted the disease and the more symptomatic she was, the greater the likelihood of transplacental transfer of IgG to her newborn.

CONCLUSION

Approximately one in five women had detectable anti-SARS-CoV-2 spike protein IgG antibodies at delivery during the first year of the pandemic, and these antibodies were significantly transferred to their fetuses. This research provides further evidence to better understand the dynamics of the placental transfer of SARS-CoV-2 IgG antibodies from mothers to their newborns, which is necessary to improve vaccination strategies.

Maternal and perinatal health research during emerging and ongoing epidemic threats: a landscape analysis and expert consultation

INTRODUCTION

Pregnant women and their offspring are often at increased direct and indirect risks of adverse outcomes during epidemics and pandemics. A coordinated research response is paramount to ensure that this group is offered at least the same level of disease prevention, diagnosis, and care as the general population. We conducted a landscape analysis and held expert consultations to identify research efforts relevant to pregnant women affected by disease outbreaks, highlight gaps and challenges, and propose solutions to addressing them in a coordinated manner.

METHODS

Literature searches were conducted from 1 January 2015 to 22 March 2022 using Web of Science, Google Scholar and PubMed augmented by key informant interviews. Findings were reviewed and Quid analysis was performed to identify clusters and connectors across research networks followed by two expert consultations. These formed the basis for the development of an operational framework for maternal and perinatal research during epidemics.

RESULTS

Ninety-four relevant research efforts were identified. Although well suited to generating epidemiological data, the entire infrastructure to support a robust research response remains insufficient, particularly for use of medical products in pregnancy. Limitations in global governance, coordination, funding and data-gathering systems have slowed down research responses.

CONCLUSION

Leveraging current research efforts while engaging multinational and regional networks may be the most effective way to scale up maternal and perinatal research preparedness and response. The findings of this landscape analysis and proposed operational framework will pave the way for developing a roadmap to guide coordination efforts, facilitate collaboration and ultimately promote rapid access to countermeasures and clinical care for pregnant women and their offspring in future epidemics.