Association of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection With Maternal Mortality and Neonatal Birth Outcomes in Botswana by Human Immunodeficiency Virus Status.
Infant, Newborn
Pregnancy
Female
Humans
SARS-CoV-2
Pregnancy Outcome
/ epidemiology
Stillbirth
/ epidemiology
COVID-19
/ epidemiology
HIV Infections
/ epidemiology
Maternal Mortality
Botswana
/ epidemiology
Premature Birth
/ epidemiology
Pregnancy Complications
HIV
Pregnancy Complications, Infectious
/ epidemiology
Journal
Obstetrics and gynecology
ISSN: 1873-233X
Titre abrégé: Obstet Gynecol
Pays: United States
ID NLM: 0401101
Informations de publication
Date de publication:
01 01 2023
01 01 2023
Historique:
received:
25
05
2022
accepted:
11
08
2022
pmc-release:
01
01
2024
entrez:
26
1
2023
pubmed:
27
1
2023
medline:
31
1
2023
Statut:
ppublish
Résumé
To evaluate the combined association of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and human immunodeficiency virus (HIV) infection on adverse birth outcomes in an HIV-endemic region. The Tsepamo Study abstracts data from antenatal and obstetric records in government maternity wards across Botswana. We assessed maternal mortality and adverse birth outcomes for all singleton pregnancies from September 2020 to mid-November 2021 at 13 Tsepamo sites among individuals with documented SARS-CoV-2 screening tests and known HIV status. Of 20,410 individuals who gave birth, 11,483 (56.3%) were screened for SARS-CoV-2 infection; 4.7% tested positive. People living with HIV were more likely to test positive (144/2,421, 5.9%) than those without HIV (392/9,030, 4.3%) (P=.001). Maternal deaths occurred in 3.7% of those who had a positive SARS-CoV-2 test result compared with 0.1% of those who tested negative (adjusted relative risk [aRR] 31.6, 95% CI 15.4-64.7). Maternal mortality did not differ by HIV status. The offspring of individuals with SARS-CoV-2 infection experienced more overall adverse birth outcomes (34.5% vs 26.6%; aRR 1.2, 95% CI 1.1-1.4), severe adverse birth outcomes (13.6% vs 9.8%; aRR 1.2, 95% CI 1.0-1.5), preterm delivery (21.4% vs 13.4%; aRR 1.4, 95% CI 1.2-1.7), and stillbirth (5.6% vs 2.7%; aRR 1.7 95% CI 1.2-2.5). Neonates exposed to SARS-CoV-2 and HIV infection had the highest prevalence of adverse birth outcomes (43.1% vs 22.6%; aRR 1.7, 95% CI 1.4-2.0). Infection with SARS-CoV-2 at the time of delivery was associated with 3.7% maternal mortality and 5.6% stillbirth in Botswana. Most adverse birth outcomes were worse among neonates exposed to both SARS-CoV-2 and HIV infection.
Identifiants
pubmed: 36701614
doi: 10.1097/AOG.0000000000005020
pii: 00006250-202301000-00014
pmc: PMC10462386
mid: NIHMS1897056
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
135-143Subventions
Organisme : NICHD NIH HHS
ID : K23 HD088230
Pays : United States
Organisme : NICHD NIH HHS
ID : R01 HD080471
Pays : United States
Organisme : NIAID NIH HHS
ID : K24 AI131924
Pays : United States
Organisme : NCI NIH HHS
ID : K08 CA271949
Pays : United States
Organisme : FIC NIH HHS
ID : D43 TW010543
Pays : United States
Organisme : NICHD NIH HHS
ID : K01 HD100222
Pays : United States
Informations de copyright
Copyright © 2022 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
Financial Disclosure The authors did not report any potential conflicts of interest.
Références
Biochem Biophys Res Commun. 2021 Jan 29;538:180-186
pubmed: 33384142
MMWR Morb Mortal Wkly Rep. 2021 Nov 26;70(47):1640-1645
pubmed: 34818318
Ultrasound Obstet Gynecol. 2021 Apr;57(4):573-581
pubmed: 33620113
Am J Perinatol. 2020 Sep;37(11):1110-1114
pubmed: 32620022
BMC Pediatr. 2016 Jul 21;16:103
pubmed: 27439303
J Int AIDS Soc. 2022 Mar;25(3):e25892
pubmed: 35324084
BMJ. 2020 Sep 1;370:m3320
pubmed: 32873575
Am J Obstet Gynecol MFM. 2021 Nov;3(6):100468
pubmed: 34425296
J Perinat Med. 2020 Nov 26;48(9):977-980
pubmed: 33085639
JAMA Pediatr. 2021 Aug 1;175(8):817-826
pubmed: 33885740
Lancet Infect Dis. 2020 May;20(5):531-532
pubmed: 32243818
S Afr Med J. 2021 Dec 02;111(12):1174-1180
pubmed: 34949304
Lancet. 2021 Jun 26;397(10293):2461-2462
pubmed: 34139198
JAMA Pediatr. 2017 Oct 2;171(10):e172222
pubmed: 28783807
Placenta. 2015 Apr;36 Suppl 1:S20-8
pubmed: 25582276
MMWR Morb Mortal Wkly Rep. 2020 Nov 06;69(44):1641-1647
pubmed: 33151921
Am J Public Health. 2002 Aug;92(8):1323-30
pubmed: 12144992
BMJ Glob Health. 2020 Nov;5(11):
pubmed: 33187963
Medicine (Baltimore). 2020 Feb;99(8):e19213
pubmed: 32080112
Int J Equity Health. 2021 Mar 15;20(1):77
pubmed: 33722225
Lancet Glob Health. 2018 Jul;6(7):e804-e810
pubmed: 29880310
Am J Reprod Immunol. 2020 Nov;84(5):e13304
pubmed: 32662111
Am J Reprod Immunol. 2015 Mar;73(3):199-213
pubmed: 25582523
Ultrasound Obstet Gynecol. 2016 Nov;48(5):579-584
pubmed: 27781319
J Infect Dev Ctries. 2011 Dec 13;5(12):868-73
pubmed: 22169786
Nat Med. 2022 Mar;28(3):504-512
pubmed: 35027756
PLoS One. 2011;6(11):e28172
pubmed: 22140535
BJOG. 2022 Jan;129(1):101-109
pubmed: 34657368
Lancet Reg Health Eur. 2022 Jan;12:100252
pubmed: 34729548
Blood. 2011 Feb 10;117(6):1861-8
pubmed: 21163930
Lancet Infect Dis. 2014 Jul;14(7):627-39
pubmed: 24406145
Eur J Obstet Gynecol Reprod Biol. 2020 Sep;252:490-501
pubmed: 32795828
Arch Pathol Lab Med. 2022 Jun 1;146(6):660-676
pubmed: 35142798
Eur J Obstet Gynecol Reprod Biol. 2019 Sep;240:336-340
pubmed: 31382146
Am J Obstet Gynecol. 2022 Feb;226(2):177-186
pubmed: 34534497
Eur J Med Res. 2020 Sep 4;25(1):39
pubmed: 32887660
J Infect Dis. 2022 Mar 2;225(5):748-753
pubmed: 35024853
Clin Infect Dis. 2021 Jul 15;73(Suppl 1):S24-S31
pubmed: 33977298
Clin Infect Dis. 2021 Nov 16;73(10):1768-1775
pubmed: 33556958
J Acquir Immune Defic Syndr. 2016 Apr 1;71(4):428-36
pubmed: 26379069
N Engl J Med. 2020 May 28;382(22):2163-2164
pubmed: 32283004
BMC Infect Dis. 2021 Sep 20;21(1):980
pubmed: 34544389
Lancet Glob Health. 2020 Jul;8(7):e877-e878
pubmed: 32333854