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American Journal of Obstetrics and Gynecology

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Maternal and neonatal outcomes of pregnancies with COVID-19 after medically assisted reproduction: results from the prospective COVID-19-Related Obstetrical and Neonatal Outcome Study - 23/08/22

Doi : 10.1016/j.ajog.2022.04.021 
Yvonne Ziert, PhD a, Michael Abou-Dakn, MD b, Clara Backes, MD c, Constanze Banz-Jansen, MD d, Nina Bock, MD e, Michael Bohlmann, MD f, Charlotte Engelbrecht, MD g, Teresa Mia Gruber, MD g, Antonella Iannaccone, MD h, Magdalena Jegen, MD i, Corinna Keil, MD j, Ioannis Kyvernitakis, MD k, Katharina Lang, MD l, Angela Lihs, MD m, Jula Manz, MD n, Christine Morfeld, MD o, Manuela Richter, MD p, Gregor Seliger, MD q, Marina Sourouni, MD r, Constantin Sylvius von Kaisenberg, MD s, Silke Wegener, MD t, Ulrich Pecks, MD u, Frauke von Versen-Höynck, MD, MSc v, ⁎
On behalf of the

COVID-19-Related Obstetric and Neonatal Outcome Study (CRONOS) Network

a Institute of Biostatistics, Hannover Medical School, Hannover, Germany 
b Department of Obstetrics and Gynecology, St. Joseph Hospital, Berlin, Germany 
c Department of Obstetrics and Gynecology, München Klinik Harlaching, Munich, Germany 
d Department of Gynecology and Obstetrics, Protestant Hospital of Bethel Foundation, University Medical School OWL, Bielefeld, Germany 
e Department of Obstetrics and Gynecology, Klinikum Hanau, Hanau, Germany 
f Department of Obstetrics and Gynecology, St. Elisabeth Hospital Loerrach, Loerrach, Germany 
g Department of Obstetrics, Charité – Universitätsmedizin Berlin, Berlin, Germany 
h Department of Obstetrics and Gynecology, University of Duisburg-Essen, Essen, Germany 
i Department of Gynecology and Obstetrics, University Hospital, LMU Munich, Munich, Germany 
j Department of Gynecology and Obstetrics, University Hospital Marburg, Philipps University Marburg, Marburg, Germany 
k Department of Obstetrics and Prenatal Medicine, Asklepios Clinic Barmbek, Hamburg, Germany 
l Department of Obstetrics and Gynecology, Albertinen Krankenhaus, Hamburg, Germany 
m Department of Obstetrics and Gynecology, Klinikverbund Suedwest, Boeblingen, Germany 
n Department of Obstetrics and Gynecology, City Hospital, Darmstadt, Deutschland 
o Department of Obstetrics, Diakovere Henriettenstift, Hannover, Germany 
p Department of Neonatology, Kinderkrankenhaus auf der Bult, Kinder- und Jugendkrankenhaus, Hannover, Germany 
q Center for Reproductive Medicine & Andrology and Department of Obstetrics & Prenatal Medicine, University Hospital, Halle (Saale), Germany 
r Department of Obstetrics and Gynecology, University Clinic, Muenster, Germany 
s Department of Obstetrics, Gynecology and Reproductive Medicine, Hannover Medical School, Hannover, Germany 
t Department of Obstetrics and Gynecology, Ernst von Bergmann Hospital, Potsdam, Germany 
u Department of Obstetrics and Gynecology, University Hospital of Schleswig-Holstein, Kiel, Germany 
v Department of Obstetrics, Gynecology and Reproductive Medicine, Hannover Medical School, Hannover, Germany 

∗Corresponding author: Frauke von Versen-Höynck, MD, MSc.
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Abstract

Background

Severe acute respiratory syndrome coronavirus type 2 infections in pregnancy have been associated with maternal morbidity, admission to intensive care, and adverse perinatal outcomes such as preterm birth, stillbirth, and hypertensive disorders of pregnancy. It is unclear whether medically assisted reproduction additionally affects maternal and neonatal outcomes in women with COVID-19.

Objective

To evaluate the effect of medically assisted reproduction on maternal and neonatal outcomes in women with COVID-19 in pregnancy.

Study Design

A total of 1485 women with COVID-19 registered in the COVID-19 Related Obstetric and Neonatal Outcome Study (a multicentric, prospective, observational cohort study) were included. The maternal and neonatal outcomes in 65 pregnancies achieved with medically assisted reproduction and in 1420 spontaneously conceived pregnancies were compared. We used univariate und multivariate (multinomial) logistic regressions to estimate the (un)adjusted odds ratios and 95% confidence intervals for adverse outcomes.

Results

The incidence of COVID-19-associated adverse outcomes (eg, pneumonia, admission to intensive care, and death) was not different in women after conceptions with COVID-19 than in women after medically assisted reproduction pregnancies. Yet, the risk of obstetrical and neonatal complications was higher in pregnancies achieved through medically assisted reproduction. However, medically assisted reproduction was not the primary risk factor for adverse maternal and neonatal outcomes including pregnancy-related hypertensive disorders, gestational diabetes mellitus, cervical insufficiency, peripartum hemorrhage, cesarean delivery, preterm birth, or admission to neonatal intensive care. Maternal age, multiple pregnancies, nulliparity, body mass index >30 (before pregnancy) and multiple gestation contributed differently to the increased risks of adverse pregnancy outcomes in women with COVID-19 independent of medically assisted reproduction.

Conclusion

Although women with COVID-19 who conceived through fertility treatment experienced a higher incidence of adverse obstetrical and neonatal complications than women with spontaneous conceptions, medically assisted reproduction was not the primary risk factor.

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Key words : assisted reproduction, cohort study, COVID-19, fertility treatment, maternal outcomes, neonatal outcomes, pregnancy, preterm birth, SARS-CoV-2 infection


Plan


 The authors declare no conflict of interest.
 CRONOS has been funded by Krumme-Stiftung, the German Society of Perinatal Medicine (DGPM), and the Federal State of Schleswig-Holstein
 Cite this article as: Ziert Y, Abou-Dakn M, Backes C, et al. Maternal and neonatal outcomes of pregnancies with COVID-19 after medically assisted reproduction: results from the prospective COVID-19-Related Obstetrical and Neonatal Outcome Study. Am J Obstet Gynecol 2022;227:495.e1-11.


© 2022  Publié par Elsevier Masson SAS.
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Vol 227 - N° 3

P. 495.e1-495.e11 - septembre 2022 Retour au numéro
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