Postpartum hemorrhage emerges as a key outcome of maternal SARS-CoV-2 omicron variant infection surge across pregnancy trimesters

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2025-03-06 DOI:10.1016/j.jiph.2025.102733

Zhou Xu , Er-Han Li , Jia Liu , Yong-Jia Zhang , Rui Xiao , Xin-Zhen Chen , Zhao-Hui Zhong , Xiao-Jun Tang , Li-Juan Fu , Hua Zhang , Mei-Hua Bao , Hong-Bo Qi , Gong-Li Chen , Yu-Bin Ding

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Abstract

Background

Despite evidence showing changes in disease severity with the virus's evolution and vaccination efforts, the link between maternal, perinatal, and neonatal outcomes and SARS-CoV-2 infections during different pregnancy trimesters remains unclear, especially with the BA.5 and BF.7 Omicron subvariant surge in China in December 2022. This study investigates the correlation between maternal, perinatal, and neonatal outcomes and SARS-CoV-2 infection across various pregnancy trimesters.

Methods

This prospective cohort study was conducted at two hospitals in southwest China, examining the clinical records and infection status of 2158 pregnant women registered between January 1, 2022, and September 30, 2023. Initially shielded from COVID-19, the population later experienced a significant infection surge. A comparative analysis evaluated maternal, perinatal, and neonatal outcomes between infected and uninfected subjects. Primary outcomes included pregnancy complications and premature births, while secondary outcomes encompassed cesarean sections, delivery complications, and neonatal outcomes.

Results

Pregnant women infected with SARS-CoV-2 had higher incidence of placenta increta/percreta and postpartum hemorrhage compared to uninfected women. First trimester infections were associated with a lower incidence of intrahepatic cholestasis of pregnancy [aOR = 0.29, 95 % CI 0.13–0.63] but a higher incidence of preterm birth [aOR = 2.16, 95 % CI 1.25–3.71]. Third trimester infections increased the risk of postpartum hemorrhage [aOR = 2.74, 95 % CI 1.21–6.18].

Conclusion

SARS-CoV-2 infection during pregnancy is linked to increased incidence of placenta increta/percreta and postpartum hemorrhage. First trimester infections are associated with higher incidence of premature birth and lower incidence of intrahepatic cholestasis of pregnancy, while third trimester infections are linked to higher incidence of postpartum hemorrhage.

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.