Table 5.
Pregnancy and neonatal outcomes according to the variant time period among patients exposed to SARS-CoV-2 with a known pregnancy outcome from 20 weeks of gestation.
| Pre-Delta |
Delta |
Omicron |
|||||||
|---|---|---|---|---|---|---|---|---|---|
|
n = 1212 |
n = 236 |
n = 347 |
|||||||
| N | % | 95%CI | n | % | 95%CI | n | % | 95%CI | |
| Pregnancy complications (after viral exposure) | 363 | 30.0% | 27.4–32.6 | 83 | 35.2% | 29.1–41.6 | 105 | 30.3% | 25.5–35.4 |
| Preeclampsia | 35 | 2.9% | 2.0–4.0 | 7 | 3.0% | 1.2–6.0 | 8 | 2.3% | 1.0–4.5 |
| Gestational Diabetes | 111 | 9.2% | 7.6–10.9 | 28 | 11.9% | 8.0–16.7 | 41 | 11.8% | 8.6–15.7 |
| Intrauterine growth restriction | 56 | 4.6% | 3.5–6.0 | 12 | 5.1% | 2.7–8.7 | 13 | 3.7% | 2.0–6.3 |
| Abnormal fetal Doppler | 8 | 0.7% | 0.3–1.3 | 2 | 0.8% | 0.1–3.0 | 2 | 0.6% | 0.1–2.1 |
| Suspected macrosomia | 24 | 2.0% | 1.3–2.9 | 5 | 2.1% | 0.7–4.9 | 12 | 3.5% | 1.8–6.0 |
| Threatened preterm labor | 38 | 3.1% | 2.2–4.3 | 9 | 3.8% | 1.8–7.1 | 9 | 2.6% | 1.2–4.9 |
| Preterm Premature Rupture Of Membranes | 23 | 1.9% | 1.2–2.8 | 5 | 2.1% | 0.7–4.9 | 7 | 2.0% | 0.8–4.1 |
| Post-partum hemorrhage | 12 | 1.0% | 0.5–1.7 | 1 | 0.4% | 0.0–2.3 | 2 | 0.6% | 0.1–2.1 |
| Other | 127 | 10.5% | 8.8–12.3 | 28 | 11.9% | 8.0–16.7 | 31 | 8.9% | 6.2–12.4 |
| Labour | |||||||||
| Spontaneous | 633 | 52.2% | 49.4–55.1 | 123 | 52.1% | 45.5–58.6 | 185 | 53.3% | 47.9–58.7 |
| Induction of labor | 353 | 29.1% | 26.6–31.8 | 68 | 28.8% | 23.1–35.0 | 113 | 32.6% | 27.7–37.8 |
| Cesarean out of labor/induction | 206 | 17.0% | 14.9–19.2 | 39 | 16.5% | 12.0–21.9 | 45 | 13.0% | 9.6–17.0 |
| Unknown | 20 | 1.7% | 1.0–2.5 | 6 | 2.5% | 0.9–5.5 | 4 | 1.2% | 0.3–2.9 |
| Mode of delivery | |||||||||
| Vaginal birth | 835 | 68.9% | 66.2–71.5 | 169 | 71.6% | 65.4–77.3 | 261 | 75.2% | 70.3–79.7 |
| - Assisted | 109 | 9.0% | 7.4–10.7 | 20 | 8.5% | 5.3–12.8 | 32 | 9.2% | 6.4–12.8 |
| Cesarean section | 357 | 29.5% | 26.9–32.1 | 61 | 25.8% | 20.4–31.9 | 82 | 23.6% | 19.3–28.5 |
| - Emergency during labor/induction | 151 | 12.5% | 10.7–14.5 | 22 | 9.3% | 5.9–13.8 | 37 | 10.7% | 7.6–14.4 |
| - Emergency out of labor | 52 | 4.3% | 3.2–5.6 | 5 | 2.1% | 0.7–4.9 | 13 | 3.7% | 2.0–6.3 |
| Related directly to COVID-19 | 23 | 1.9% | 1.2–2.8 | 12 | 5.1% | 2.7–8.7 | 1 | 0.3% | 0.0–1.6 |
| - Planned cesarean section | 154 | 15.5% | 13.317.9 | 34 | 14.4% | 10.2–19.5 | 32 | 9.2% | 6.4–12.8 |
| Unknown | 20 | 1.7% | 1.0–2.5 | 6 | 2.5% | 0.9–5.5 | 4 | 1.2% | 0.3–2.9 |
| Prematurity | |||||||||
| <37 weeks | 108 | 8.9% | 7.4–10.7 | 32 | 13.6% | 9.5–18.6 | 32 | 9.2% | 6.4–12.8 |
| - Spontaneous | 35 | 2.9% | 2.0–4.0 | 9 | 3.8% | 1.8–7.1 | 9 | 2.6% | 1.2–4.9 |
| - Iatrogenic birth related directly to COVID-19 | 16 | 1.3% | 0.8–2.1 | 7 | 3.0% | 1.2–6.0 | 0 | 0.0% | 0.0–1.1 |
| <32 weeks | 30 | 2.5% | 1.7–3.5 | 13 | 5.5% | 3.0–9.2 | 8 | 2.3% | 1.0–4.5 |
| - Spontaneous | 6 | 0.5% | 0.2–1.1 | 2 | 0.8% | 0.1–3.0 | 2 | 0.6% | 0.1–2.1 |
| - Iatrogenic birth related directly to COVID-19 | 5 | 0.4% | 0.1–1.0 | 2 | 0.8% | 0.1–3.0 | 0 | 0.0% | 0.0–1.1 |
| <28 weeks | 13 | 1.1% | 0.6–1.8 | 2 | 0.8% | 0.1–3.0 | 4 | 1.2% | 0.3–2.9 |
| - Spontaneous | 6 | 0.5% | 0.2–1.1 | 2 | 0.8% | 0.1–3.0 | 2 | 0.6% | 0.1–2.1 |
| - Iatrogenic birth related directly to COVID-19 | 2 | 0.2% | 0.0–0.6 | 0 | 0.0% | 0.0–1.6 | 0 | 0.0% | 0.0–1.1 |
| Pregnancy outcomes | |||||||||
| Number of fetuses | n = 1238 | n = 239 | n = 356 | ||||||
| Livebirths | 1226 | 99.0% | 98.3–99.5 | 233 | 97.5% | 94.6–99.1 | 352 | 98.9% | 97.1–99.7 |
| Pre-viable fetus birth (≥20 and < 24 weeks) | 4 | 0.3% | 0.1–0.8 | 0 | 0.0% | 0.0–1.5 | 1 | 0.3% | 0.0–1.6 |
| Late termination of pregnancy (≥20 weeks | 2 | 0.2% | 0.0–0.6 | 0 | 0.0% | 0.0–1.5 | 1 | 0.3% | 0.0–1.6 |
| Stillbirths | 6 | 0.5% | 0.2–1.1 | 6 | 2.5% | 0.9–5.4 | 2 | 0.6% | 0.1–2.0 |
| Neonatal outcomes | n = 1226 | n = 233 | n = 352 | ||||||
| Weight at birth (mean in g.; SD) | 3226 | 609 | 3226 | 675 | 3246 | 596 | |||
| <10th percentile for gestational agea | 85 | 6.9% | 5.6–8.5 | 11 | 4.7% | 2.4–8.3 | 21 | 6.0% | 3.7–9.0 |
| <3rd percentile for gestational agea | 25 | 2.0% | 1.3–3.0 | 3 | 1.3% | 0.3–3.7 | 3 | 0.9% | 0.2–2.5 |
| Apgar score 5 min (mean; SD) | 9.5 | 1.1 | 9.4 | 1.2 | 9.5 | 1.1 | |||
| Apgar score <7 | 39 | 3.2% | 2.3–4.3 | 6 | 2.6% | 1.0–5.5 | 9 | 2.6% | 1.2–4.8 |
| NICU admission | 153 | 12.5% | 10.7–14.5 | 23 | 9.9% | 6.4–14.4 | 34 | 9.7% | 6.8–13.2 |
| Neonatal death | 4 | 0.3% | 0.1–0.8 | 0 | 0.0% | 0.0–1.6 | 2 | 0.6% | 0.1–2.0 |
In bold: 95% CI does not includes 1.
PPROM: preterm premature rupture of membranes, NICU: neonatal intensive care unit admission, SD: standard deviation.
a
Neonatal weight <10th and <3rd percentile defined according to the INTERGROWTH 21st scale (Villar J, Giuliani F, Bhutta ZA et al. Postnatal growth standards for preterm infants: the Preterm Postnatal Follow-up Study of the INTERGROWTH-21st Project. The Lancet Global Health 2015; 3(11):e681–91).