@article{05efc9895ee740c7bea27efaa0ac76cb,
title = "SARS-CoV-2 during pregnancy and associated outcomes: Results from an ongoing prospective cohort",
abstract = "Background: The COVID-19 pandemic is an ongoing global health threat, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Questions remain about how SARS-CoV-2 impacts pregnant individuals and their children. Objective: To expand our understanding of the effects of SARS-CoV-2 infection during pregnancy on pregnancy outcomes, regardless of symptomatology, by using serological tests to measure IgG antibody levels. Methods: The Generation C Study is an ongoing prospective cohort study conducted at the Mount Sinai Health System. All pregnant individuals receiving obstetrical care at the Mount Sinai Healthcare System from 20 April 2020 onwards are eligible for participation. For the current analysis, we included participants who had given birth to a liveborn singleton infant on or before 22 September 2020. For each woman, we tested the latest prenatal blood sample available to establish seropositivity using a SARS-CoV-2 serologic enzyme-linked immunosorbent assay. Additionally, RT-PCR testing was performed on a nasopharyngeal swab taken during labour. Pregnancy outcomes of interest (i.e., gestational age at delivery, preterm birth, small for gestational age, Apgar scores, maternal and neonatal intensive care unit admission, and length of neonatal hospital stay) and covariates were extracted from medical records. Excluding individuals who tested RT-PCR positive at delivery, we conducted crude and adjusted regression models to compare antibody positive with antibody negative individuals at delivery. We stratified analyses by race/ethnicity to examine potential effect modification. Results: The SARS-CoV-2 seroprevalence based on IgG measurement was 16.4% (95% confidence interval 13.7, 19.3; n=116). Twelve individuals (1.7%) were SARS-CoV-2 RT-PCR positive at delivery. Seropositive individuals were generally younger, more often Black or Hispanic, and more often had public insurance and higher pre-pregnancy BMI compared with seronegative individuals. None of the examined pregnancy outcomes differed by seropositivity, overall or stratified by race/ethnicity. Conclusion: Seropositivity for SARS-CoV-2 without RT-PCR positivity at delivery (suggesting that infection occurred earlier during pregnancy) was not associated with selected adverse maternal or neonatal outcomes among live births in a cohort sample from New York City.",
keywords = "COVID-19, SARS-CoV-2, infection, neonatal outcomes, pregnancy outcomes, seroepidemiologic studies",
author = "Molenaar, {Nina M.} and Rommel, {Anna Sophie} and {de Witte}, Lotje and Dolan, {Siobhan M.} and Whitney Lieb and Erona Ibroci and Sophie Ohrn and Jezelle Lynch and Christina Capuano and Daniel Stadlbauer and Florian Krammer and Zapata, {Lauren B.} and Brody, {Rachel I.} and Pop, {Victor J.} and Jessel, {Rebecca H.} and Sperling, {Rhoda S.} and Omara Afzal and Frederieke Gigase and Roy Missall and Teresa Janevic and Joanne Stone and Howell, {Elizabeth A.} and Veerle Bergink",
note = "Funding Information: This study is partially funded (contract 75D30120C08186) by the US Centers for Disease Control and Prevention (CDC), who also provided technical assistance related to analysis and interpretation of data and writing the report. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC. Initial assay development work in the Krammer laboratory was partially supported by the NIAID Centers of Excellence for Influenza Research and Surveillance (CEIRS) contract HHSN272201400008C (FK, for reagent generation), Collaborative Influenza Vaccine Innovation Centers (CIVIC) contract 75N93019C00051 (FK, for reagent generation), the generous support of the JPB foundation, the Open Philanthropy Project (#2020‐215611) and other philanthropic donations. These funding sources were not involved in the current study Funding Information: This study is partially funded (contract 75D30120C08186) by the US Centers for Disease Control and Prevention (CDC), who also provided technical assistance related to analysis and interpretation of data and writing the report. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC. Initial assay development work in the Krammer laboratory was partially supported by the NIAID Centers of Excellence for Influenza Research and Surveillance (CEIRS) contract HHSN272201400008C (FK, for reagent generation), Collaborative Influenza Vaccine Innovation Centers (CIVIC) contract 75N93019C00051 (FK, for reagent generation), the generous support of the JPB foundation, the Open Philanthropy Project (#2020-215611) and other philanthropic donations. These funding sources were not involved in the current study. The authors would like to thank several members of the US Centers for Disease Control (CDC) that have contributed to the interpretation of the data and have provided their feedback on the manuscript: Margaret C. Snead, Sascha R. Ellington, Romeo R. Galang, Suzanne M. Gilboa, Kate R. Woodworth, Titilope Oduyebo, Ashley Smoots and Laura D. Zambrano. The authors also thank Dr. Michael Brodman, Dr. Alan Adler and Dr. Francesco Callipari in the Department of Obstetrics, Gynecology and Reproductive Science at the Mount Sinai Health System for their efforts to optimize participant recruitment. They did not receive any financial compensation for their contribution. Publisher Copyright: {\textcopyright} 2021 John Wiley & Sons Ltd.",
year = "2022",
month = jul,
doi = "10.1111/ppe.12812",
language = "English",
volume = "36",
pages = "466--475",
journal = "Paediatric and Perinatal Epidemiology",
issn = "0269-5022",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "4",
}