Severe COVID‐19 during pregnancy in Sweden, Norway, and Denmark
Abstract Introduction Pregnancy is a risk factor for severe coronavirus disease 2019 (COVID‐19) and adverse pregnancy outcomes. We aimed to explore maternal characteristics, pregnancy outcomes, vaccination status, and virus variants among pregnant women admitted to intensive care units (ICU) with se...
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| Format: | Article |
| Language: | English |
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Wiley
2023-06-01
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| Series: | Acta Obstetricia et Gynecologica Scandinavica |
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| Online Access: | https://doi.org/10.1111/aogs.14552 |
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| author | Anne K. Örtqvist Maria C. Magnus Anna J. M. Aabakke Stine Kjaer Urhoj Anne Vinkel Hansen Anne‐Marie Nybo Andersen Lone Krebs Karin Pettersson Siri E. Håberg Olof Stephansson |
| author_facet | Anne K. Örtqvist Maria C. Magnus Anna J. M. Aabakke Stine Kjaer Urhoj Anne Vinkel Hansen Anne‐Marie Nybo Andersen Lone Krebs Karin Pettersson Siri E. Håberg Olof Stephansson |
| author_sort | Anne K. Örtqvist |
| collection | DOAJ |
| description | Abstract Introduction Pregnancy is a risk factor for severe coronavirus disease 2019 (COVID‐19) and adverse pregnancy outcomes. We aimed to explore maternal characteristics, pregnancy outcomes, vaccination status, and virus variants among pregnant women admitted to intensive care units (ICU) with severe COVID‐19. Material and methods We identified pregnant women admitted to ICU in Sweden (n = 96), Norway (n = 31), and Denmark (n = 16) because of severe COVID‐19, from national registers and clinical databases between March 2020 and February 2022 (Denmark), August 2022 (Sweden), or December 2022 (Norway). Their background characteristics, pregnancy outcome, and vaccination status were compared with all birthing women and severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) test‐positive pregnant women during the same time period. We calculated the number admitted to ICU per 10 000 birthing and per 1000 SARS‐CoV‐2 test‐positive women during the Index, Alpha, Delta, and Omicron periods. Results Women admitted to ICU had a higher mean body mass index, were more often of non‐Scandinavian origin, had on average lower education and income levels, had a higher proportion of chronic and pregnancy‐related conditions, delivered preterm, had neonates with low Apgar scores, and had more infants admitted to neonatal care, compared with all birthing and test‐positive pregnant women. Of those admitted to ICU, only 7% had been vaccinated before admission. Overall, the highest proportion of women admitted to ICU per birthing was during the Delta period (4.1 per 10 000 birthing women). In Norway, the highest proportion admitted to ICU per test‐positive pregnant women was during the Delta period (17.8 per 1000 test‐positive), whereas the highest proportion of admitted per test‐positive in Sweden and Denmark was seen during the Index period (15.4 and 8.9 per 1000 test‐positive, respectively). Conclusions Admission to ICU because of COVID‐19 in pregnancy was a rare event in the Scandinavian countries, but women who were unvaccinated, of non‐Scandinavian origin, and with lower socio‐economic status were at higher risk of admission to ICU. In addition, women admitted to ICU for COVID‐19 had higher risk of adverse pregnancy outcomes. |
| format | Article |
| id | doaj-art-e3596557ef5f4086b0f2a4e39a7af6d4 |
| institution | OA Journals |
| issn | 0001-6349 1600-0412 |
| language | English |
| publishDate | 2023-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Acta Obstetricia et Gynecologica Scandinavica |
| spelling | doaj-art-e3596557ef5f4086b0f2a4e39a7af6d42025-08-20T02:36:31ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122023-06-01102668168910.1111/aogs.14552Severe COVID‐19 during pregnancy in Sweden, Norway, and DenmarkAnne K. Örtqvist0Maria C. Magnus1Anna J. M. Aabakke2Stine Kjaer Urhoj3Anne Vinkel Hansen4Anne‐Marie Nybo Andersen5Lone Krebs6Karin Pettersson7Siri E. Håberg8Olof Stephansson9Clinical Epidemiology Division Department of Medicine, Solna, Karolinska Institutet Stockholm SwedenCenter for Fertility and Health, Norwegian Institute of Public Health Oslo NorwayDepartment of Obstetrics and Gynecology Copenhagen University Hospital‐Holbæk Holbæk DenmarkDepartment of Public Health University of Copenhagen Copenhagen DenmarkDepartment of Public Health University of Copenhagen Copenhagen DenmarkDepartment of Public Health University of Copenhagen Copenhagen DenmarkDepartment of Clinical Medicine University of Copenhagen Copenhagen DenmarkDepartment of Clinical Science Intervention and Technology Karolinska Institutet Stockholm SwedenCenter for Fertility and Health, Norwegian Institute of Public Health Oslo NorwayClinical Epidemiology Division Department of Medicine, Solna, Karolinska Institutet Stockholm SwedenAbstract Introduction Pregnancy is a risk factor for severe coronavirus disease 2019 (COVID‐19) and adverse pregnancy outcomes. We aimed to explore maternal characteristics, pregnancy outcomes, vaccination status, and virus variants among pregnant women admitted to intensive care units (ICU) with severe COVID‐19. Material and methods We identified pregnant women admitted to ICU in Sweden (n = 96), Norway (n = 31), and Denmark (n = 16) because of severe COVID‐19, from national registers and clinical databases between March 2020 and February 2022 (Denmark), August 2022 (Sweden), or December 2022 (Norway). Their background characteristics, pregnancy outcome, and vaccination status were compared with all birthing women and severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) test‐positive pregnant women during the same time period. We calculated the number admitted to ICU per 10 000 birthing and per 1000 SARS‐CoV‐2 test‐positive women during the Index, Alpha, Delta, and Omicron periods. Results Women admitted to ICU had a higher mean body mass index, were more often of non‐Scandinavian origin, had on average lower education and income levels, had a higher proportion of chronic and pregnancy‐related conditions, delivered preterm, had neonates with low Apgar scores, and had more infants admitted to neonatal care, compared with all birthing and test‐positive pregnant women. Of those admitted to ICU, only 7% had been vaccinated before admission. Overall, the highest proportion of women admitted to ICU per birthing was during the Delta period (4.1 per 10 000 birthing women). In Norway, the highest proportion admitted to ICU per test‐positive pregnant women was during the Delta period (17.8 per 1000 test‐positive), whereas the highest proportion of admitted per test‐positive in Sweden and Denmark was seen during the Index period (15.4 and 8.9 per 1000 test‐positive, respectively). Conclusions Admission to ICU because of COVID‐19 in pregnancy was a rare event in the Scandinavian countries, but women who were unvaccinated, of non‐Scandinavian origin, and with lower socio‐economic status were at higher risk of admission to ICU. In addition, women admitted to ICU for COVID‐19 had higher risk of adverse pregnancy outcomes.https://doi.org/10.1111/aogs.14552intensive care unitregistervaccinationvirus variant |
| spellingShingle | Anne K. Örtqvist Maria C. Magnus Anna J. M. Aabakke Stine Kjaer Urhoj Anne Vinkel Hansen Anne‐Marie Nybo Andersen Lone Krebs Karin Pettersson Siri E. Håberg Olof Stephansson Severe COVID‐19 during pregnancy in Sweden, Norway, and Denmark Acta Obstetricia et Gynecologica Scandinavica intensive care unit register vaccination virus variant |
| title | Severe COVID‐19 during pregnancy in Sweden, Norway, and Denmark |
| title_full | Severe COVID‐19 during pregnancy in Sweden, Norway, and Denmark |
| title_fullStr | Severe COVID‐19 during pregnancy in Sweden, Norway, and Denmark |
| title_full_unstemmed | Severe COVID‐19 during pregnancy in Sweden, Norway, and Denmark |
| title_short | Severe COVID‐19 during pregnancy in Sweden, Norway, and Denmark |
| title_sort | severe covid 19 during pregnancy in sweden norway and denmark |
| topic | intensive care unit register vaccination virus variant |
| url | https://doi.org/10.1111/aogs.14552 |
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