{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T11:39:58Z","timestamp":1780054798013,"version":"3.54.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2021,12,27]],"date-time":"2021-12-27T00:00:00Z","timestamp":1640563200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100007185","name":"University of California, Los Angeles","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007185","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003921","name":"Australian Government Department of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003921","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Although severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been associated with increased risk of adverse perinatal health outcomes, few large-scale, community-based epidemiological studies have been conducted.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a national cohort study using deidentified administrative claims data for 78\u00a0283 pregnancies with estimated conception before 30 April 2020 and pregnancy end after 11 March 2020. We identified SARS-CoV-2 infections using diagnostic and laboratory testing data, and compared the risk of pregnancy outcomes using Cox proportional hazard models treating coronavirus disease 2019 (COVID-19) as a time-varying exposure and adjusting for baseline covariates.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of the pregnancies, 2655 (3.4%) had a documented SARS-CoV-2 infection. COVID-19 during pregnancy was not associated with risk of miscarriage, antepartum hemorrhage, or stillbirth, but was associated with 2\u20133 fold higher risk of induced abortion (adjusted hazard ratio [aHR], 2.60; 95% confidence interval [CI], 1.17\u20135.78), cesarean delivery (aHR, 1.99; 95% CI, 1.71\u20132.31), clinician-initiated preterm birth (aHR, 2.88; 95% CI, 1.93\u20134.30), spontaneous preterm birth (aHR, 1.79; 95% CI, 1.37\u20132.34), and fetal growth restriction (aHR, 2.04; 95% CI, 1.72\u20132.43).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Prenatal SARS-CoV-2 infection was associated with increased risk of adverse pregnancy outcomes. Prevention could have fetal health benefits.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/infdis\/jiab626","type":"journal-article","created":{"date-parts":[[2021,12,23]],"date-time":"2021-12-23T12:10:06Z","timestamp":1640261406000},"page":"759-767","source":"Crossref","is-referenced-by-count":44,"title":["SARS-CoV-2 Infection During Pregnancy and Associated Perinatal Health Outcomes: A National US Cohort Study"],"prefix":"10.1093","volume":"225","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3879-6193","authenticated-orcid":false,"given":"Annette K","family":"Regan","sequence":"first","affiliation":[{"name":"School of Nursing and Health Professions, University of San Francisco, Orange, California, USA"},{"name":"Fielding School of Public Health, University of California Los Angeles, Los Angeles, California, USA"},{"name":"OptumLabs, Eden Prairie, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Onyebuchi A","family":"Arah","sequence":"additional","affiliation":[{"name":"Fielding School of Public Health, University of California Los Angeles, Los Angeles, California, USA"},{"name":"Department of Statistics, College of Letters and Science, University of California Los Angeles, Los Angeles, California, USA"},{"name":"Department of Public Health, Aarhus University, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deshayne B","family":"Fell","sequence":"additional","affiliation":[{"name":"School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada"},{"name":"Children\u2019s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheena G","family":"Sullivan","sequence":"additional","affiliation":[{"name":"Fielding School of Public Health, University of California Los Angeles, Los Angeles, California, USA"},{"name":"World Health Organization Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, Melbourne, Victoria, Australia"},{"name":"Department of Infectious Diseases, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,12,27]]},"reference":[{"key":"2022030208291407300_CIT0001","doi-asserted-by":"crossref","first-page":"769","DOI":"10.15585\/mmwr.mm6925a1","article-title":"Characteristics of women of reproductive age with laboratory-confirmed SARS-CoV-2 infection by pregnancy status\u2014United States, January 22-June 7, 2020.","volume":"69","author":"Ellington","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2022030208291407300_CIT0002","doi-asserted-by":"crossref","first-page":"1641","DOI":"10.15585\/mmwr.mm6944e3","article-title":"Update: characteristics of symptomatic women of reproductive age with laboratory-confirmed SARS-CoV-2 infection by pregnancy status\u2014United States, January 22-October 3, 2020.","volume":"69","author":"Zambrano","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2022030208291407300_CIT0003","doi-asserted-by":"crossref","first-page":"e100","DOI":"10.1056\/NEJMc2009226","article-title":"Clinical characteristics of pregnant women with Covid-19 in Wuhan, China.","volume":"382","author":"Chen","year":"2020","journal-title":"N Engl J Med"},{"key":"2022030208291407300_CIT0004","doi-asserted-by":"crossref","first-page":"m3320","DOI":"10.1136\/bmj.m3320","article-title":"Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis.","volume":"370","author":"Allotey","year":"2020","journal-title":"BMJ"},{"key":"2022030208291407300_CIT0005","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1001\/jamainternmed.2020.9241","article-title":"Clinical characteristics and outcomes of hospitalized women giving birth with and without COVID-19.","volume":"181","author":"Jering","year":"2021","journal-title":"JAMA Intern Med"},{"key":"2022030208291407300_CIT0006","first-page":"n615","article-title":"Update to living systematic review on covid-19 in pregnancy.","volume":"372","year":"2021","journal-title":"BMJ"},{"key":"2022030208291407300_CIT0007","doi-asserted-by":"crossref","first-page":"1611","DOI":"10.1111\/aogs.14160","article-title":"COVID-19 in pregnancy\u2014characteristics and outcomes of pregnant women admitted to hospital because of SARS-CoV-2 infection in the Nordic countries.","volume":"100","author":"Engjom","year":"2021","journal-title":"Acta Obstet Gynecol Scand"},{"key":"2022030208291407300_CIT0008","doi-asserted-by":"crossref","first-page":"e2029256","DOI":"10.1001\/jamanetworkopen.2020.29256","article-title":"Pregnancy outcomes among women with and without severe acute respiratory syndrome coronavirus 2 infection.","volume":"3","author":"Adhikari","year":"2020","journal-title":"JAMA Netw Open"},{"key":"2022030208291407300_CIT0009","doi-asserted-by":"crossref","first-page":"m2107","DOI":"10.1136\/bmj.m2107","article-title":"Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: national population based cohort study.","volume":"369","author":"Knight","year":"2020","journal-title":"BMJ"},{"key":"2022030208291407300_CIT0010","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1093\/ije\/dyaa252","article-title":"Educational note: addressing special cases of bias that frequently occur in perinatal epidemiology.","volume":"50","author":"Neophytou","year":"2021","journal-title":"Int J Epidemiol"},{"key":"2022030208291407300_CIT0011","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1093\/ije\/dyu249","article-title":"Bias from conditioning on live birth in pregnancy cohorts: an illustration based on neurodevelopment in children after prenatal exposure to organic pollutants.","volume":"44","author":"Liew","year":"2015","journal-title":"Int J Epidemiol"},{"key":"2022030208291407300_CIT0012","volume-title":"OptumLabs and OptumLabs data warehouse (OLDW) descriptions and citation","author":"OptumLabs.","year":"2020"},{"key":"2022030208291407300_CIT0013","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1002\/bdra.23573","article-title":"Using insurance claims data to identify and estimate critical periods in pregnancy: An application to antidepressants.","volume":"106","author":"Ailes","year":"2016","journal-title":"Birth Defects Res A Clin Mol 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Maternal mortality rates in the United States, 2019","author":"Hoyert","year":"2021"},{"key":"2022030208291407300_CIT0034","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1002\/ijgo.13804","article-title":"Mortality in pregnancy and the postpartum period in women with severe acute respiratory distress syndrome related to COVID-19 in Brazil, 2020.","volume":"155","author":"Scheler","year":"2021","journal-title":"Int J Gynaecol Obstet"},{"key":"2022030208291407300_CIT0035","doi-asserted-by":"crossref","first-page":"e759","DOI":"10.1016\/S2214-109X(21)00079-6","article-title":"Effects of the COVID-19 pandemic on maternal and perinatal outcomes: a systematic review and meta-analysis.","volume":"9","author":"Chmielewska","year":"2021","journal-title":"Lancet Glob Health"},{"key":"2022030208291407300_CIT0036","doi-asserted-by":"crossref","first-page":"1355","DOI":"10.15585\/mmwr.mm6938e2","article-title":"SARS-CoV-2 infection among hospitalized pregnant women: reasons for admission and pregnancy characteristics\u2014eight U.S. health care centers, March 1-May 30, 2020.","volume":"69","author":"Panagiotakopoulos","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"}],"container-title":["The Journal of Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jid\/advance-article-pdf\/doi\/10.1093\/infdis\/jiab626\/42553051\/jiab626.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jid\/article-pdf\/225\/5\/759\/42660344\/jiab626.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jid\/article-pdf\/225\/5\/759\/42660344\/jiab626.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,2]],"date-time":"2022-03-02T08:29:40Z","timestamp":1646209780000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jid\/article\/225\/5\/759\/6484616"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,27]]},"references-count":36,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,12,27]]},"published-print":{"date-parts":[[2022,3,2]]}},"URL":"https:\/\/doi.org\/10.1093\/infdis\/jiab626","relation":{},"ISSN":["0022-1899","1537-6613"],"issn-type":[{"value":"0022-1899","type":"print"},{"value":"1537-6613","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,3,1]]},"published":{"date-parts":[[2021,12,27]]}}}