{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T19:08:33Z","timestamp":1792004913861,"version":"4.4.0"},"reference-count":33,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,11,20]],"date-time":"2021-11-20T00:00:00Z","timestamp":1637366400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The primary aim of this article was to describe SARS\u2010CoV\u20102 infection among pregnant women during the wild\u2010type and Alpha\u2010variant periods in Italy. The secondary aim was to compare the impact of the virus variants on the severity of maternal and perinatal outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>National population\u2010based prospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>A total of 315 Italian maternity hospitals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Sample<\/jats:title><jats:p>A cohort of 3306 women with SARS\u2010CoV\u20102 infection confirmed within 7\u2009days of hospital admission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cases were prospectively reported by trained clinicians for each participating maternity unit. Data were described by univariate and multivariate analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>COVID\u201019 pneumonia, ventilatory support, intensive care unit (ICU) admission, mode of delivery, preterm birth, stillbirth, and maternal and neonatal mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found that 64.3% of the cohort was asymptomatic, 12.8% developed COVID\u201019 pneumonia and 3.3% required ventilatory support and\/or ICU admission. Maternal age of 30\u201334\u2009years (OR\u20091.43, 95%\u2009CI 1.09\u20131.87) and \u226535\u2009years (OR\u20091.62, 95%\u2009CI 1.23\u20132.13), citizenship of countries with high migration pressure (OR\u20091.75, 95%\u2009CI 1.36\u20132.25), previous comorbidities (OR\u20091.49, 95%\u2009CI 1.13\u20131.98) and obesity (OR\u20091.72, 95%\u2009CI 1.29\u20132.27) were all associated with a higher occurrence of pneumonia. The preterm birth rate was 11.1%. In comparison with the pre\u2010pandemic period, stillbirths and maternal and neonatal deaths remained stable. The need for ventilatory support and\/or ICU admission among women with pneumonia increased during the Alpha\u2010variant period compared with the wild\u2010type period (OR\u20093.24, 95%\u2009CI 1.99\u20135.28).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our results are consistent with a low risk of severe COVID\u201019 disease among pregnant women and with rare adverse perinatal outcomes. During the Alpha\u2010variant period there was a significant increase of severe COVID\u201019 illness. Further research is needed to describe the impact of different SARS\u2010CoV\u20102 viral strains on maternal and perinatal outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.16980","type":"journal-article","created":{"date-parts":[[2021,10,23]],"date-time":"2021-10-23T18:33:57Z","timestamp":1635014037000},"page":"221-231","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":63,"title":["SARS\u2010CoV\u20102 infection among hospitalised pregnant women and impact of different viral strains on COVID\u201019 severity in Italy: a national prospective population\u2010based cohort study"],"prefix":"10.1111","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4607-2072","authenticated-orcid":false,"given":"S","family":"Donati","sequence":"first","affiliation":[{"name":"National Centre for Disease Prevention and Health Promotion Istituto Superiore di Sanit\u00e0 \u2013 Italian National Institute of Health Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1337-2666","authenticated-orcid":false,"given":"E","family":"Corsi","sequence":"additional","affiliation":[{"name":"National Centre for Disease Prevention and Health Promotion Istituto Superiore di Sanit\u00e0 \u2013 Italian National Institute of Health Rome Italy"},{"name":"Department of Biomedicine and Prevention University of Rome Tor Vergata Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4754-5385","authenticated-orcid":false,"given":"A","family":"Maraschini","sequence":"additional","affiliation":[{"name":"Servizio tecnico scientifico di statistica Istituto Superiore di Sanit\u00e0 \u2013 Italian National Institute of Health Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MA","family":"Salvatore","sequence":"additional","affiliation":[{"name":"National Centre for Disease Prevention and Health Promotion Istituto Superiore di Sanit\u00e0 \u2013 Italian National Institute of Health Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the ItOSS\u2010COVID\u201019 Working Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,11,20]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2021.26.16.2100348"},{"key":"e_1_2_6_3_1","unstructured":"Istituto Superiore di Sanit\u00e0 Fondazione Bruno Kessler e Ministero della Salute. Prevalenza delle varianti VOC (Variant Of Concern) in Italia: lineage B.1.1.7 P.1 P.2 lineage B.1.351 lineage B.1.525 (Indagine del 18\/2\/2021) [Presence of Variant Of concern in Italy: lineage B.1.1.7 P.1 P.2 lineage B.1.351 lineage B.1.525 Survey of 18\/02\/2021]. [Italian] [https:\/\/www.epicentro.iss.it\/coronavirus\/pdf\/sars\u2010cov\u20102\u2010monitoraggio\u2010varianti\u2010indagini\u2010rapide\u201018\u2010marzo\u20102021.pdf]. Accessed 29 September 2021."},{"key":"e_1_2_6_4_1","unstructured":"Istituto Superiore di Sanit\u00e0 Fondazione Bruno Kessler e Ministero della Salute. Prevalenza delle varianti VOC (Variant Of Concern) in Italia: lineage B.1.1.7 P.1 P.2 lineage B.1.351 lineage B.1.525 (Indagine del 18\/3\/2021) [Presence of Variant Of concern in Italy: lineage B.1.1.7 P.1 P.2 lineage B.1.351 lineage B.1.525 Survey of 18\/03\/2021]. [Italian] [https:\/\/www.epicentro.iss.it\/coronavirus\/pdf\/sars\u2010cov\u20102\u2010monitoraggio\u2010varianti\u2010indagini\u2010rapide\u201018\u2010marzo\u20102021.pdf]. Accessed 29 September 2021."},{"key":"e_1_2_6_5_1","unstructured":"Istituto Superiore di Sanit\u00e0 Fondazione Bruno Kessler e Ministero della Salute. Prevalenza delle varianti VOC (Variant Of Concern) in Italia: lineage B.1.1.7 P.1 P.2 lineage B.1.351 lineage B.1.525 (Indagine del 22\/6\/2021) [Presence of Variant Of concern in Italy: lineage B.1.1.7 P.1 P.2 lineage B.1.351 lineage B.1.525 Survey of 22\/06\/2021]. [Italian] [https:\/\/www.epicentro.iss.it\/coronavirus\/pdf\/sars\u2010cov\u20102\u2010monitoraggio\u2010varianti\u2010indagini\u2010rapide\u201018\u2010marzo\u20102021.pdf]. 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La presenza straniera in Italia: caratteristiche socio\u2010demografiche \u2013 Permessi di soggiorno al 1\u00b0 gennaio degli anni 2001 2002 2003 [The foreign population living in Italy: socio\u2010demographic characteristics \u2013 years 2001 2002 2003]. [Italian] [http:\/\/www.cestim.it\/sezioni\/dati_statistici\/italia\/Istat\/2004\u201006%20permessi%20soggiorno%20Italia%202001%202003.pdf]. Accessed 4 August 2021."},{"key":"e_1_2_6_17_1","unstructured":"Directorate\u2010general of digitalization of health informative system and of statistics Italian Ministry of Health. Certificato di assistenza al parto (CeDAP). Analisi dell\u2019evento nascita \u2013 2019 [Birth Registry \u2013 Year 2019]. [Italian] [http:\/\/www.salute.gov.it\/imgs\/C_17_pubblicazioni_3076_allegato.pdf]. Accessed 4 August 2021."},{"key":"e_1_2_6_18_1","unstructured":"Istituto Nazionale di Statistica (ISTAT). La dinamica demografica durante la pandemia COVID\u201019 \u2013 Anno 2020 [The demographic dynamic during the COVID\u201019 pandemic \u2013 Year 2020]. [Italian] [https:\/\/www.istat.it\/it\/files\/2021\/03\/REPORT\u2010IMPATTO\u2010COVIDDEMOGRAFIA_2020.pdf]. Accessed 4 August 2021."},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.4067"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/9780470316696"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2020.25.49.2000790"},{"key":"e_1_2_6_22_1","unstructured":"EpiCentro \u2013 Epidemiology for Public Health \u2013 Istituto Superiore di Sanit\u00e0 (ISS) \u2013 Italian National Institute of Health. The Italian Obstetric Surveillance System (ItOSS). Maternal Mortality Surveillance [https:\/\/www.epicentro.iss.it\/en\/itoss\/maternal\u2010mortality\u2010surveillance]. 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