{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T19:08:34Z","timestamp":1792004914425,"version":"4.4.0"},"reference-count":18,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,11,18]],"date-time":"2021-11-18T00:00:00Z","timestamp":1637193600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007687","name":"Svenska L\u00e4kares\u00e4llskapet","doi-asserted-by":"publisher","award":["2020\u2010937944"],"award-info":[{"award-number":["2020\u2010937944"]}],"id":[{"id":"10.13039\/501100007687","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004785","name":"NordForsk","doi-asserted-by":"publisher","award":["105545"],"award-info":[{"award-number":["105545"]}],"id":[{"id":"10.13039\/501100004785","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004047","name":"Karolinska Institutet","doi-asserted-by":"publisher","award":["ALF 2020\u20100443"],"award-info":[{"award-number":["ALF 2020\u20100443"]}],"id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006128","name":"Svenska Frimurarorden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006128","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess associations of severe acute respiratory syndrome coronavirus 2 (SARS\u2010CoV\u20102) infection and pregnancy outcomes considering testing policy and test\u2010positivity\u2010to\u2010delivery interval.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Nationwide cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Sweden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>From the Pregnancy\u2010Register we identified 88\u2009593 singleton births, 11 March 2020\u201331 January 2021, linked to data on SARS\u2010CoV\u20102\u2010positivity from the Public Health Agency, and information on neonatal care admission from the Neonatal Quality Register. Adjusted odds ratios (aORs) were estimated stratified by testing\u2010policy and test\u2010positivity\u2010to\u2010delivery interval.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Five\u2010minute Apgar score, neonatal care admission, stillbirth and preterm birth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During pregnancy, SARS\u2010CoV\u20102 test\u2010positivity was 5.4% (794\/14\u2009665) under universal testing and 1.9% (1402\/73\u2009928) under non\u2010universal testing. There were generally lower risks associated with SARS\u2010CoV\u20102 under universal than non\u2010universal testing. In women testing positive &gt;10\u2009days from delivery, generally no significant differences in risk were observed under either testing policy. Neonatal care admission was more common (15.3% versus 8.0%; aOR 2.24, 95% CI 1.62\u20133.11) in women testing positive \u226410\u2009days before delivery under universal testing. There was no significant association with 5\u2010minute Apgar score below 7 (1.0% versus 1.7%; aOR 0.64, 95% CI 0.24\u20131.72) or stillbirth (0.3% versus 0.4%; aOR 0.72, 95% CI 0.10\u20135.20). Compared with term births (2.1%), test\u2010positivity was higher in medically indicated preterm birth (5.7%; aOR 2.70, 95% CI 1.60\u20134.58) but not significantly increased in spontaneous preterm birth (2.3%; aOR 1.12, 95% CI 0.62\u20132.02).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Testing policy and timing of test\u2010positivity impact associations between SARS\u2010CoV\u20102\u2010positivity and pregnancy outcomes. Under non\u2010universal testing, women with complications near delivery are more likely to be tested than women without complications, thereby inflating any association with adverse pregnancy outcomes compared with findings under universal testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Tweetable abstract<\/jats:title>\n                    <jats:p>Testing policy and time from SARS\u2010CoV\u20102 infection to delivery influence the association with pregnancy outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.16990","type":"journal-article","created":{"date-parts":[[2021,10,27]],"date-time":"2021-10-27T12:24:57Z","timestamp":1635337497000},"page":"282-290","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["SARS\u2010CoV\u20102 and pregnancy outcomes under universal and non\u2010universal testing in Sweden: register\u2010based nationwide cohort study"],"prefix":"10.1111","volume":"129","author":[{"given":"O","family":"Stephansson","sequence":"first","affiliation":[{"name":"The Clinical Epidemiology Division Department of Medicine, Solna Karolinska Institutet Stockholm Sweden"},{"name":"Department of Women's Health Karolinska University Hospital Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Pasternak","sequence":"additional","affiliation":[{"name":"The Clinical Epidemiology Division Department of Medicine, Solna Karolinska Institutet Stockholm Sweden"},{"name":"Statens Serum Institut Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Ahlberg","sequence":"additional","affiliation":[{"name":"The Clinical Epidemiology Division Department of Medicine, Solna Karolinska Institutet Stockholm Sweden"},{"name":"Department of Women's Health Karolinska University Hospital Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Hervius Askling","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine, Solna Karolinska Institutet Stockholm Sweden"},{"name":"Department of Infectious Diseases Karolinska University Hospital Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Aronsson","sequence":"additional","affiliation":[{"name":"The Public Health Agency of Sweden Solna Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Appelqvist","sequence":"additional","affiliation":[{"name":"The Public Health Agency of Sweden Solna Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Jonsson","sequence":"additional","affiliation":[{"name":"The Public Health Agency of Sweden Solna Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V","family":"Sengpiel","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Sahlgrenska University Hospital Gothenburg Sweden"},{"name":"Department of Obstetrics and Gynecology Sahlgrenska Academy University of Gothenburg Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"S\u00f6derling","sequence":"additional","affiliation":[{"name":"The Clinical Epidemiology Division Department of Medicine, Solna Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Norman","sequence":"additional","affiliation":[{"name":"Department of Clinical Science, Intervention and Technology Karolinska Institutet Stockholm Sweden"},{"name":"Department of Neonatal Medicine Karolinska University Hospital Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JF","family":"Ludvigsson","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden"},{"name":"Department of Paediatrics \u00d6rebro University Hospital \u00d6rebro Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Neovius","sequence":"additional","affiliation":[{"name":"The Clinical Epidemiology Division Department of Medicine, Solna Karolinska Institutet Stockholm 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An International Journal of Obstetrics &amp; 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