{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T15:52:43Z","timestamp":1764690763835,"version":"3.46.0"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T00:00:00Z","timestamp":1735776000000},"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":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There are no published Australian population\u2010based data on serious COVID\u201019\u2010associated maternal morbidity before and after widespread vaccination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To compare COVID\u201019 infection rates, intensive care unit (ICU) admissions, and length of stay in hospitalised pregnant patients before and after achieving 70% state\u2010wide maternal COVID\u201019 vaccination coverage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>\n                      Population\u2010based retrospective cohort study involving all hospital\u2010admitted episodes for pregnant patients over 15\u2010years\u2010old with COVID\u201019 in Victoria from 1 March 2020 to 31 March 2022. Phase 1 was defined as March 2020\u2014October 2021 when maternal vaccination coverage &lt;\u200970%; Phase 2 was defined as November 2021\u2013March 2022 when maternal vaccination coverage \u2265\u200970%. Primary outcomes include COVID\u201019 rates, ICU admission rates, and length of stay. A\n                      <jats:italic>p<\/jats:italic>\n                      \u2010value of &lt;\u20090.05 was considered statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We analysed 215,363 hospital admissions, among which 2,128 (0.99%) had COVID\u201019. The percentage of admitted pregnant patients with COVID\u201019 was higher in Phase 2 than Phase 1 (3.27% vs. 0.41% respectively,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). However, Phase 2 was associated with lower maternal ICU admission rates (2.02% vs. 5.39%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and lower median length of stay (2.19 vs. 3.11\u2009days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) compared with Phase 1. The risk of COVID\u201019 was significantly lower in socioeconomically advantaged pregnant patients (aRR\u2009=\u20090.83 [95% CI, 0.76\u20130.90],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and pregnant patients \u2265\u200930\u2010years\u2010old (aRR\u2009=\u20090.81 [95% CI, 0.74\u20130.88],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Maternal ICU admission risk and length of stay were significantly lower among pregnant patients with COVID\u201019 during Phase 2, which is likely due to the combined effects of high maternal COVID\u201019 vaccination coverage and changes in SARS\u2010CoV\u20102 variants.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ajo.13931","type":"journal-article","created":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T07:01:23Z","timestamp":1735801283000},"page":"462-468","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association Between\n                    <scp>COVID<\/scp>\n                    \u201019 Pandemic Phases and the Risk of Maternal Intensive Care Unit Admission: A Retrospective Analysis of 215,363 Victorian Hospital Admissions"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-9763-2658","authenticated-orcid":false,"given":"Michele","family":"Barrese","sequence":"first","affiliation":[{"name":"Melbourne Medical School The University of Melbourne  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2696-7335","authenticated-orcid":false,"given":"Melvin B.","family":"Marzan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynaecology and Newborn Health, Melbourne Medical School The University of Melbourne  Melbourne Victoria Australia"},{"name":"Centre for Alcohol Policy Research (CAPR) La Trobe University  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9720-3562","authenticated-orcid":false,"given":"Lisa","family":"Hui","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynaecology and Newborn Health, Melbourne Medical School The University of Melbourne  Melbourne Victoria Australia"},{"name":"Department of Obstetrics and Gynaecology The Northern Hospital, Northern Health  Melbourne Victoria Australia"},{"name":"Reproductive Epidemiology Group Murdoch Children's Research Institute  Melbourne Victoria Australia"},{"name":"Department of Perinatal Medicine Mercy Hospital for Women, Mercy Health  Melbourne 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