{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T01:54:17Z","timestamp":1780624457088,"version":"3.54.1"},"reference-count":36,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T00:00:00Z","timestamp":1692316800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100013120","name":"European Medicines Agency","doi-asserted-by":"publisher","award":["EMA\/2018\/28\/PE"],"award-info":[{"award-number":["EMA\/2018\/28\/PE"]}],"id":[{"id":"10.13039\/501100013120","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010135","name":"Finska L\u00e4kares\u00e4llskapet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010135","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002001","name":"Health Services and Delivery Research Programme","doi-asserted-by":"publisher","award":["11\/46\/12"],"award-info":[{"award-number":["11\/46\/12"]}],"id":[{"id":"10.13039\/501100002001","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008376","name":"Helsingin ja Uudenmaan Sairaanhoitopiiri","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008376","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The majority of data on COVID\u201019 in pregnancy are not from sound population\u2010based active surveillance systems.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>We conducted a multi\u2010national study of population\u2010based national or regional prospective cohorts using standardized definitions within the International Network of Obstetric Survey systems (INOSS). From a source population of women giving birth between March 1 and August 31, 2020, we included pregnant women admitted to hospital with a positive SARS\u2010CoV\u20102 PCR test \u22647\u2009days prior to or during admission and up to 2\u2009days after birth. The admissions were further categorized as COVID\u201019\u2010related or non\u2010COVID\u201019\u2010related. The primary outcome of interest was incidence of COVID\u201019\u2010related hospital admission. Secondary outcomes included severe maternal disease (ICU admission and mechanical ventilation) and COVID\u201019\u2010directed medical treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In a source population of 816\u2009628 maternities, a total of 2338 pregnant women were admitted with SARS\u2010CoV\u20102; among them 940 (40%) were COVID\u201019\u2010related admissions. The pooled incidence estimate for COVID\u201019\u2010related admission was 0.59 (95%\u2009confidence interval 0.27\u20131.02) per 1000 maternities, with notable heterogeneity across countries (<jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200997.3%, <jats:italic>P<\/jats:italic>\u2009=\u20090.00). In the COVID\u201019 admission group, between 8% and 17% of the women were admitted to intensive care, and 5%\u201313% needed mechanical ventilation. Thromboprophylaxis was the most frequent treatment given during COVID\u201019\u2010related admission (range 14%\u201355%). Among 908 infants born to women in the COVID\u201019\u2010related admission group, 5 (0.6%) stillbirths were reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>During the initial months of the pandemic, we found substantial variations in incidence of COVID\u201019\u2010related admissions in nine European countries. Few pregnant women received COVID\u201019\u2010directed medical treatment. Several barriers to rapid surveillance were identified. Investment in robust surveillance should be prioritized to prepare for future pandemics.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14643","type":"journal-article","created":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T20:44:21Z","timestamp":1692650661000},"page":"1521-1530","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Variations across Europe in hospitalization and management of pregnant women with <scp>SARS\u2010CoV<\/scp>\u20102 during the initial phase of the pandemic: Multi\u2010national population\u2010based cohort study using the International Network of Obstetric Survey Systems (<scp>INOSS<\/scp>)"],"prefix":"10.1111","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6295-3411","authenticated-orcid":false,"given":"Odette","family":"de Bruin","sequence":"first","affiliation":[{"name":"Department of Obstetrics, Birth Center Wilhelmina Children's Hospital, Division Woman and Baby University Medical Center Utrecht  Utrecht the Netherlands"},{"name":"Department of Biostatistics and Research Support, Julius Center for Health Sciences and Primary Care University Medical Center Utrecht  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1582-4283","authenticated-orcid":false,"given":"Hilde","family":"Engjom","sequence":"additional","affiliation":[{"name":"Division of Mental and Physical Health Norwegian Institute of Public Health  Bergen Norway"},{"name":"Department of Obstetrics and Gynecology Haukeland University Hospital  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Vousden","sequence":"additional","affiliation":[{"name":"National Perinatal Epidemiology Unit, Nuffield Department of Population Health University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rema","family":"Ramakrishnan","sequence":"additional","affiliation":[{"name":"National Perinatal Epidemiology Unit, Nuffield Department of Population Health University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4754-506X","authenticated-orcid":false,"given":"Anna J. M.","family":"Aabakke","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Copenhagen University Hospital\u2010Holb\u00e6k  Holb\u00e6k Denmark"},{"name":"Department of Obstetrics and Gynecology Copenhagen University Hospital\u2010Nordsj\u00e6lland\u2010Hiller\u00f8d  Hiller\u00f8d Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2423-611X","authenticated-orcid":false,"given":"Outi","family":"\u00c4yr\u00e4s","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Helsinki University Hospital and University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4607-2072","authenticated-orcid":false,"given":"Serena","family":"Donati","sequence":"additional","affiliation":[{"name":"National Center for Disease Prevention and Health Promotion Istituto Superiore di Sanit\u00e0 \u2013 Italian National Institute of Health  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"J\u00f3nasd\u00f3ttir","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Landspitali University Hospital  Reykjavik Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1984-4575","authenticated-orcid":false,"given":"Marian","family":"Knight","sequence":"additional","affiliation":[{"name":"National Perinatal Epidemiology Unit, Nuffield Department of Population Health University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6454-4531","authenticated-orcid":false,"given":"Evelien M.","family":"Overtoom","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Birth Center Wilhelmina Children's Hospital, Division Woman and Baby University Medical Center Utrecht  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele A.","family":"Salvatore","sequence":"additional","affiliation":[{"name":"National Center for Disease Prevention and Health Promotion Istituto Superiore di Sanit\u00e0 \u2013 Italian National Institute of Health  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam C. 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M.","family":"Sturkenboom","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Research Support, Julius Center for Health Sciences and Primary Care University Medical Center Utrecht  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1947-679X","authenticated-orcid":false,"given":"Teresia","family":"Svanvik","sequence":"additional","affiliation":[{"name":"Region V\u00e4stra G\u00f6taland, Sahlgrenska University Hospital Department of Obstetrics and Gynecology  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reetta","family":"Varpula","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Helsinki University Hospital and University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"An","family":"Vercoutere","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, CUB H\u00f4pital Erasme H\u00f4pital Universitaire de Bruxelles (H.U.B.), Universit\u00e9 Libre de Bruxelles (ULB)  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1377-4625","authenticated-orcid":false,"given":"Kitty W. 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