{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T22:35:26Z","timestamp":1762900526978,"version":"3.40.4"},"reference-count":21,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,11,16]],"date-time":"2023-11-16T00:00:00Z","timestamp":1700092800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Data from different countries show partly controversial impact of SARS\u2010CoV\u20102 infection on pregnancy outcomes. A nationwide register\u2010based study was conducted in Estonia to assess the impact of SARS\u2010CoV\u20102 infection at any time during pregnancy on stillbirth, perinatal mortality, Apgar score at 5\u2009minutes, cesarean section rates, rates of preterm birth and preeclampsia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>Data on all newborns and their mothers were obtained from the Estonian Medical Birth Registry, and data on SARS\u2010CoV\u20102 testing dates, test results and vaccination dates against SARS\u2010CoV\u20102 from the Estonian Health Information System. Altogether, 26\u2009211 births in 2020 and 2021 in Estonia were included. All analyses were performed per newborn. Odds ratios with 95% confidence intervals (CI) were analyzed for all outcomes, adjusted for mother's place of residence, body mass index, age of mother at delivery and hypertension and for all the aforementioned variables together with mother's vaccination status using data from 2021 when vaccinations against SARS\u2010CoV\u20102 became available. For studying the effect of a positive SARS\u2010CoV\u20102 test during pregnancy on preeclampsia, hypertension was omitted from the models to avoid overadjustment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>SARS\u2010CoV\u20102 infection during pregnancy was associated with an increased risk of stillbirth (adjusted odds ratio [aOR] 2.81; 95% CI 1.37\u20135.74) and perinatal mortality (aOR 2.34; 95% CI 1.20\u20134.56) but not with a lower Apgar score at 5\u2009minutes, higher risk of cesarean section, preeclampsia or preterm birth. Vaccination slightly decreased the impact of SARS\u2010CoV\u20102 infection during pregnancy on perinatal mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A positive SARS\u2010CoV\u20102 test during pregnancy was associated with higher rates of stillbirth and perinatal mortality in Estonia but was not associated with change in preeclampsia, cesarean section or preterm birth rates.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14721","type":"journal-article","created":{"date-parts":[[2023,11,17]],"date-time":"2023-11-17T08:02:53Z","timestamp":1700208173000},"page":"250-256","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["SARS\u2010CoV\u20102 infection during pregnancy and perinatal outcomes in Estonia in 2020 and 2021: A register\u2010based study"],"prefix":"10.1111","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4769-0008","authenticated-orcid":false,"given":"Piret","family":"Veerus","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics National Institute for Health Development  Tallinn Estonia"},{"name":"West\u2013Tallinn Central Hospital Women's Clinic  Tallinn Estonia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oskar","family":"N\u00f5mm","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics National Institute for Health Development  Tallinn Estonia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaire","family":"Innos","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics National Institute for Health Development  Tallinn Estonia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K\u00e4rt","family":"Allvee","sequence":"additional","affiliation":[{"name":"Estonian Medical Birth Registry National Institute for Health Development  Tallinn Estonia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helle","family":"Karro","sequence":"additional","affiliation":[{"name":"University of Tartu  Tartu Estonia"},{"name":"Tartu University Hospital  Tartu Estonia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,11,16]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.14206"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2022-009495"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2022-010060"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2023.02.022"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2022.2051008"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17315"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.23619"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.14231"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.14329"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.14252"},{"key":"e_1_2_12_12_1","unstructured":"Estonian Medical Birth Registry. Accessed February 25 2023.https:\/\/en.tai.ee\/en\/r\u2010and\u2010d\/registers\/estonian\u2010medical\u2010birth\u2010registry\u2010and\u2010estonian\u2010abortion\u2010registry"},{"key":"e_1_2_12_13_1","unstructured":"International Statistical Classification of Diseases and Related Health Problems 10th Revision. Accessed February 25 2023.https:\/\/icd.who.int\/browse10\/2019\/en"},{"key":"e_1_2_12_14_1","unstructured":"The Estonian National Health Information System. Accessed February 25 2023.https:\/\/e\u2010estonia.com\/solutions\/healthcare\/e\u2010health\u2010records\/"},{"key":"e_1_2_12_15_1","unstructured":"NUTS \u2010 Nomenclature of territorial units for statistics. Accessed February 25 2023.https:\/\/ec.europa.eu\/eurostat\/web\/nuts\/background"},{"volume-title":"Neonatal Encephalopathy and Neurologic Outcome","year":"2014","author":"American College of Obstetrics and Gynecology","key":"e_1_2_12_16_1"},{"volume-title":"Stata Statistical Software: Release 16","year":"2019","author":"StataCorp","key":"e_1_2_12_17_1"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.placenta.2022.07.009"},{"key":"e_1_2_12_19_1","unstructured":"Health Research and Health Statistics Database. Accessed February 25 2023.https:\/\/statistika.tai.ee\/pxweb\/et\/Andmebaas\/Andmebaas__01Rahvastik__04Surmad\/?tablelist=true"},{"issue":"6","key":"e_1_2_12_20_1","first-page":"12","article-title":"Muutused Eesti s\u00fcnnitusabis aastatel 1992\u20132021 \u2010 kahe perioodi v\u00f5rdlus raseduse infos\u00fcsteemi p\u00f5hjal.[Changes in Estonian obstetric care in the years 1992\u20132021 \u2010 comparison of two periods based on the pregnancy information system. Eesti Arst 2022:101(Supplement 6):12\u201320. Article in Estonian.] In Estonian","volume":"101","author":"Karro H","year":"2022","journal-title":"Eesti Arst"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjpo-2022-001686"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpm-2022-0463"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.14721","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,12]],"date-time":"2025-04-12T02:30:08Z","timestamp":1744425008000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.14721"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,16]]},"references-count":21,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1111\/aogs.14721"],"URL":"https:\/\/doi.org\/10.1111\/aogs.14721","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"type":"print","value":"0001-6349"},{"type":"electronic","value":"1600-0412"}],"subject":[],"published":{"date-parts":[[2023,11,16]]},"assertion":[{"value":"2023-06-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}