{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:48:17Z","timestamp":1760057297500,"version":"build-2065373602"},"reference-count":65,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T00:00:00Z","timestamp":1738281600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Carlos Chagas Foundation for the Advancement of Science of the State of Rio de Janeiro","award":["E-26\/200.935\/2022","E-26\/010.146\/2020","311562\/2021-3","409108\/2022-7","866410","MR\/V033530\/1","101016167","101137283"],"award-info":[{"award-number":["E-26\/200.935\/2022","E-26\/010.146\/2020","311562\/2021-3","409108\/2022-7","866410","MR\/V033530\/1","101016167","101137283"]}]},{"DOI":"10.13039\/501100003593","name":"National Council for Scientific and Technological Development","doi-asserted-by":"publisher","award":["E-26\/200.935\/2022","E-26\/010.146\/2020","311562\/2021-3","409108\/2022-7","866410","MR\/V033530\/1","101016167","101137283"],"award-info":[{"award-number":["E-26\/200.935\/2022","E-26\/010.146\/2020","311562\/2021-3","409108\/2022-7","866410","MR\/V033530\/1","101016167","101137283"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000893","name":"Simons Foundation Autism Research Initiative","doi-asserted-by":"publisher","award":["E-26\/200.935\/2022","E-26\/010.146\/2020","311562\/2021-3","409108\/2022-7","866410","MR\/V033530\/1","101016167","101137283"],"award-info":[{"award-number":["E-26\/200.935\/2022","E-26\/010.146\/2020","311562\/2021-3","409108\/2022-7","866410","MR\/V033530\/1","101016167","101137283"]}],"id":[{"id":"10.13039\/100000893","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"UK Medical Research Council","doi-asserted-by":"publisher","award":["E-26\/200.935\/2022","E-26\/010.146\/2020","311562\/2021-3","409108\/2022-7","866410","MR\/V033530\/1","101016167","101137283"],"award-info":[{"award-number":["E-26\/200.935\/2022","E-26\/010.146\/2020","311562\/2021-3","409108\/2022-7","866410","MR\/V033530\/1","101016167","101137283"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000780","name":"Orchestra","doi-asserted-by":"publisher","award":["E-26\/200.935\/2022","E-26\/010.146\/2020","311562\/2021-3","409108\/2022-7","866410","MR\/V033530\/1","101016167","101137283"],"award-info":[{"award-number":["E-26\/200.935\/2022","E-26\/010.146\/2020","311562\/2021-3","409108\/2022-7","866410","MR\/V033530\/1","101016167","101137283"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000780","name":"Contagio","doi-asserted-by":"publisher","award":["E-26\/200.935\/2022","E-26\/010.146\/2020","311562\/2021-3","409108\/2022-7","866410","MR\/V033530\/1","101016167","101137283"],"award-info":[{"award-number":["E-26\/200.935\/2022","E-26\/010.146\/2020","311562\/2021-3","409108\/2022-7","866410","MR\/V033530\/1","101016167","101137283"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Understanding perinatal health outcomes following SARS-CoV-2 infection during pregnancy necessitates large-scale studies of mother-infant dyads. Hospital-based studies of pregnant women and their neonates provide valuable insights within the field of perinatal health research. The aim of this study was to evaluate the effect of SARS-CoV-2 infection on maternal and perinatal outcomes among hospitalized pregnant women in Rio de Janeiro during the COVID-19 pandemic. Methods: The study consisted of a time-to-event analysis of a hospital-based cohort of 1185 pregnant women \u2265 16 years and their infants from May 2020 to March 2022. Pregnant women were classified as infected if they had a SARS CoV-2 positive RT-PCR or a positive rapid antigen test. An exploratory analysis of qualitative variables was conducted with calculation of absolute and relative frequencies and calculation of 95% confidence intervals. Survival functions were estimated by the Kaplan\u2013Meier method, and the Cox proportional hazards model was employed to interpret the effects of SARS-CoV-2 infection on time to adverse maternal and perinatal outcomes, adjusted for vaccination, comorbidity, and gestational trimester. Results: A total of 21% (249\/1185) women were infected with SARS-CoV-2, with a median age of 26 (range: 16\u201347). Cesarean section deliveries were performed in 57% (135\/237) SARS CoV-2+ participants vs. 43% (391\/914) of uninfected participants, p &lt; 0.001. Intensive care unit admission and\/or death occurred in 68 of 1185 participants (5.7%), 44 of 249 participants (17.7%) infected with SARS CoV-2 vs. 24 of 936 uninfected participants (2.5%). All 21 participants who died were unvaccinated against COVID-19. Women infected with SARS-CoV-2 were at greater risk of adverse maternal outcomes (crude HR: 5.93, 95% CI: 3.58\u20139.84; adjusted HR: 5.47, 95% CI: 3.16\u20139.48) than uninfected pregnant women. SARS CoV-2 vertical transmission was observed in 6 of 169 (3.6%) tested neonates. Preterm deliveries occurred more frequently in patients testing positive for SARS-CoV-2 (30.7% vs. 23.6). In the survival analysis, no effect of SARS-CoV-2 infection was observed on prematurity (HR: 0.92, 95% CI: 0.68\u20131.23) and adverse perinatal outcomes, including fetal distress (HR: 1.29, 95% CI: 0.82\u20132.05), stillbirth (HR: 1.07, 95% CI: 0.48\u20132.38), and neonatal death (HR: 0.96, 95% CI: 0.35\u20132.67), even after adjusting for vaccination, comorbidity, gestational trimester, and periods of time. Conclusion: The risk of maternal death due to COVID-19 highlights the need for adequate preventive measures, particularly vaccination, during the prenatal and postpartum periods.<\/jats:p>","DOI":"10.3390\/v17020207","type":"journal-article","created":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T05:08:26Z","timestamp":1738300106000},"page":"207","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["SARS-CoV-2 Infection and Adverse Maternal and Perinatal Outcomes: Time-to-Event Analysis of a Hospital-Based Cohort Study of Pregnant Women in Rio de Janeiro, Brazil"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1714-2737","authenticated-orcid":false,"given":"Michelle","family":"Brendolin","sequence":"first","affiliation":[{"name":"Maternity Department, Ad\u00e3o Pereira Nunes Hospital, Duque de Caxias 25.211-970, Brazil"},{"name":"Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, Rio de Janeiro 21.040-360, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9380-3387","authenticated-orcid":false,"given":"Mayumi Duarte","family":"Wakimoto","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, Rio de Janeiro 21.040-360, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9387-8645","authenticated-orcid":false,"given":"Raquel de Vasconcellos Carvalhaes","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, Rio de Janeiro 21.040-360, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Larissa Rangel","family":"Mageste","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, Rio de Janeiro 21.040-360, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1742-5211","authenticated-orcid":false,"given":"Karin","family":"Nielsen-Saines","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases Division, David Geffen School of Medicine, University of California, Los Angeles, CA 90024, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9555-7976","authenticated-orcid":false,"given":"Patricia","family":"Brasil","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, Rio de Janeiro 21.040-360, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1016\/j.ajog.2020.02.017","article-title":"Coronavirus Disease 2019 (COVID-19) and pregnancy: What obstetricians need to know","volume":"222","author":"Rasmussen","year":"2020","journal-title":"Am. 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