Severe acute respiratory syndrome coronavirus 2 infection and pregnancy in Sub-Saharan Africa : a 6-country retrospective cohort analysis

dc.contributor.authorNachega, Jean B.
dc.contributor.authorSam-Agudu, Nadia A.
dc.contributor.authorMachekano, Rhoderick N.
dc.contributor.authorRosenthal, Philip J.
dc.contributor.authorSchell, Sonja
dc.contributor.authorDe Waard, Liesl
dc.contributor.authorBekker, Adrie
dc.contributor.authorGachuno, Onesmus W.
dc.contributor.authorKinuthia, John
dc.contributor.authorMwongeli, Nancy
dc.contributor.authorBudhram, Samantha
dc.contributor.authorVannevel, Valerie
dc.contributor.authorSoma-Pillay, Priya
dc.contributor.authorProzesky, Hans W.
dc.contributor.authorTaljaard, Jantjie
dc.contributor.authorParker, Arifa
dc.contributor.authorAgyare, Elizabeth
dc.contributor.authorOpoku, Akwasi Baafuor
dc.contributor.authorMakarfi, Aminatu Umar
dc.contributor.authorAbdullahi, Asara M.
dc.contributor.authorAdirieje, Chibueze
dc.contributor.authorIshoso, Daniel Katuashi
dc.contributor.authorPipo, Michel Tshiasuma
dc.contributor.authorTshilanda, Marc B.
dc.contributor.authorNswe, Christian Bongo-Pasi
dc.contributor.authorDitekemena, John
dc.contributor.authorSigwadhi, Lovemore Nyasha
dc.contributor.authorNyasulu, Peter S.
dc.contributor.authorHermans, Michel P.
dc.contributor.authorSekikubo, Musa
dc.contributor.authorMusoke, Philippa
dc.contributor.authorNsereko, Christopher
dc.contributor.authorAgbeno, Evans K.
dc.contributor.authorYeboah, Michael Yaw
dc.contributor.authorUmar, Lawal W.
dc.contributor.authorNtakwinja, Mukanire
dc.contributor.authorMukwege, Denis M.
dc.contributor.authorBirindwa, Etienne Kajibwami
dc.contributor.authorMushamuka, Serge Zigabe
dc.contributor.authorSmith, Emily R.
dc.contributor.authorMills, Edward J.
dc.contributor.authorOtshudiema, John Otokoye
dc.contributor.authorMbala-Kingebeni, Placide
dc.contributor.authorTamfum, Jean-Jacques Muyembe
dc.contributor.authorZumla, Alimuddin
dc.contributor.authorTsegaye, Aster
dc.contributor.authorMteta, Alfred
dc.contributor.authorSewankambo, Nelson K.
dc.contributor.authorSuleman, Fatima
dc.contributor.authorAdejumo, Prisca
dc.contributor.authorAnderson, Jean R.
dc.contributor.authorNoormahomed, Emilia V.
dc.contributor.authorDeckelbaum, Richard J.
dc.contributor.authorStringer, Jeffrey S.A.
dc.contributor.authorMukalay, Abdon
dc.contributor.authorTaha, Taha E.
dc.contributor.authorFowler, Mary Glenn
dc.contributor.authorWasserheit, Judith N.
dc.contributor.authorMasekela, Refiloe
dc.contributor.authorMellors, John W.
dc.contributor.authorSiedner, Mark J.
dc.contributor.authorMyer, Landon
dc.contributor.authorKengne, Andre-Pascal
dc.contributor.authorYotebieng, Marcel
dc.contributor.authorMofenson, Lynne M.
dc.contributor.authorLangenegger, Eduard
dc.contributor.authorAFREhealth Research Collaboration on COVID-19 and Pregnancy
dc.date.accessioned2023-11-20T12:13:22Z
dc.date.available2023-11-20T12:13:22Z
dc.date.issued2022-06-08
dc.descriptionDATA AVAILABILITY : The dataset used for this study, including individual deidentified participant data and a data dictionary defining each field in the set, will be made available at publication on request to Professor Jean Nachega (jbn16@pitt.edu).en_US
dc.description.abstractBACKGROUND : Few data are available on COVID-19 outcomes among pregnant women in sub-Saharan Africa (SSA), where high-risk comorbidities are prevalent. We investigated the impact of pregnancy on SARS-CoV-2 infection and of SARS-CoV-2 infection on pregnancy to generate evidence for health policy and clinical practice. METHODS : We conducted a 6-country retrospective cohort study among hospitalized women of childbearing age between 1 March 2020 and 31 March 2021. Exposures were (1) pregnancy and (2) a positive SARS-CoV-2 RT-PCR test. The primary outcome for both analyses was intensive care unit (ICU) admission. Secondary outcomes included supplemental oxygen requirement, mechanical ventilation, adverse birth outcomes, and in-hospital mortality. We used log-binomial regression to estimate the effect between pregnancy and SARS-CoV-2 infection. Factors associated with mortality were evaluated using competing-risk proportional subdistribution hazards models. RESULTS : Our analyses included 1315 hospitalized women: 510 pregnant women with SARS-CoV-2, 403 nonpregnant women with SARS-CoV-2, and 402 pregnant women without SARS-CoV-2 infection. Among women with SARS-CoV-2 infection, pregnancy was associated with increased risk for ICU admission (adjusted risk ratio [aRR]: 2.38; 95% CI: 1.42– 4.01), oxygen supplementation (aRR: 1.86; 95% CI: 1.44–2.42), and hazard of in-hospital death (adjusted sub-hazard ratio [aSHR]: 2.00; 95% CI: 1.08–3.70). Among pregnant women, SARS-CoV-2 infection increased the risk of ICU admission (aRR: 2.0; 95% CI: 1.20–3.35), oxygen supplementation (aRR: 1.57; 95% CI: 1.17–2.11), and hazard of in-hospital death (aSHR: 5.03; 95% CI: 1.79–14.13). CONCLUSIONS : Among hospitalized women in SSA, both SARS-CoV-2 infection and pregnancy independently increased risks of ICU admission, oxygen supplementation, and death. These data support international recommendations to prioritize COVID-19 vaccination among pregnant women.en_US
dc.description.departmentObstetrics and Gynaecologyen_US
dc.description.librarianam2023en_US
dc.description.sdgSDG-03:Good heatlh and well-beingen_US
dc.description.sponsorshipThe US National Institutes of Health (NIH)/Fogarty International Center to the African Forum for Research and Education in Health (AFREhealth) and payment to the University of Ibadan, Ibadan, Nigeria; Makerere University, Kampala, Uganda; University of Kwazulu Natal, Durban, South Africa; Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, South Africa.en_US
dc.description.urihttps://academic.oup.com/ciden_US
dc.identifier.citationNachega, J.B., Sam-Agudu, N.A., Macheko, R.N. et al. 2022, 'Severe acute respiratory syndrome coronavirus 2 infection and pregnancy in Sub-Saharan Africa : a 6-country retrospective cohort analysis', Clinical Infectious Diseases, vol. 75, pp. 1950-1961. DOI : 10.1093/cid/ciac294.en_US
dc.identifier.issn1058-4838 (print)
dc.identifier.issn1537-6591 (online)
dc.identifier.other10.1093/cid/ciac294
dc.identifier.urihttp://hdl.handle.net/2263/93367
dc.language.isoenen_US
dc.publisherOxford University Pressen_US
dc.rights© The Author(s) 2022. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution- NonCommercial-NoDerivs licence.en_US
dc.subjectPregnancyen_US
dc.subjectMartenalen_US
dc.subjectNeonateen_US
dc.subjectAfricaen_US
dc.subjectCOVID-19 pandemicen_US
dc.subjectSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2)en_US
dc.subjectSub-Saharan Africa (SSA)en_US
dc.subjectCoronavirus disease 2019 (COVID-19)en_US
dc.subjectSDG-03: Good health and well-beingen_US
dc.titleSevere acute respiratory syndrome coronavirus 2 infection and pregnancy in Sub-Saharan Africa : a 6-country retrospective cohort analysisen_US
dc.typeArticleen_US

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