Martinez-Perez, OscarPrats-Rodriguez, PilarMuner-Hernandez, MartaEncinas-Pardilla, Maria BegoñaPerez-Perez, NoeliaVila-Hernandez, Maria RosaVillalba-Yarza, AnaNieto-Velasco, OlgaDel-Barrio-Fernandez, Pablo GuillermoForcen-Acebal, LauraOrizales-Lago, Carmen MariaMartinez-Varea, AliciaMuñoz-Abellana, BegoñaSuarez-Arana, MariaFuentes-Ricoy, LauraMartinez-Diago, ClaraJaneiro-Freire, Maria JesusAlférez-Alvarez-Mallo, MacarenaCasanova-Pedraz, CristinaAlomar-Mateu, OnofreLesmes-Heredia, CristinaWizner-de-Alva, Juan CarlosBernardo-Vega, RutMacia-Badia, MontserratAlvarez-Colomo, CristinaSanchez-Muñoz, AntonioPratcorona-Alicart, LaiaAlonso-Saiz, RubenLopez-Rodriguez, MonicaDel-Carmen-Barbancho-Lopez, MariaMeca-Casbas, Marta RuthVaquerizo-Ruiz, OscarMoran-Antolin, EvaNuñez-Valera, Maria JoseFernandez-Fernandez, CaminoTubau-Navarra, AlbertCano-Garcia, Alejandra MariaBaena-Luque, CarmenSoldevilla-Perez, SusanaGastaca-Abasolo, IreneAdanez-Garcia, JoseTeulon-Gonzalez, MariaPuertas-Prieto, AlbertoOstos-Serna, RosaDel-Pilar-Guadix-Martin, MariaCatalina-Coello, MonicaFerriols-Perez, ElenaCaño-Aguilar, AfricaDe-la-Cruz-Conty, Maria LuisaSainz-Bueno, Jose Antonio2023-02-092023-02-092021-04-01Martinez-Perez O, Prats Rodriguez P, Muner Hernandez M, Encinas Pardilla MB, Perez Perez N, Vila Hernandez MR, et al. The association between SARS-CoV-2 infection and preterm delivery: a prospective study with a multivariable analysis. BMC Pregnancy Childbirth. 2021 Apr 1;21(1):273http://hdl.handle.net/10668/17435To determine whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, the cause of COVID-19 disease) exposure in pregnancy, compared to non-exposure, is associated with infection-related obstetric morbidity. We conducted a multicentre prospective study in pregnancy based on a universal antenatal screening program for SARS-CoV-2 infection. Throughout Spain 45 hospitals tested all women at admission on delivery ward using polymerase-chain-reaction (PCR) for COVID-19 since late March 2020. The cohort of positive mothers and the concurrent sample of negative mothers was followed up until 6-weeks post-partum. Multivariable logistic regression analysis, adjusting for known confounding variables, determined the adjusted odds ratio (aOR) with 95% confidence intervals (95% CI) of the association of SARS-CoV-2 infection and obstetric outcomes. Preterm delivery (primary), premature rupture of membranes and neonatal intensive care unit admissions. Among 1009 screened pregnancies, 246 were SARS-CoV-2 positive. Compared to negative mothers (763 cases), SARS-CoV-2 infection increased the odds of preterm birth (34 vs 51, 13.8% vs 6.7%, aOR 2.12, 95% CI 1.32-3.36, p = 0.002); iatrogenic preterm delivery was more frequent in infected women (4.9% vs 1.3%, p = 0.001), while the occurrence of spontaneous preterm deliveries was statistically similar (6.1% vs 4.7%). An increased risk of premature rupture of membranes at term (39 vs 75, 15.8% vs 9.8%, aOR 1.70, 95% CI 1.11-2.57, p = 0.013) and neonatal intensive care unit admissions (23 vs 18, 9.3% vs 2.4%, aOR 4.62, 95% CI 2.43-8.94, p  This prospective multicentre study demonstrated that pregnant women infected with SARS-CoV-2 have more infection-related obstetric morbidity. This hypothesis merits evaluation of a causal association in further research.enAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/COVID-19CoronavirusIntensive care units, neonatalPregnancyPremature birthPremature rupture of membranesSARS-CoV-2Área de Gestión Sanitaria de Jerez, Costa Noroeste y Sierra de CádizArea de Gestión Sanitaria Sur de CórdobaÁrea de Gestión Sanitaria Sur de SevillaAdolescentAdultCOVID-19Case-Control StudiesCesarean SectionFemaleFetal Membranes, Premature RuptureGestational AgeHumansInfant, Extremely PrematureInfant, NewbornInfant, PrematureIntensive Care Units, NeonatalLabor, InducedLogistic ModelsMiddle AgedMultivariate AnalysisOdds RatioPregnancyPregnancy Complications, InfectiousPremature BirthProspective StudiesSARS-CoV-2SpainYoung Adultresearch article33794829open accessSARS-CoV-2MadresEmbarazoRoturaMorbilidadInfeccionesMujeres embarazadas10.1186/s12884-021-03742-41471-2393PMC8016158https://bmcpregnancychildbirth.biomedcentral.com/counter/pdf/10.1186/s12884-021-03742-4https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8016158/pdf