TY - JOUR
T1 - COVID-19 antibody positivity over time and pregnancy outcomes in seven low-and-middle-income countries
T2 - A prospective, observational study of the Global Network for Women's and Children's Health Research
AU - Goldenberg, Robert L.
AU - Saleem, Sarah
AU - Billah, Sk Masum
AU - Kim, Jean
AU - Moore, Janet L.
AU - Ghanchi, Najia Karim
AU - Haque, Rashidul
AU - Figueroa, Lester
AU - Ayala, Alejandra
AU - Lokangaka, Adrien
AU - Tshefu, Antoinette
AU - Goudar, Shivaprasad S.
AU - Kavi, Avinash
AU - Somannavar, Manjunath
AU - Esamai, Fabian
AU - Mwenechanya, Musaku
AU - Chomba, Elwyn
AU - Patel, Archana
AU - Das, Prabir
AU - Emonyi, Wilfred Injera
AU - Edidi, Samuel
AU - Deshmukh, Madhavi
AU - Hossain, Biplob
AU - Siraj, Shahjahan
AU - Mazariegos, Manolo
AU - Garces, Ana L.
AU - Bauserman, Melissa
AU - Bose, Carl L.
AU - Petri, William A.
AU - Krebs, Nancy F.
AU - Derman, Richard J.
AU - Carlo, Waldemar A.
AU - Liechty, Edward A.
AU - Hibberd, Patricia L.
AU - Koso-Thomas, Marion
AU - Peres-da-Silva, Nalini
AU - Nolen, Tracy L.
AU - McClure, Elizabeth M.
N1 - Publisher Copyright:
© 2022 John Wiley & Sons Ltd.
PY - 2023/3
Y1 - 2023/3
N2 - Objectives: To determine COVID-19 antibody positivity rates over time and relationships to pregnancy outcomes in low- and middle-income countries (LMICs). Design: With COVID-19 antibody positivity at delivery as the exposure, we performed a prospective, observational cohort study in seven LMICs during the early COVID-19 pandemic. Setting: The study was conducted among women in the Global Network for Women's and Children's Health's Maternal and Newborn Health Registry (MNHR), a prospective, population-based study in Kenya, Zambia, the Democratic Republic of the Congo (DRC), Bangladesh, Pakistan, India (two sites), and Guatemala. Population: Pregnant women enrolled in an ongoing pregnancy registry at study sites. Methods: From October 2020 to October 2021, standardised COVID-19 antibody testing was performed at delivery among women enrolled in MNHR. Trained staff masked to COVID-19 status obtained pregnancy outcomes, which were then compared with COVID-19 antibody results. Main Outcome Measures: Antibody status, stillbirth, neonatal mortality, maternal mortality and morbidity. Results: At delivery, 26.0% of women were COVID-19 antibody positive. Positivity increased over the four time periods across all sites: 13.8%, 15.4%, 21.0% and 40.9%. In the final period, positivity rates were: DRC 27.0%, Kenya 33.1%, Pakistan 32.8%, Guatemala 37.0%, Zambia 37.8%, Bangladesh 47.2%, Nagpur, India 57.4% and Belagavi, India 62.4%. Adjusting for site and maternal characteristics, stillbirth, neonatal mortality, low birthweight and preterm birth were not significantly associated with COVID-19. The adjusted relative risk (aRR) for stillbirth was 1.27 (95% CI 0.95–1.69). Postpartum haemorrhage was associated with antibody positivity (aRR 1.44; 95% CI 1.01–2.07). Conclusions: In pregnant populations in LMICs, COVID-19 antibody positivity has increased. However, most adverse pregnancy outcomes were not significantly associated with antibody positivity.
AB - Objectives: To determine COVID-19 antibody positivity rates over time and relationships to pregnancy outcomes in low- and middle-income countries (LMICs). Design: With COVID-19 antibody positivity at delivery as the exposure, we performed a prospective, observational cohort study in seven LMICs during the early COVID-19 pandemic. Setting: The study was conducted among women in the Global Network for Women's and Children's Health's Maternal and Newborn Health Registry (MNHR), a prospective, population-based study in Kenya, Zambia, the Democratic Republic of the Congo (DRC), Bangladesh, Pakistan, India (two sites), and Guatemala. Population: Pregnant women enrolled in an ongoing pregnancy registry at study sites. Methods: From October 2020 to October 2021, standardised COVID-19 antibody testing was performed at delivery among women enrolled in MNHR. Trained staff masked to COVID-19 status obtained pregnancy outcomes, which were then compared with COVID-19 antibody results. Main Outcome Measures: Antibody status, stillbirth, neonatal mortality, maternal mortality and morbidity. Results: At delivery, 26.0% of women were COVID-19 antibody positive. Positivity increased over the four time periods across all sites: 13.8%, 15.4%, 21.0% and 40.9%. In the final period, positivity rates were: DRC 27.0%, Kenya 33.1%, Pakistan 32.8%, Guatemala 37.0%, Zambia 37.8%, Bangladesh 47.2%, Nagpur, India 57.4% and Belagavi, India 62.4%. Adjusting for site and maternal characteristics, stillbirth, neonatal mortality, low birthweight and preterm birth were not significantly associated with COVID-19. The adjusted relative risk (aRR) for stillbirth was 1.27 (95% CI 0.95–1.69). Postpartum haemorrhage was associated with antibody positivity (aRR 1.44; 95% CI 1.01–2.07). Conclusions: In pregnant populations in LMICs, COVID-19 antibody positivity has increased. However, most adverse pregnancy outcomes were not significantly associated with antibody positivity.
KW - developing countries
KW - obstetrics and gynaecology
UR - http://www.scopus.com/inward/record.url?scp=85145393711&partnerID=8YFLogxK
U2 - 10.1111/1471-0528.17366
DO - 10.1111/1471-0528.17366
M3 - Article
C2 - 36504437
AN - SCOPUS:85145393711
SN - 1470-0328
VL - 130
SP - 366
EP - 376
JO - BJOG: An International Journal of Obstetrics and Gynaecology
JF - BJOG: An International Journal of Obstetrics and Gynaecology
IS - 4
ER -
