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 - Funding Information:
This study was funded by grants from the National Institute of Child Health and Human Development (NICHD). Staff from the funder had input into the study design and reviewed the data in this report. However, the views presented in the paper do not necessarily represent those of the NICHD. Eunice Kennedy Shriver
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 -
