TY - JOUR
T1 - COVID-19 symptoms and antibody positivity among unvaccinated pregnant women
T2 - An observational study in seven countries from the Global Network
AU - Kavi, Avinash
AU - Goudar, Shivaprasad S.
AU - Somannavar, Manjunath S.
AU - Moore, Janet L.
AU - Derman, Richard J.
AU - Saleem, Sarah
AU - Naqvi, Seemab
AU - Billah, Sk Masum
AU - Haque, Rashidul
AU - Figueroa, Lester
AU - Mazariegos, Manolo
AU - Lokangaka, Adrien
AU - Tshefu, Antoinette
AU - Esamai, Fabian
AU - Mwenechanya, Musaku
AU - Chomba, Elwyn
AU - Patel, Archana
AU - Das, Prabirkumar
AU - Bauserman, Melissa
AU - Petri, William A.
AU - Krebs, Nancy F.
AU - Carlo, Waldemar A.
AU - Bucher, Sherri
AU - Hibberd, Patricia L.
AU - Koso-Thomas, Marion
AU - McClure, Elizabeth M.
AU - Goldenberg, Robert L.
N1 - Publisher Copyright:
© 2023 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.
PY - 2023/11
Y1 - 2023/11
N2 - Objective: To determine the relation of COVID-19 symptoms to COVID-19 antibody positivity among unvaccinated pregnant women in low- and middle-income countries (LMIC). Design: COVID-19 infection status measured by antibody positivity at delivery was compared with the symptoms of COVID-19 in the current pregnancy in a prospective, observational cohort study in seven LMICs. 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 (Belagavi and Nagpur sites) and Guatemala. Population: Pregnant women enrolled in the ongoing pregnancy registry at study sites. Methods: Data on COVID-19 symptoms during the current pregnancy were collected by trained staff between October 2020 and June 2022. COVID-19 antibody testing was performed on samples collected at delivery. The relation between COVID-19 antibody positivity and symptoms was assessed using generalised linear models with a binomial distribution adjusting for site and symptoms. Main outcome measures: COVID-19 antibody status and symptoms of COVID-19 among pregnant women. Results: Among 19 218 non-vaccinated pregnant women who were evaluated, 14.1% of antibody-positive women had one or more symptoms compared with 13.4% in antibody-negative women. Overall, 85.3% of antibody-positive women reported no COVID-19 symptoms during the present pregnancy. Reported fever was significantly associated with antibody status (relative risk [RR] 1.10, 95% CI 1.03–11.18; P = 0.008). A multiple variable model adjusting for site and all eight symptoms during pregnancy showed similar results (RR 1.13, 95% CI 1.04–1.23; P = 0.012). None of the other symptoms was significantly related to antibody positivity. Conclusions: In a population-based cohort in LMICs, unvaccinated pregnant women who were antibody-positive had slightly more symptoms during their pregnancy and a small but significantly greater increase in fever. However, for prevalence studies, evaluating COVID-19-related symptoms does not appear to be useful in differentiating pregnant women who have had a COVID-19 infection.
AB - Objective: To determine the relation of COVID-19 symptoms to COVID-19 antibody positivity among unvaccinated pregnant women in low- and middle-income countries (LMIC). Design: COVID-19 infection status measured by antibody positivity at delivery was compared with the symptoms of COVID-19 in the current pregnancy in a prospective, observational cohort study in seven LMICs. 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 (Belagavi and Nagpur sites) and Guatemala. Population: Pregnant women enrolled in the ongoing pregnancy registry at study sites. Methods: Data on COVID-19 symptoms during the current pregnancy were collected by trained staff between October 2020 and June 2022. COVID-19 antibody testing was performed on samples collected at delivery. The relation between COVID-19 antibody positivity and symptoms was assessed using generalised linear models with a binomial distribution adjusting for site and symptoms. Main outcome measures: COVID-19 antibody status and symptoms of COVID-19 among pregnant women. Results: Among 19 218 non-vaccinated pregnant women who were evaluated, 14.1% of antibody-positive women had one or more symptoms compared with 13.4% in antibody-negative women. Overall, 85.3% of antibody-positive women reported no COVID-19 symptoms during the present pregnancy. Reported fever was significantly associated with antibody status (relative risk [RR] 1.10, 95% CI 1.03–11.18; P = 0.008). A multiple variable model adjusting for site and all eight symptoms during pregnancy showed similar results (RR 1.13, 95% CI 1.04–1.23; P = 0.012). None of the other symptoms was significantly related to antibody positivity. Conclusions: In a population-based cohort in LMICs, unvaccinated pregnant women who were antibody-positive had slightly more symptoms during their pregnancy and a small but significantly greater increase in fever. However, for prevalence studies, evaluating COVID-19-related symptoms does not appear to be useful in differentiating pregnant women who have had a COVID-19 infection.
KW - COVID-19 antibody
KW - COVID-19 symptoms
KW - low- and middle-income countries
KW - pregnant women
UR - http://www.scopus.com/inward/record.url?scp=85165493062&partnerID=8YFLogxK
U2 - 10.1111/1471-0528.17604
DO - 10.1111/1471-0528.17604
M3 - Article
C2 - 37470094
AN - SCOPUS:85165493062
SN - 1470-0328
VL - 130
SP - 140
EP - 148
JO - BJOG: An International Journal of Obstetrics and Gynaecology
JF - BJOG: An International Journal of Obstetrics and Gynaecology
IS - S3
ER -
