Early suppression policies protected pregnant women from COVID-19 in 2020: A population-based surveillance from the Nordic countries

Reetta Varpula*, Outi Äyräs, Anna J M Aabakke, Kari Klungsøyr, Teresia Svanvik, Julia Kanerva, Eva Jonasdottir, Camilla Tjønneland Mentzoni, Lars Thurn, Elin Jones, Lisa Fredriksson, Karin Pettersson, Lill Trine Nyfløt, Siri Vangen, Kjerstine Røe, Pétur B Júlíusson, Karin Källén, Mika Gissler, Aura Pyykönen, Maija JakobssonLone Krebs, Hilde Marie Engjom

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftArtikelForskningpeer review

Abstract

INTRODUCTION: The Coronavirus 2019 Disease (COVID-19) pandemic reached the Nordic countries in March 2020. Public health interventions to limit viral transmission varied across different countries both in timing and in magnitude. Interventions indicated by an Oxford Stringency Index ≥50 were implemented early (March 13-17, 2020) in Denmark, Finland, Norway and Iceland, and on March 26, 2020 in Sweden. The aim of the current study was to assess the incidence of COVID-19-related admissions of pregnant women in the Nordic countries in relation to the different national public health strategies during the first year of the pandemic.

MATERIAL AND METHODS: This is a meta-analysis of population-based cohort studies in the five Nordic countries with national or regional surveillance in the Nordic Obstetric Surveillance System (NOSS) collaboration: national data from Denmark, Finland, Iceland and Norway, and regional data covering 31% of births in Sweden. The source population consisted of women giving birth in the included areas March 1-December 31, 2020. Pregnant women with a positive SARS-CoV-2 PCR test ≤14 days before hospital admission were included, and admissions were stratified as either COVID-19-related or non-COVID (other obstetric healthcare). Information about public health policies was retrieved retrospectively.

RESULTS: In total, 392 382 maternities were considered. Of these, 600 women were diagnosed with SARS-CoV-2 infection and 137 (22.8%) were admitted for COVID-19 symptoms. The pooled incidence of COVID-19 admissions per 1000 maternities was 0.5 (95% confidence interval [CI] 0.2 to 1.2, I2  = 77.6, tau2  = 0.68, P = 0.0), ranging from no admissions in Iceland to 1.9 admissions in the Swedish regions. Interventions to restrict viral transmission were less stringent in Sweden than in the other Nordic countries.

CONCLUSIONS: There was a clear variation in pregnant women's risk of COVID-19 admission across countries with similar healthcare systems but different public health interventions to limit viral transmission. The meta-analysis indicates that early suppression policies protected pregnant women from severe COVID-19 disease prior to the availability of individual protection with vaccines.

OriginalsprogEngelsk
Sider (fra-til)1063-1072
Antal sider10
TidsskriftActa Obstetricia et Gynecologica Scandinavica
Vol/bind103
Udgave nummer6
Tidlig onlinedato21 feb. 2024
DOI
StatusUdgivet, E-publikation før trykning - 21 feb. 2024

Bibliografisk note

© 2024 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).

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