loading page

SARS-CoV-2 infection in pregnancy during the first wave of COVID-19 in the Netherlands: a prospective nationwide population-based cohort study
  • +4
  • Evelien Overtoom,
  • Ageeth Rosman,
  • Joost Zwart,
  • Tatjana Vogelvang,
  • Timme Schaap,
  • Thomas van den Akker,
  • Kitty Bloemenkamp
Evelien Overtoom
University Medical Centre Utrecht

Corresponding Author:[email protected]

Author Profile
Ageeth Rosman
Author Profile
Joost Zwart
Deventer Hospital
Author Profile
Tatjana Vogelvang
Diakonessenhuis Utrecht-Zeist Doorn
Author Profile
Timme Schaap
University Medical Centre Utrecht
Author Profile
Thomas van den Akker
Leiden University Medical Center
Author Profile
Kitty Bloemenkamp
University Medical Centre Utrecht
Author Profile


Objective: Description of characteristics, risk factors, management strategies and maternal, obstetric and neonatal outcomes of SARS-CoV-2 infected pregnant women in the Netherlands. Design: Multi-centre prospective nationwide population-based cohort study. Setting: Nationwide. Population: All pregnant women in the Netherlands with confirmed SARS-CoV-2 infection in home-isolation or admitted to hospital between March 1st, 2020 and August 31st, 2020. Methods: Pregnant women with positive PCR or antibody tests were registered using the Netherlands Obstetrics Surveillance System. Testing occurred according to national guidelines (selective testing). Data from the national birth registry (Perined) and Dutch National Institute for Public Health and the Environment (RIVM) were used as reference. Main Outcome Measures: Incidence of pregnant women with SARS-CoV-2 infection. Maternal, obstetric and neonatal outcomes including hospital and critical care admission, clinical management and mode of birth. Results: Of 312 registered women, 65 (20%) were admitted to hospital, of whom 5 (2%) to intensive care and 9 (14%) to obstetric high care units. Risk factors for admission were non-Caucasian background (n=28; OR 6.67, 95%CI 4.08-10.90) and being overweight or obese (n=38; OR 2.64, 95%CI1.51 to 4.61). Hospital and intensive care admission were higher compared to age-matched infected women (respectively, OR 14.57, 95%CI 10.99-19.03 and OR 5.02, 95%CI 2.04-12.34). One maternal death occurred. Caesarean section after labour onset was increased (OR 2.50; 95%CI 1.57-3.97). Conclusions: Pregnant women with SARS-CoV-2 infection are at increased risk of hospital admission, ICU admission and caesarean section. Funding: No funding was received. Keywords: Pregnancy, COVID-19, SARS-CoV-2, Pregnancy complications, Pregnancy outcome, Obstetric surveillance system.
09 Oct 2020Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
09 Oct 2020Submission Checks Completed
09 Oct 2020Assigned to Editor
10 Oct 2020Reviewer(s) Assigned
25 Oct 2020Review(s) Completed, Editorial Evaluation Pending
02 Nov 2020Editorial Decision: Revise Major
21 Dec 20201st Revision Received
21 Dec 2020Submission Checks Completed
21 Dec 2020Assigned to Editor
11 Jan 2021Review(s) Completed, Editorial Evaluation Pending
09 Feb 2021Editorial Decision: Revise Minor
01 Mar 20212nd Revision Received
02 Mar 2021Submission Checks Completed
02 Mar 2021Assigned to Editor
08 Mar 2021Review(s) Completed, Editorial Evaluation Pending
23 Mar 2021Editorial Decision: Accept
Jan 2022Published in BJOG: An International Journal of Obstetrics & Gynaecology volume 129 issue 1 on pages 91-100. 10.1111/1471-0528.16903