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\begin{document}

\title{SARS-CoV-2 infection in pregnancy during the first wave of COVID-19 in
the Netherlands: a prospective nationwide population-based cohort study}



\author[1]{Evelien Overtoom}%
\author[2]{Ageeth Rosman}%
\author[3]{Joost Zwart}%
\author[4]{Tatjana Vogelvang}%
\author[1]{Timme Schaap}%
\author[5]{Thomas van den Akker}%
\author[1]{Kitty Bloemenkamp}%
\affil[1]{University Medical Centre Utrecht}%
\affil[2]{Perined}%
\affil[3]{Deventer Hospital}%
\affil[4]{Diakonessenhuis Utrecht-Zeist Doorn}%
\affil[5]{Leiden University Medical Center}%


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  \date{May 04, 2024}


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\begin{abstract}
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.%
\end{abstract}%



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