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If pregnant women become infected with the SARS-CoV-2 coronavirus, they are more likely to suffer from severe COVID-19 compared to non-pregnant women. Expectant mothers are therefore more likely to require intensive medical care in hospital. In addition, the risk of premature births and stillbirths increases, as well as complications in the newborns, who consequently have to be cared for in a neonatal intensive care unit. However, the method of conception – whether natural or medically assisted – does not seem to play a role. This is the result of a study led by Professor Dr Frauke von Versen-Höynck, senior physician at the Department of Obstetrics and Gynaecology at the Hannover Medical School (MHH) in cooperation with the University Hospital Schleswig-Holstein (UKSH) at the Kiel Campus. The results of the multi-centre study have now been published in the American Journal of Obstetrics and Gynecology, one of the world’s most important specialist journals in gynaecology.

CRONOS register as data basis

For the study, the researchers compared the pregnancy histories of 1485 SARS CoV 2 positive expectant mothers from about 100 German maternity hospitals across Germany. The data came from the so-called CRONOS register for assessing the risk of corona infection for pregnant women and their newborns. Patients who tested positive in the clinic during their pregnancy were observed – from the course of the postpartum period until six weeks after birth. „Since the beginning of the pandemic, we have seen a great deal of uncertainty among women who rely on the help of reproductive medicine to become pregnant,“ says Professor von Versen-Höynck, head of the Reproductive Medicine and Molecular Perinatology Unit at the MHH Women’s Clinic. „We therefore asked ourselves in this study whether there is an additional increased risk for these women with a coronavirus infection compared to pregnancies after spontaneous conception.“

Higher risk of complications has other causes

In order to be able to set this special focus, the finished data tables from the Cronos register first had to be processed in a complex way. The necessary programme codes were developed by Dr. Yvonne Ziert, research assistant at the MHH Institute of Biometry and first author of the study. „The special thing about this project for me was the very close cooperation with the doctors,“ the scientist reports. „They provided the medical hypotheses, and I prepared the data so that they could be answered precisely.“ The result: it is true that the risk of obstetric and neonatal complications is higher in pregnancies after medically assisted conception. „However, this is due to corresponding pre-existing conditions such as diabetes, obesity and high blood pressure, a higher age of the pregnant women or multiple pregnancies, which are mainly found in this group of expectant mothers,“ Professor von Versen-Höynck emphasises. However, the type of conception is not a risk factor for a severe course of COVID.

Influence of vaccination still unclear

Next, the research team would like to look at the influence of vaccination. „The data still come from the first pandemic phase, when there was no vaccination recommendation for pregnant women,“ explains the senior physician. In the meantime, however, the Cronos register already contains the data of more than 1000 vaccinated expectant mothers. „It is to be expected that the prognosis for these women will be much more favourable,“ she assumes. But one thing is already certain: the all-clear can be given for fertility clinics even in times of pandemic.

Keyword CRONOS: The CRONOS register study was initiated by the research network of the German Society for Perinatal Medicine (DGPM) under the direction of Professor Dr. Ulrich Pecks (UKSH, Campus Kiel) and Professor Dr. Mario Rüdiger (University Hospital Dresden). The aim is to research the effects of a SARS CoV 2 infection on the health of mothers and their newborns. With the data obtained in Germany, the DGPM wants to give doctors a basis for treating and advising affected patients.

SERVICE:

For further information, please contact Professor Dr Frauke von Versen-Höynck, vonVersen-Hoeynck.Frauke@mh-hannover.de, telephone (0511) 532-6080.

The original paper „Maternal and neonatal outcomes of pregnancies with COVID-19 after medically assisted reproduction – results from the prospective Covid-19-Related Obstetric and Neonatal Outcome Study (CRONOS)“ can be found here:
https://www.ajog.org/article/S0002-9378(22)00300-3/fulltext