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

Varpula, Reetta ; Äyräs, Outi ; Aabakke, Anna J.M. ; Klungsøyr, Kari ; Svanvik, Teresia ; Kanerva, Julia LU ; Jonasdottir, Eva ; Mentzoni, Camilla Tjønneland ; Thurn, Lars LU orcid and Jones, Elin , et al. (2024) In Acta Obstetricia et Gynecologica Scandinavica
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... (More)

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.

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organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
COVID-19, incidence, Nordic countries, pregnancy outcome, risk factor, SARS-CoV-2
in
Acta Obstetricia et Gynecologica Scandinavica
publisher
Wiley-Blackwell
external identifiers
  • pmid:38382894
  • scopus:85186486995
ISSN
0001-6349
DOI
10.1111/aogs.14808
language
English
LU publication?
yes
id
204b9716-1192-4929-b15e-a4b02cb75e3d
date added to LUP
2024-03-22 10:26:42
date last changed
2024-04-19 11:29:22
@article{204b9716-1192-4929-b15e-a4b02cb75e3d,
  abstract     = {{<p>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, I<sup>2</sup> = 77.6, tau<sup>2</sup> = 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.</p>}},
  author       = {{Varpula, Reetta and Äyräs, Outi and Aabakke, Anna J.M. and Klungsøyr, Kari and Svanvik, Teresia and Kanerva, Julia and Jonasdottir, Eva and Mentzoni, Camilla Tjønneland and Thurn, Lars and Jones, Elin and Fredriksson, Lisa and Pettersson, Karin and Nyfløt, Lill Trine and Vangen, Siri and Røe, Kjerstine and Júlíusson, Pétur B. and Källén, Karin and Gissler, Mika and Pyykönen, Aura and Jakobsson, Maija and Krebs, Lone and Engjom, Hilde Marie}},
  issn         = {{0001-6349}},
  keywords     = {{COVID-19; incidence; Nordic countries; pregnancy outcome; risk factor; SARS-CoV-2}},
  language     = {{eng}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Acta Obstetricia et Gynecologica Scandinavica}},
  title        = {{Early suppression policies protected pregnant women from COVID-19 in 2020 : A population-based surveillance from the Nordic countries}},
  url          = {{http://dx.doi.org/10.1111/aogs.14808}},
  doi          = {{10.1111/aogs.14808}},
  year         = {{2024}},
}