Journal Article

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

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

2024

Overview

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. The Nordic countries adopted different restriction policies to limit viral transmission in the beginning of the COVID‐19 pandemic in 2020. This meta‐analysis indicates that early suppression policies protected pregnant women from severe COVID‐19 disease prior to the availability of individual protection with vaccines.

• Publisher: John Wiley & Sons, Inc,John Wiley and Sons Inc,Wiley
• Subject: Adult / Clinical Medicine / Clinical outcomes / COVID-19 / COVID-19 - epidemiology / COVID-19 - prevention & control / Female / Health risks / Humans / Incidence / Infectious Medicine / Infektionsmedicin / Klinisk medicin / Medical and Health Sciences / Medicin och hälsovetenskap / Nordic countries / Obstetrics / Original / Pandemics / Pandemics - prevention & control / Population Surveillance - methods / Pregnancy / Pregnancy Complications, Infectious - epidemiology / Pregnancy Complications, Infectious - prevention & control / pregnancy outcome / Public health / risk factor / SARS-CoV-2 / Scandinavian and Nordic Countries - epidemiology / Womens health