Browsing by Author "Lees, Christoph"

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    Adverse maternal, fetal, and newborn outcomes among pregnant women with SARS- CoV- 2 infection: an individual participant data meta- analysis
    (2023) Smith, Emily R.; Oakley, Erin; Wable Grandner, Gargi; Ferguson, Kacey; Farooq, Fouzia; Afshar, Yalda; Ahlberg, Mia; Ahmadzia, Homa; Akelo, Victor; Aldrovandi, Grace; Tippett Barr, Beth A.; Bevilacqua, Elisa; Brandt, Justin S.; Broutet, Nathalie; Fernández Buhigas, Irene; Carrillo Termini, Jorge; Clifton, Rebecca; Conry, Jeanne; Cosmi, Erich; Crispi, Fatima; Crovetto, Francesca; Delgado-López, Camille; Divakar, Hema; Driscoll, Amanda J.; Favre, Guillaume; Flaherman, Valerie J.; Gale, Chris; Gil, Maria M.; Gottlieb, Sami L.; Gratacós, Eduard; Hernandez, Olivia; Jones, Stephanie; Kalafat, Erkan; Khagayi, Sammy; Knight, Marian; Kotloff, Karen; Lanzone, Antonio; Le Doare, Kirsty; Lees, Christoph; Litman, Ethan
    Introduction Despite a growing body of research on the risks of SARS-CoV-2 infection during pregnancy, there is continued controversy given heterogeneity in the quality and design of published studies. Methods We screened ongoing studies in our sequential, prospective meta-analysis. We pooled individual participant data to estimate the absolute and relative risk (RR) of adverse outcomes among pregnant women with SARS-CoV-2 infection, compared with confirmed negative pregnancies. We evaluated the risk of bias using a modified Newcastle-Ottawa Scale. Results We screened 137 studies and included 12 studies in 12 countries involving 13 136 pregnant women. Pregnant women with SARS-CoV-2 infection—as compared with uninfected pregnant women—were at significantly increased risk of maternal mortality (10 studies; n=1490; RR 7.68, 95% CI 1.70 to 34.61); admission to intensive care unit (8 studies; n=6660; RR 3.81, 95% CI 2.03 to 7.17); receiving mechanical ventilation (7 studies; n=4887; RR 15.23, 95% CI 4.32 to 53.71); receiving any critical care (7 studies; n=4735; RR 5.48, 95% CI 2.57 to 11.72); and being diagnosed with pneumonia (6 studies; n=4573; RR 23.46, 95% CI 3.03 to 181.39) and thromboembolic disease (8 studies; n=5146; RR 5.50, 95% CI 1.12 to 27.12). Neonates born to women with SARS-CoV-2 infection were more likely to be admitted to a neonatal care unit after birth (7 studies; n=7637; RR 1.86, 95% CI 1.12 to 3.08); be born preterm (7 studies; n=6233; RR 1.71, 95% CI 1.28 to 2.29) or moderately preterm (7 studies; n=6071; RR 2.92, 95% CI 1.88 to 4.54); and to be born low birth weight (12 studies; n=11 930; RR 1.19, 95% CI 1.02 to 1.40). Infection was not linked to stillbirth. Studies were generally at low or moderate risk of bias. Conclusions This analysis indicates that SARS-CoV-2 infection at any time during pregnancy increases the risk of maternal death, severe maternal morbidities and neonatal morbidity, but not stillbirth or intrauterine growth restriction. As more data become available, we will update these findings per the published protocol.
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    Experiences and well-being of healthcare professionals working in the field of ultrasound in obstetrics and gynaecology as the SARS-CoV-2 pandemic were evolving: a crosssectional survey study
    (2022) Bourne, Tom; Kyriacou, Christopher; Shah, Harsha; Ceusters, Jolien; Preisler, Jessica; Metzger, Ulrike; Landolfo, Chiara; Lees, Christoph; Timmerman, Dirk
    Objective: Assess experience of healthcare professionals (HCPs) working with ultrasound in obstetrics and gynaecology during the evolving SARS-CoV-2 pandemic, given the new and unprecedented challenges involving viral exposure, personal protective equipment (PPE) and well-being. Design: Prospective cross-sectional survey study. Setting: Online international survey. Single-best, open box and Hospital Anxiety and Depression Scale (HADS) questions. Participants: The survey was sent to 35 509 HCPs in 124 countries and was open from 7 to 21 May 2020. 2237/3237 (69.1%) HCPs from 115 countries who consented to participate completed the survey. 1058 (47.3%) completed the HADS. Primary outcome measures: Overall prevalence of SARS-CoV-2, depression and anxiety among HCPs in relation to country and PPE availability. Analyses: Univariate analyses were used to investigate associations without generating erroneous causal conclusions. Results: Confirmed/suspected SARS-CoV-2 prevalence was 13.0%. PPE provision concerns were raised by 74.1% of participants; highest among trainees/resident physicians (83.9%) and among HCPs in Spain (89.7%). Most participants worked in self-perceived high-risk areas with SARS-CoV-2 (67.5%-87.0%), with proportionately more trainees interacting with suspected/confirmed infected patients (57.1% vs 24.2%-40.6%) and sonographers seeing more patients who did not wear a mask (33.3% vs 13.9%-7.9%). The most frequent PPE combination used was gloves and a surgical mask (22.3%). UK and US respondents reported spending less time self-isolating (8.8 days) and lower satisfaction with their national pandemic response (37.0%-43.0%). 19.8% and 8.8% of respondents met the criteria for moderate to severe anxiety and depression, respectively. Conclusions: Reported prevalence of SARS-CoV-2 in HCPs is consistent with literature findings. Most respondents used gloves and a surgical mask, with a greater SARS-CoV-2 prevalence compared with those using 'full' PPE. HCPs with the least agency (trainees and sonographers) were not only more likely to see high-risk patients but also less likely to be protected. A fifth of respondents reported moderate to severe anxiety.

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