Objectives: To evaluate universal SARS-CoV-2 screening in labouring women in a tertiary hospital in the Netherlands. Women with an unknown SARS-CoV-2 were treated as COVID-19 positive in theatre. As COVID-19 precautions differed from standard care, this may have contributed to adverse perinatal outcomes. Methods: Women admitted to the labour- and pregnancy ward were consecutively asked for COVID-19 symptoms and then screened for SARS-CoV-2 by PCR. Results: From March 5 2020 to May 13, 283 women without COVID-19 symptoms were screened. One post-symptomatic woman was excluded from the analysis. 3/ 282 women (1.1%) tested positive for SARS-CoV-2. In one woman, a pending SARS-CoV-2 test, may have worsened perinatal asphyxia in her child, and in two other cases with post-partum haemorrhage the prolonged decision-to intervention interval may have contributed to more blood loss. Conclusion: Caretakers should balance the potential additional perinatal risks of alternative care processes for unscreened SARS-CoV-2 patients in obstetric emergencies.
Objective: To determine the association between HDP and cardiovascular mortality. Design: Cohort study Setting: Population based using the Dutch National Birth Hospital Registry linked with the National Death Registry. Population: All women who gave birth between 1995 – 2015 Methods: Cox-regression models with hazard ratios (HR) and survival curves were executed. Main outcome and measures: The cardiovascular mortality risk after HDP was analyzed. Cardiovascular mortality-risk was analyzed in women with a history of HDP in one or more pregnancies compared to women without a history of HDP. In a subgroup of this cohort the effect of HDP on cardiovascular mortality was analyzed using only the nulliparous pregnancy of women. Results: Women were followed for a mean time of 10.4 years. Of 1,625,246 parous women 21.9% had a history of HDP. Gestational hypertension (18.1%) was associated with an aHR of 2.13 (95% CI: 1.91 – 2.38) for CVM. Preeclampsia (3.8%) was associated with an aHR of 3.35 (95 %CI: 2.80 – 4.00) for CVM. Cardiovascular mortality risk was highest in women with a history of HDP combined with a preterm birth (<37 weeks) and a growth restricted child (