Abstract：
BACKGROUND: With the dominance of different SARS-CoV-2 variants, the severity of COVID-19 has evolved. We aimed to investigate the difference in symptom prevalence and the association between symptoms and adverse pregnancy outcomes during the dominance of Wild-type/Alpha, Delta, and Omicron.
METHODS: COVID-19 related symptom prevalence, maternal and specific neonatal outcomes of 5431 pregnant women registered in this prospective study were compared considering the dominant virus variant. Logistic regression models analyzed the association between specific symptoms and intensive care unit (ICU) admission or preterm birth.
RESULTS: Infection with the Delta variant led to an increase in the symptom burden compared to the Wild-type/Alpha variant and the highest risk for respiratory tract symptoms, feeling of sickness, headache, and dizziness/drowsiness. An infection with the Omicron variant was associated with the lowest risk of dyspnea and changes in smell/taste but the highest risk for nasal obstruction, expectoration, headaches, myalgia, and fatigue compared to the Wild-type/Alpha and Delta variant dominant periods. With the progression of the Wild-type/Alpha to the Delta variant neonatal outcomes worsened. Dyspnea and fever were strong predictors for maternal ICU admission and preterm birth independent of vaccination status or trimester of infection onset.
CONCLUSIONS: The symptom burden increased during the Delta period and was associated with worse pregnancy outcomes than in the Wild-type/Alpha area. During the Omicron dominance there still was a high prevalence of less severe symptoms. Dyspnea and fever can predict a severe maternal illness.
METHODS: COVID-19 related symptom prevalence, maternal and specific neonatal outcomes of 5431 pregnant women registered in this prospective study were compared considering the dominant virus variant. Logistic regression models analyzed the association between specific symptoms and intensive care unit (ICU) admission or preterm birth.
RESULTS: Infection with the Delta variant led to an increase in the symptom burden compared to the Wild-type/Alpha variant and the highest risk for respiratory tract symptoms, feeling of sickness, headache, and dizziness/drowsiness. An infection with the Omicron variant was associated with the lowest risk of dyspnea and changes in smell/taste but the highest risk for nasal obstruction, expectoration, headaches, myalgia, and fatigue compared to the Wild-type/Alpha and Delta variant dominant periods. With the progression of the Wild-type/Alpha to the Delta variant neonatal outcomes worsened. Dyspnea and fever were strong predictors for maternal ICU admission and preterm birth independent of vaccination status or trimester of infection onset.
CONCLUSIONS: The symptom burden increased during the Delta period and was associated with worse pregnancy outcomes than in the Wild-type/Alpha area. During the Omicron dominance there still was a high prevalence of less severe symptoms. Dyspnea and fever can predict a severe maternal illness.
摘要：
背景：由于不同的SARS-CoV-2变种的优势，COVID-19的严重程度已经演变。我们旨在调查症状患病率的差异以及症状与不良妊娠结局之间的关联，Delta,还有Omicron.
方法：COVID-19相关症状患病率，本前瞻性研究中注册的5431名孕妇的母体和特定新生儿结局进行了比较,考虑到显性病毒变异.Logistic回归模型分析了特定症状与重症监护病房（ICU）入院或早产之间的关系。
结果：与野生型/Alpha变体相比，Delta变体的感染导致症状负担增加，并且呼吸道症状的风险最高，疾病的感觉，头痛,和头晕/困倦。Omicron变体感染与呼吸困难和气味/味道变化的风险最低，但鼻塞的风险最高。咳痰,头痛,肌痛，和疲劳与野生型/Alpha和Delta变体的优势期相比。随着野生型/Alpha向Delta变异的进展，新生儿结局恶化。呼吸困难和发热是孕产妇入住ICU和早产的重要预测因素，与疫苗接种状态或感染发作的三个月无关。
结论：症状负担在Delta期增加，与野生型/Alpha区相比，其妊娠结局更差。在Omicron占主导地位期间，不太严重的症状仍然很高。呼吸困难和发烧可以预测严重的孕产妇疾病。
方法：COVID-19相关症状患病率，本前瞻性研究中注册的5431名孕妇的母体和特定新生儿结局进行了比较,考虑到显性病毒变异.Logistic回归模型分析了特定症状与重症监护病房（ICU）入院或早产之间的关系。
结果：与野生型/Alpha变体相比，Delta变体的感染导致症状负担增加，并且呼吸道症状的风险最高，疾病的感觉，头痛,和头晕/困倦。Omicron变体感染与呼吸困难和气味/味道变化的风险最低，但鼻塞的风险最高。咳痰,头痛,肌痛，和疲劳与野生型/Alpha和Delta变体的优势期相比。随着野生型/Alpha向Delta变异的进展，新生儿结局恶化。呼吸困难和发热是孕产妇入住ICU和早产的重要预测因素，与疫苗接种状态或感染发作的三个月无关。
结论：症状负担在Delta期增加，与野生型/Alpha区相比，其妊娠结局更差。在Omicron占主导地位期间，不太严重的症状仍然很高。呼吸困难和发烧可以预测严重的孕产妇疾病。
