Nordic research collaboration on COVID-19 in pregnancy

Nordic research collaboration on COVID-19 in pregnancy

The Nordic Obstetric Surveillance Study (NOSS) group is currently running a prospective study including pregnant women with COVID-19 infection admitted to hospital. The aim is to assess the maternal and perinatal outcomes of infection during pregnancy, to guide clinical care and the health system response.

The World Health Organization declared a global pandemic of coronavirus disease in March 2020. Evidence on transmission, incidence, and clinical outcomes of SARS-CoV-2 infection (COVID-19) in pregnant women remains limited. During the H1N1-influenza pregnant women were particularly vulnerable, resulting in increases of maternal and perinatal mortality among those infected. And other respiratory illnesses such as SARS-CoV and MERS have also been reported to increase the risk of adverse pregnancy outcomes. It is therefore essential to learn about the consequences of COVID-19 in pregnancy to guide management of the disease in pregnancy.

NOSS is a Nordic collaboration between clinicians and the medical birth registries in all the Nordic countries with a focus on severe complications in pregnancy. The objective of the current NOSS study is to prospectively monitor admissions with COVID-19 in pregnancy to provide data about the level of care needed for these women, including respiratory support and intensive care management. The project will provide new information about the maternal, fetal, and neonatal morbidity and mortality in relation to COVID-19 infection and identify risk factors for severe disease among pregnant women. With this study we will be able to provide ongoing guidance on prevention, and management of COVID-19 infection in pregnancy to our Nordic colleagues.

The NOSS study will also contribute to an international monitoring and analysis of COVID-19 in pregnancy by providing data to a study initiated by the International Obstetric Survey Systems (INOSS).

The study will take place in two stages. The first stage is a prospective reporting of pregnant women with COVID-19 infection from the hospitals running from 1. March 2020 to 1. March 2021. In the second stage, birth registry data will be linked with relevant national health registries and with the prospective reports collected in the first stage. The data collected is based on an international case report form developed by the National Perinatal Epidemiology Unit (NPEU) at Oxford University and INOSS to guarantee comparable data. The same case report form is implemented in several European countries as well as in Australia, New Zealand, the United States and South Africa.

The group is planning to disseminate the outcomes of the study in several international publications, national reports and guidelines and during a COVID-19 session at the NFOG congress 2021.

The Nordic project group represents members from the Societies for Gynaecology and Obstetrics in all the Nordic countries, and the collaboration is financially supported by the NFOG.

The group would like to thank all the national representatives taking part in this project by reporting cases to the national databases, and to thank NFOG for financial support.

National contacts (countries in alphabetical order):  


Anna Aabakke, MD, PhD. Holbæk Hospital and Copenhagen University.

Lone Krebs, Professor, DMSc, Hvidovre Hospital and Copenhagen University



Outi Äyräs, MD, PhD. Helsinki University Hospital



Eva Jonasdottir, MD. Landspitali University Hospital;



Hilde Marie Engjom, MD, PhD. Haukeland University Hospital



Teresia Svanvik, MD, PhD. Sahlgrenska University Hospital,