Does COVID-19 Infection during Pregnancy Increase the Appearance of Congenital Gastrointestinal Malformations in Neonates?

Abstract

Background: COVID-19 was an infection that was capable of bringing the entire world to a standstill position within a period of days to months. Despite the advancements in the medical sector, the contagion was difficult to control and costed the lives of millions of people worldwide. Many short- and long-term effects are witnessed even to date in people that contracted the disease. Pregnant females had to suffer not only the devastating effects of the virus, but also the psycho-social impact of the lockdown. The impact of COVID-19 infection during pregnancy causing decreased antenatal care or hypoxemic episodes due to severe respiratory distress and whether it could lead to the appearance of congenital gastrointestinal malformation in neonates is still unclear. The aim of our study was to analyze if COVID-19 infection during pregnancy could increase the incidence of gastric malformations in neonates born from these women. Materials and Methods: We sifted the files of all neonates admitted into our hospital between January 2022 and December 2022, and based on inclusion and exclusion criteria, we included the cases having gastrointestinal congenital malformations during the COVID-19 pandemic. We performed a single-center, retrospective, observational descriptive study. We further divided the patients based on the anatomical location of the malformation. We also took down details of the evolution of pregnancy and whether the mother had contracted a SARS-CoV-2 infection during the pregnancy. Details regarding the Apgar score, days of intensive care admission, sex, and nutrition were the key findings studied. Results: A total of 47 neonates were found to have digestive anomalies, among which, based on the anatomical locations, the number of malformation cases found at the level of the esophagus were 15, while 16 occurred at the level of the pylorus; we found 12 cases of malformation of the duodenum, and four cases had malformation of the rectum. Out of these 47 neonates, 38.3% were females and 61.7% were males. A total of 58% were preemies, among which 9% had intra-uterine growth retardation (IUGR), and 42% were full-term newborns, among which 4% had intra-uterine growth retardation (IUGR). A total of 45% of the births were primiparous pregnancies and 55% were from multiparous females. A total of 14 mothers were found to have tested positive for COVID-19 during the course of pregnancy (p-value = 0.23); many had mild symptoms but were not tested. Conclusions: COVID-19 can affect the wellbeing of the pregnant female and their fetus. Larger studies can help gain extensive knowledge as to whether COVID-19 also has the potential to result in congenital gastrointestinal anomalies in children born from COVID-19 positive mothers. In our study, only a few infants born with this pathology were found to be born from COVID-19 positive mothers. Hence, it is difficult to conclude or exclude a direct correlation between the infection and the congenital malformations.

Special Issue “Latest Research in Post-COVID (Long COVID): Pathological and Treatment Studies of Sequelae and Complications”

“…Nevertheless, Rodriguez-Wallberg et al warned of a 44% increase in the rate of miscarriage rate in recent years [ 24 ]. Similar results were also identified by Brandibur et al, who reported that SARS-CoV-2 acute infection during pregnancy was unlikely to cause congenital digestive malformations; however, these authors observed that the number of gastrointestinal malformations was higher during 2022 (n = 47) than during the 3 years (2017–2020) prior to the COVID-19 outbreak (n = 39) [ 26 ].…”

The Legacy of the COVID-19 Pandemic: Impact on Infant and Maternal and Health from an Appalachian Academic Medical Center

“…The effect of the hypercoagulable state known to result from maternal COVID-19 infection was considered by Repucci et al as a possible cause for congenital anomalies secondary to in utero vascular accidents and found not to be associated with GI or limb anomalies in their relatively small single center American cohort [34]. Additionally, increases in microcephaly noted in the late pandemic period in a Canadian cohort was concluded to be more likely secondary to an artifact of enhanced surveillance for anomalies [35], and no conclusion could be made as to increases in GI anomalies due to overall low incidence in a Romanian cohort [36].…”