Perinatal outcomes in women with severe acute respiratory syndrome coronavirus 2 infection: comparison with contemporary and matched pre-COVID-19 controls

Abstract

Objectives To compare perinatal outcomes in women with vs. without severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Methods Perinatal outcomes in SARS-CoV-2 positive pregnant women who delivered at our institution between October 27th 2020 and January 31st 2021 were compared to SARS-CoV-2 negative pregnancies (contemporary controls) and historical 2019 controls matched by maternal age, pre-pregnancy body mass index and parity. Testing was performed based on symptoms or close contact at any time during pregnancy and as part of universal screening at hospital admission. Multivariable log-linear regression models were used adjusting for potential confounders (p < 0.05 statistically significant). Results One thousand three hundred seventeen women delivered at our institution during the study period. 1,124 (85%) tested negative and 193 (15%) positive for SARS-CoV-2. 189 (98%) were infected during third trimester. 19 (10%) were asymptomatic, 171 (89%) had mild to moderate coronavirus disease 2019 (COVID-19), and 3 (2%) were critically ill with one case of maternal death. There were no significant differences in preterm birth, small-for-gestational-age birth weight, congenital anomalies, operative delivery, intrapartum hypoxia, and perinatal mortality in SARS-CoV-2 positive pregnancies compared to contemporary reference group or historical controls from pre-COVID-19 period. Labor was more commonly induced in SARS-CoV-2 positive women compared to reference SARS-CoV-2 negative group (68 [35%] vs. 278 [25%], adjusted odds ratio 1.62; 95% confidence interval 1.14–2.28). Conclusions SARS-CoV-2 infection in pregnancy was not strongly associated with adverse perinatal outcomes. While the majority of SARS-CoV-2 positive women had no or mild/moderate symptoms, 2% were critically ill, with one case of maternal death.

Perinatal COVID-19 maternal and neonatal outcomes at two academic birth hospitals

“…Neonatal infection did occur, supporting international and national guidelines which advocate for infection prevention measures in those postpartum settings, when feasible. Consistent with other studies, we did not find a direct effect of maternal or neonatal SARS-CoV-2 infection on short-term newborn health during the birth hospitalization period [22,23]. Although much has been learned in the past 2 years regarding how long persons are contagious when infected with SARS-CoV-2, less is known about the short-and long-term effects (if any) of infection in the immediate neonatal period.…”

Comparison of maternal outcome in COVID-19 positive and negative antenatal women: a comparative study

“…In terms of symptom severity, the majority of pregnant women in the case group exhibited mild to moderate symptoms, consistent with previous studies. 16,17 However, there were variations in symptom presentation and asymptomatic cases across different studies, indicating the diverse clinical manifestations of COVID-19 in pregnant women. 18,19 This highlights the importance of close monitoring and early detection of symptoms in pregnant women to provide timely medical interventions.…”

Brixia Score in Outcomes of Alpha versus Delta Variant of Infection in Pregnant Critical COVID-19 Patients

“…Pregnant patients admitted to the intensive care unit (ICU) constitute a relatively unique population in that both the maternal and fetal status must be taken into account simultaneously [4]. Critical COVID-19 patients account for 1.7% [5,6] to 13% [7][8][9][10] of all pregnant COVID-19 patients.…”

“…Lokken [3] and Moieindarbary [12] reported only one patient admitted to the ICU, who subsequently died of respiratory failure after a prolonged ICU stay despite multiple COVID-19 therapeutics, which is a 100% mortality rate. Lucovnik [6] reported a 33.33% mortality rate in critically ill pregnant patients. The World Association of Perinatal Medicine [13] reported 3 maternal deaths among 36 patients admitted to the ICU, which is an 8.33% mortality rate.…”