Pregnancy and neonatal outcomes of SARS-CoV-2 infection discovered at the time of delivery: a tertiary center experience in North Italy

Abstract

Objectives Although the knowledge on SARS-CoV-2 infection in pregnancy has greatly improved, there is still a lack of information on its role in the later stages of gestation. The aim of this study is to investigate whether SARS-CoV-2 discovered at delivery is associated with any obstetric or neonatal complications. Methods A retrospective case-control study was conducted at Department of Obstetrics, University Hospital Maggiore della Carità, Novara, Italy, from March 2020 to March 2023. Pregnant women admitted were tested for SARS-CoV-2. 168 women resulted positive at the time of delivery; the women were asymptomatic or paucisymptomatic. 170 negative women were selected as controls, selecting, for each SARS-CoV-2 positive patient, the patient who gave birth right before, if negative. Demographic and anamnestic characteristics, pregnancy, labor, and neonatal outcomes were evaluated. Results SARS-CoV-2 positive patients were more likely to have gestational diabetes (13.7 vs. 5.3 %) and required less frequently intrapartum analgesia (11.3 vs. 27 %) and labor augmentation (7.3 vs. 16.5 %). Post-partum hemorrhage rate was lower (13.7 vs. 22.9 %) and a shorter length of first and second stage of labor occurred. There were no statistically significant differences between the two groups regarding the mode of delivery and neonatal outcomes. Conclusions SARS-CoV-2 positive patients have shorter labor length and a lower incidence of postpartum hemorrhage. Fewer obstetric interventions, as well as less use of intrapartum analgesia and oxytocin, could explain these findings. Moreover, gestational diabetes could increase susceptibility to infection. SARS-CoV-2 infection discovered at the time of delivery in asymptomatic or paucisymptomatic patients does not appear to increase the rate of cesarean delivery or other obstetric complications, and neonatal outcomes have not worsened.

Impact of Clinical Severity on Maternal and Perinatal Outcome Across Trimesters in COVID 19 Pregnancies: A Prospective Cohort Study

“…However, other studies have identified that the association between COVID-19 during pregnancy and adverse maternal or fetal/neonatal outcomes occurs independent of the severity of COVID-19 [3,25]. Despite recently published studies disagreeing with obstetric and neonatal complications, our study was carried out in the first and second waves of COVID-19, only with normal-risk pregnant women [26,27].…”

Impact of SARS-COV-2 Infection on Maternal, Obstetric and Neonatal Outcomes in a Cohort of Vaccinated Women: A Pilot Study

“…The effects of the COVID-19 pandemic on prematurity rates likely reflect the increase in preeclampsia-induced preterm births (Andrikopoulou et al, 2020) and infection-induced spontaneous preterm births (Villar et al, 2021;Weinberger et al, 2022). Nevertheless, reports on the impact of the pandemic on preterm birth remain conflicting, and earlier research has reported a lack of changes in preterm labor during COVID-19 (Arnaez et al, 2021;Di Toro et al, 2021), or even a reduction in preterm birth rates (Delius et al, 2023) or improvement of maternal outcomes such as shorter labor length and a lower incidence of postpartum hemorrhage (Libretti et al, 2023). Conflicting results may be related to the diversity in gestational ages and the contributing etiologic factors for preterm labor in the studied population.…”

“…Previous studies have shown that having COVID-19 during pregnancy increases the risk of preterm birth (Andrikopoulou et al, 2020;Karasek et al, 2021;Smith et al, 2022;Villar et al, 2021;Vouga et al, 2021;Weinberger et al, 2022;Yao et al, 2022) and has an increased risk of maternal death and admission to intensive care units (Allotey et al, 2020). However, others report a lack of changes in preterm pregnancies due to COVID-19 (Arnaez et al, 2021;Di Toro et al, 2021), or even shorter labor length and lower incidence of postpartum haemorrhage (Libretti et al, 2023). Therefore, manifesting a contradiction in the published results that requires further investigation.…”

Septicemia caused by Enterococcus coli in a pregnant woman after cerclage—A case report

“…It was found that women with SARS-CoV-2 pauci-symptomatic infection had an increased rate of malposition of the fetus and gestational diabetes. 1 However, there is limited knowledge regarding E. coli bacteremia specifically in pregnant women after cervical cerclage. None of the previous case studies have reported about women who contract E. coli bacteria after they went through cervical cerclage surgery.…”