Retrospective Analysis of the Impact of SARS‐CoV‐2 (COVID‐19) on Pregnancy and Neonatal Outcomes

Abstract

Background: The novel coronavirus disease 2019 (COVID‐19) was more devastating in people with comorbidities such as advanced age and immunodeficiency. Another group affected by COVID‐19 was pregnant women. Immunological changes during pregnancy and conditions such as gestational diabetes and pre‐eclampsia that occur during pregnancy also have effects on the fetus. The aim of this study was to analyze the effects of PCR‐proven COVID‐19 infection during pregnancy on fetus and newborn.Methods: Between December 2019 and October 2021, data from pregnant women with COVID‐19 symptoms or a history of contact with people with COVID‐19, infected with PCR‐proven COVID‐19 virus, were analyzed retrospectively. Clinical and laboratory data of pregnant women were analyzed. Death data associated with COVID‐19 were evaluated. Clinical and laboratory findings of newborns related to COVID‐19 and mortality data related to COVID‐19 were recorded. The study received approval from the Gazi Yasargil Training and Research Hospital ethics committee (09.07.2021/853).Results: We evaluated 327 pregnant women who were followed up in our hospital and whose deliveries ended in live birth, stillbirth, miscarriage, or curettage. One hundred eighty‐five (56.6%) of the pregnant women had at least one COVID‐19‐related symptom. We evaluated the data of 306 live births, 21 intrauterine fetal deaths, and 13 postnatal deaths. Among the postnatal deaths, five infants succumbed directly due to COVID‐19 infection. A total of 23 live‐born babies (7.5%) were classified as small for gestational age (SGA), while 80 babies (26.1%) were born before 37 weeks of gestation, and 32 babies (10.4%) were born before 32 weeks. Cord blood gas analysis revealed that 19 infants (6.3%) had pH < 7 and base excess (BE) < −12. The rate of perinatal asphyxia was significantly higher in babies born to mothers who did not survive (p = 0.027). A considerable number of infants, 119 (40.3%), were admitted to the neonatal intensive care unit (NICU). Among the seven infants with positive PCR results admitted to the NICU, five (4.2%) did not survive.Conclusion: While COVID‐19 infection in pregnancy seriously affects mortality and morbidity in pregnant women, it also causes mortality and morbidity on the fetus.