Exploring Pregnancy Outcomes Associated with SARS-CoV-2 Infection.

Madalina Timircan,Oana Suciu,Valentina Avram,Livius Tirnea,Iulia Vidican,Felix Bratosin,Iosif Marincu

doi:10.3390/medicina57080796

Madalina Timircan, Oana Suciu + Show 5 more

Open Access

https://doi.org/10.3390/medicina57080796

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Abstract

Background and Objectives: The ongoing pandemic proved to be a tremendous challenge to all economic layers, healthcare, and people safety. As more than one year elapsed since the beginning of the COVID-19 pandemic, a multitude of medical studies involving the SARS-CoV-2 virus helped researchers and medical practitioners in understanding the effects it has on all sorts of patients until effective vaccines were finally developed and distributed for mass vaccination. Still, the SARS-CoV-2 and its new variants remain a potential threat towards all categories of patients, including a more delicate group represented by pregnant women. Thus, the current study aims to investigate the potential effects on obstetrical outcomes after a positive SARS-CoV-2 infection. Materials and Methods: This single-center prospective cohort study investigated the pregnancy outcomes in a total of 1039 eligible pregnant women between 30 August 2020 and 30 January 2021. Multiple patient characteristics and obstetrical outcomes were tested and analyzed in a multivariate regression model to establish potential risks determined by a COVID-19-positive pregnancy towards the mother and the newborn. Results: In the study sample, there were 938 pregnancies included without COVID-19 and 101 pregnant women identified with a positive COVID-19 infection. COVID-19 was significantly associated with a 2-fold increase in the risk of premature rupture of membranes and 1.5 times higher risk of preterm birth with emergency c-sections and lower APGAR scores. Also, significantly more newborns were given birth prematurely, with lower APGAR scores after the mothers were infected with SARS-CoV-2. Conclusions: A third-trimester infection with SARS-CoV-2 is a significant risk factor for preterm birth via an emergency cesarean section, a premature rupture of membranes, and a lower APGAR score in newborns, as compared with pregnancies where COVID-19 was not identified.

Highlights

Coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) triggered a pandemic in 2020, making it responsible for an estimated 979 thousand excess deaths in 29 high-income countries [1], including the US and the UK, and a total of at least 3 million deaths worldwide by the end of 2020 [2]
The current study aims to analyze pregnancies that covered a longer period of the pandemic and determine if singleton live birth outcomes from mothers infected with SARS-CoV-2 differ from mothers that did not contact the virus throughout their pregnancy and if the COVID-19 itself is an independent risk factor for adverse birth outcomes
The general characteristics and demographics of the women enrolled in the study (Table 1) indicated the highest incidence (>70%) of pregnancies eligible for this study in the 24–35-year-old group, without any significant differences between COVID-19-negative and -positive women (p-value = 0.152)

Summary

Introduction

Coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) triggered a pandemic in 2020, making it responsible for an estimated 979 thousand excess deaths in 29 high-income countries [1], including the US and the UK, and a total of at least 3 million deaths worldwide by the end of 2020 [2]. Considering the drop in admissions and the association between deferred care and increased morbidity, it is expected that future patients who postpone hospitalization will arrive with more severe conditions than usual [7] Based on these observations, we hypothesize that pregnant women left behind for antenatal observation and care due to the restrictions imposed during the COVID-19 pandemic will have adverse pregnancy outcomes [8], such as higher numbers of preterm deliveries and other major neonatal morbidities. Conclusions: A third-trimester infection with SARS-CoV-2 is a significant risk factor for preterm birth via an emergency cesarean section, a premature rupture of membranes, and a lower APGAR score in newborns, as compared with pregnancies where COVID-19 was not identified

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