Maternal and neonatal outcomes of pregnancies with COVID-19 after medically assisted reproduction - results from the prospective Covid-19-Related Obstetric and Neonatal Outcome Study (CRONOS)

• Published in: American journal of obstetrics and gynecology 2022-04
• Main Authors: Ziert, Yvonne, Abou-Dakn, Michael, Backes, Clara, Banz-Jansen, Constanze, Bock, Nina, Bohlmann, Michael, Engelbrecht, Charlotte, Mia Gruber, Teresa, Iannaccone, Antonella, Jegen, Magdalena, Keil, Corinna, Kyvernitakis, Ioannis, Lang, Katharina, Lihs, Angela, Manz, Jula, Morfeld, Christine, Richter, Manuela, Seliger, Gregor, Sourouni, Marina, VON Kaisenberg, Constantin Sylvius, Wegener, Silke, Pecks, Ulrich, Versen-Höynck, Frauke VON
• Format: Article
• Language: English
• ISSN: 1097-6868

Severe acute respiratory syndrome coronavirus type 2 infections in pregnancy have been associated with maternal morbidity, admission to intensive care, and adverse perinatal outcomes such as preterm birth, stillbirth and hypertensive disorders of pregnancy. It is unclear whether in women with COVID-19 medically assisted reproduction additionally affects maternal and neonatal outcomes. To evaluate the effect of medically assisted reproduction on maternal and neonatal outcomes of women with COVID-19 in pregnancy. A total of 1,485 women with COVID-19 registered in the Covid-19 Related Obstetric and Neonatal Outcome Study, a multicentric prospective observational cohort study, were included. Maternal and neonatal outcomes of 65 pregnancies achieved with medically assisted reproduction and 1,420 spontaneously conceived pregnancies were compared. We used univariate und multivariate (multinomial) logistic regressions to estimate (un)adjusted odds ratios and 95% confidence intervals for adverse outcomes. Compared to women after spontaneous conceptions with COVID-19, the incidence of COVID-19 associated adverse outcomes (e.g. pneumonia, admission to intensive care, death) was not different than in women after medically assisted reproduction pregnancies. Yet, the risk of obstetric and neonatal complications was higher in pregnancies achieved through medically assisted reproduction. However, medically assisted reproduction was not the primary risk factor for adverse maternal and neonatal outcomes, e.g. pregnancy-related hypertensive disorders, gestational diabetes mellitus, cervical insufficiency, peripartum hemorrhage, delivery by caesarean section, preterm birth or admission to neonatal intensive care. Maternal age, multiple pregnancies, nulliparity, BMI >30 (before pregnancy) and multiple gestation contributed differently to the increased risks of adverse pregnancy outcomes in women with COVID-19, independent of medically assisted reproduction. Although women with COVID-19 who conceived through fertility treatment experienced a higher incidence of adverse obstetric and neonatal complications than women with spontaneous conceptions, medically assisted reproduction was not the primary risk factor.