Relationship between coronavirus disease 2019 in pregnancy and maternal and fetal outcomes: Retrospective analytical cohort study

• Published in: Midwifery 2021-11, Vol.102, p.103128-103128, Article 103128
• Main Authors: Alipour, Zahra, Samadi, Parisa, Eskandari, Narges, Ghaedrahmati, Maryam, Vahedian, Mostafa, Khalajinia, Zohre, Mastanijahroodi, Ali
• Format: Article
• Language: English
• Subjects: Adult; Cesarean Section; Cohort Studies; Coronavirus pneumonia; COVID-19 - epidemiology; Epidemiological characteristics; Female; Fetal outcomes; Humans; Infant, Newborn; Infectious Disease Transmission, Vertical; Maternal outcomes; Pandemics; Pregnancy; Pregnancy Complications, Infectious - epidemiology; Pregnancy Complications, Infectious - virology; Pregnancy Outcome - epidemiology; Premature Birth - epidemiology; Retrospective Studies; Retrospective study; SARS-CoV-2
• ISSN: 0266-6138; 1532-3099
• DOI: 10.1016/j.midw.2021.103128

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has caused many deaths and complications worldwide. However, limited data are available about COVID-19 during pregnancy. This study aimed to assess the epidemiological and clinical features of COVID-19, and the adverse maternal and fetal outcomes. This retrospective analytical cohort study was conducted on all pregnant women with confirmed COVID-19 at Nekouei-Hedayati-Forghani Hospital in Qom, Iran from 15 March 2020 to 15 November 2020. For the same period, 165 pregnant women who did not have COVID-19 were selected at random and included in this study. All epidemiological and clinical features were collected from the medical records of the participants. A logistic regression model was used to determine associations between COVID-19 in pregnancy and maternal and fetal outcomes. The most common symptoms reported by pregnant women with COVID-19 were shortness of breath (60.9%), dry cough (59%) and fever (42.9%). After adjustment for potential confounding factors, COVID-19 in pregnancy was associated with a significantly higher risk of admission to the intensive care unit (ICU) [odds ratio (OR) 6.16, 95% confidence interval (CI) 1.23–31], caesarean section (OR 0.45, 95 CI 0.25–1.03), preterm birth (OR 3.01, 95% CI 1.4–6.54), fetal distress (OR 5.7, 95% CI 2.13–15.59) and admission to the neonatal intensive care unit (NICU) (OR 3.04, 95% CI 1.21–7.70). COVID-19 is associated with adverse maternal and fetal outcomes, including ICU admission, caesarean section, fetal distress, preterm birth and NICU admission.