SARS-CoV-2 Viral Load in Pregnant Women and Association with Maternal Disease Severity and Neonatal Outcomes

Background: The outbreak of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) created unexpected impacts worldwide. Objectives: This study aimed to examine the association of SARS-CoV-2 viral load in pregnant women with maternal disease severity and neonatal outcomes. Methods: In this retrospective cohort study, 55 pregnant women infected with SARS-CoV-2 and their newborn infants were included. The association between maternal viral load (tested by cycle threshold) and maternal disease severity/neonatal outcomes was examined. Results: Infants had a median gestational age of 38 (29 - 41) weeks and birth weight of 3200 (630 - 4570) grams. The median Ct value of pregnant women was 30 (20 - 37). No significant difference was detected among mild, moderate or severely ill pregnant women in terms of median Ct values (30, 28.5, and 30, respectively; P > 0.05). The median Ct value of pregnant women who gave preterm delivery was similar to those who had term delivery [30 (21 - 36) vs. 30 (25 - 35); P > 0.05]. The median Ct values were similar among pregnant women who died or survived [32.5 (30 - 34) vs. 30 (21 - 36); P > 0.05]. Preterm delivery rates and overall mortality were not associated with SARS-CoV-2 RT-qPCR Ct values, (r = 0.04, P > 0.05). No correlation was found between maternal SARS-CoV-2 viral load and maternal disease severity/neonatal outcomes. Conclusions: To the best of our knowledge, this study was the first one examining the association between maternal SARS-CoV-2 viral load and maternal/neonatal outcomes. It was suggested that viral load may not have been used for predicting the severity of maternal disease and maternal/neonatal outcomes.

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