Maternal and neonatal outcomes in COVID-19 infected pregnancies: a prospective cohort study

Abstract Background Despite the large number of pregnant women with the coronavirus disease 2019 (COVID-19), there is not enough analytical study to compare maternal and fetal consequences of COVID-19 infected with non-infected pregnancies. This cohort study aimed to compare maternal and fetal consequences of COVID-19 infected with non-infected pregnancies. Methods We included pregnant women with and without COVID-19 who were admitted to Arash Hospital in Tehran, Iran from March 1 to Sep 1, 2020. Clinical features, treatments, and maternal and fetal outcomes were assessed. Results One hundred and ninety-nine women enrolled, including 66 COVID-19 infected and 133 non-infected pregnant women prospectively. Caesarean Section (CS) was carried out in total 105 women (52.76%). A significant difference was found in term of delivery type between COVID-19 infected and non-infected pregnant women (aRR: 1.31, 95%CI: 1.04, 1.65, p = 0.024). No significant association was found between COVID-19 infection and preterm birth (PB) (aRR: 1.16, 95%CI: 0.54, 2.48, p = 0.689), low birth weight (LBW) (aRR: 1.13, 95%CI: 0.55, 2.31, p = 0.723), gestational diabetes (GDM) (aRR: 1.67, 95%CI: 0.81, 3.42, p = 0.160), preeclampsia (aRR: 2.02, 95%CI: 0.42, 6.78, p = 0.315), intrauterine growth restriction (IUGR) (aRR: 0.16, 95%CI: 0.02, 1.86, p = 0.145), preterm rupture of membrane (PROM) (aRR: 0.19, 95%CI: 0.02, 2.20, p = 0.186), stillbirth (aRR: 1.41, 95%CI: 0.08, 18.37, p = 0.614), postpartum haemorrhage (aRR: 1.84, 95%CI: 0.39, 8.63, p = 0.185), neonatal intensive care unit (NICU) admission (aRR: 1.84, 95%CI: 0.77, 4.39, p = 0.168), neonatal sepsis (aRR: 0.84, 95%CI: 0.48, 1.48, p = 0.568). The percentage of patients (4/66, 6.06%) being admitted to the ICU was significantly higher than the control group (0%) (p < 0.001). Conclusion Basically, although pregnancy and neonatal outcomes were not significantly different, the need for ICU care for pregnant women with COVID-19 was significantly higher compared with those without COVID-19.

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