Does the presence of symptoms affect pregnancy outcomes in third trimester in women with SARS-CoV-2

Abstract

Objective

Parturients with symptoms to COVID-19 have an increased risk for neonatal adverse outcomes and for any adverse outcome compared to the asymptomatic COVID-19 positive parturients and to the COVID-19-negative parturients. The purpose of this study was to determine the effect of COVID-19 on obstetric outcomes based on symptom status of parturients at or near term.

Methods

Retrospective cohort study of parturients diagnosed with COVID-19 between 26 March and 30 September 2020. Maternal and neonatal outcomes were assessed by comparing three groups of parturients: COVID-19 negative, asymptomatic COVID-19, and symptomatic COVID-19.

Results

A total of 2299 COVID-19-negative parturients and 172 patients with confirmed diagnosis of COVID-19 delivered during the study period. The median gestational age at the time of delivery was 39 (interquartile range 39–40) weeks. The most common symptom was cough (28/56, 50%). Gestational diabetes mellitus was significantly less common in COVID-19-negative than in COVID-19-positive patients. There was no significant increase in cesarean delivery in women who were COVID-19 positive and the incidence of preterm deliveries was not significantly different among the three groups. Of the 172 cases of COVID-19, only one parturient needed mechanical ventilation, and there were no maternal deaths in this group. There were no cases of severe neonatal asphyxia or neonatal death. Composite maternal adverse outcomes were not significantly different between the three groups. The aOR for composite neonatal adverse outcome and overall composite adverse outcome comparing COVID-19 positive to negative parturients was 2.1 (95% confidence interval [CI], 1.1–3.8; p = .02) and 1.6 (95% CI, 1.1–2.3; p = .02), respectively.

Conclusions

An increased risk for neonatal adverse outcomes and for any adverse outcome was found in the symptomatic COVID-19 group compared to the asymptomatic COVID-19-positive parturients and to the COVID-19-negative parturients.

Keywords:

• Pregnancy
• coronavirus disease (COVID-19)
• symptomatic
• asymptomatic
• outcome

Ethical approval

The study was approved by the Mayanei Hayeshua Medical Center Institutional Review Board (MHMC-0043-20, 12/10/2020).

Acknowledgement

There was no study funding or competing interests.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

L. H., E. E., S. J. L., Y. S., D. R., I. O., A. R., and A. T. reviewed the literature and wrote the paper. L. H. performed the statistical analyses for this study. All authors read and approved the final manuscript.

Informed Consent

The Authors did not use informed consent because this was a retrospective study and all research data was collected from the database of the hospital (with approval from the Mayanei Hayeshua Medical Center Institutional Review Board (MHMC0043-20, 12/10/2020)). All subjects in the study database were encoded in a serial number so that they could not be identified.