Relationships between Fetal and Neonatal Outcomes and Spectrum of COVID-19 Disease in Pregnant Women.

Abstract

Background: Due to the high prevalence of COVID-19 and the prevention and control of adverse fetal and neonatal outcomes in pregnant women, including vertical transmission, this study was performed to describe the fetal and neonatal outcomes of pregnancy with a spectrum of COVID-19 disease during pregnancy in Iran.

Materials and methods: In this cross-sectional study, we analyzed the medical records of 258 pregnant women admitted to the Forghani Hospital, Qom, Iran, from 18 February 2020, to May 10, 2021. PCR-RT or respiratory compromise in the presence of marked radiographic changes of COVID-19 in the lungs, or both COVID-19 disease confirmed COVID-19 disease. Then, we collected the disease spectrum of COVID-19 and fetal and neonatal outcomes from patient records.

Results: The findings of our study showed that out of 258 pregnant women who were hospitalized due to COVID-19, 79.8% had mild to moderate disease, 16.7% had severe COVID-19, and 3.5% were in the critical stage. After adjusting for the confounding variables, the severity of the disease was significantly associated with adverse fetal and neonatal outcomes such as fetal distress, Intra Uterine Growth Restriction (IUGR), preterm delivery, and Low Birth Weight (LBW), and low first minute Apgar score. However, the severity of COVID-19 was not a predictor of spontaneous preterm delivery, admission to NICU, low Apgar scores at 5 minutes, vertical transmission, stillbirth, and neonatal death.

Conclusion: Neonates of mothers with the severe and critical stage of COVID-19 are exposed to higher potential risks such as fetal distress, IUGR, preterm delivery, LBW, and low Apgar scores at 1 minute than women with mild to moderate disease.