Neonatal Outcome in Pregnant Women with Confirmed COVID-19 Infection during the Last Two Weeks of a Viable Pregnancy: A Retrospective Data Analysis

Abstract

Background: Pregnant women are typically vulnerable to infectious diseases due to exaggerated disease manifestations and detrimental effects on their obstetric and neonatal outcomes. Previous studies have demonstrated that pregnant women with COVID-19 had similar clinical manifestations as nonpregnant women. However, there is not enough knowledge about the outcomes of neonates born to infected women although it has been reported that maternal pneumonia results in unfavorable obstetrical outcomes, including the premature rupture of membranes (PROM), intrauterine fetal demise (IUFD), intrauterine growth restriction (IUGR), and neonatal death. This retrospective study analyzes the clinical characteristics of all women with confirmed COVID-19 infection who gave birth in AWH, Qatar, as well as the possible adverse neonatal outcomes associated with maternal COVID-19 infection. Objective: To identify adverse neonatal outcomes in mothers with confirmed COVID-19 infection during the last two weeks of a viable pregnancy. Methods: This retrospective study included newborn babies born to mothers diagnosed with COVID-19 infection between 1 April 2021 and 23 May 2021 at AWH, Hamad Medical Corporation. Data: Clinical characteristics, investigation results, and course of treatment were gathered from medical records for both mothers and babies. Results: Out of 108 babies born to COVID-19-infected mothers, 47 (43.5%) were identified with adverse neonatal outcomes. Prematurity (28.7%), low birth weight (26%), respiratory distress (33.3%), and neonatal depression (8.3%) were the most commonly associated outcomes. Eight out of 108 babies (7.4%) tested positive for COVID-19, with 4.6% incidence of vertical transmission and 2.8% transient viremia. Using logistic regression analysis, maternal pneumonia and CT values were found to be statistically significant factors for premature delivery but were not significantly associated with neonatal infection. However, maternal ferritin levels significantly predicted neonatal positive PCR results. Conclusion: Our data support the possibility of the intrauterine transmission of SARS-CoV-2 even in asymptomatic women. Studies with a larger number of subjects are recommended for identifying the biological mechanisms involved.