Results from a retrospective single-centre study published in the American Journal of Obstetrics & Gynecology suggest that COVID-19 in pregnancy is associated with maternal morbidity and preterm birth.
Study researchers said that while some case series with small sample sizes have reported reassuring outcomes for pregnant women with COVID-19 infection, more recent reports have highlighted cases of severe maternal morbidity requiring intubation and maternal deaths. Loïc Sentilhes, MD, Department of Obstetrics and Gynecology, Bordeaux University Hospital, Bordeaux, France, and colleagues sought to further investigate the maternal characteristics and clinical outcomes of pregnant women with COVID-19 disease.
The study included 54 pregnant women, 38 of whom had confirmed COVID-19 infection and 16 were suspected of having COVID-19, regardless of gestational age at diagnosis, admitted to the Strasbourg University Hospital, France, from March 1 to April 3. Maternal characteristics, laboratory and imaging findings, as well as maternal and neonatal outcomes, were extracted from medical records.
Findings showed that 32 of the women had an ongoing pregnancy, one a miscarriage and 21 live births, with 12 vaginal and 9 caesarean deliveries. The authors noted that among the women who gave birth, preterm deliveries were medically indicated for their COVID-19-related condition for 23.8%, with 14.3% before 32 weeks’ gestation and 9.5% before 28 weeks. Further, oxygen support was required for 24.1% of the 54 women, including high-flow oxygen (n=2), non-invasive (n=1) and invasive (n=3) mechanical ventilation, and extracorporeal membrane oxygenation (n=1). Of these women, three, aged 35 years or older with positive COVID-19 RT-PCR, all of whom were overweight or obese, and two had an additional comorbidity, had respiratory failure requiring indicated delivery before 29 weeks’ gestation.
The authors concluded that COVID-19’s association with other well-known risk factors for severe maternal morbidity in non-infected pregnant women, including maternal age above 35 years, overweight, and obesity, suggests further studies are required to determine whether these risk factors are also associated with poorer maternal outcome in these women.