Objective To study the effect of delivery on the pO 2 /FiO 2 ratio (P/F ratio) in patients with COVID-19-related acute respiratory distress syndrome (ARDS) and to compare characteristics between delivered and undelivered pregnant patients with COVID-19.Design Retrospective cohort.

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OBJECTIVE: To define the clinical significance between umbilical cord gas measurements (namely umbilical arterial blood gas pH and base deficit) collected upon delivery and neonatal outcomes. Specifically, we aimed to determine if these values act as predictors for serious neonatal complications. STUDY DESIGN: All singleton, liveborn deliveries > 35 weeks between 1/2011 e 12/2019 with umbilical cord gas samples were studied. Those with fetal acidosis (umbilical artery blood pH of < 7.15 and/ or a base deficit > 10) were compared for adverse neonatal outcomes including seizures, intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), necrotizing enterocolitis (NEC), bronchopulmonary dysplasia (BPD), neonatal death, NICU admission, ventilator support, and sepsis. Comparisons between the cohorts were evaluated using a chi-square test with effect sizes estimated using relative risks (95% CI). RESULTS: 96,511 live birth singleton deliveries met inclusion: 2,285 (2.3%) with pH < 7.15 and/or base deficit > 10. Adverse neonatal outcomes were significantly higher in those with fetal acidosis including seizures, IVH, BPD, neonatal death, NICU admission, respiratory support, and sepsis (p < 0.001, Table). CONCLUSION: Infants with cord pH < 7.15 and/or a base deficit > 10 are at a significantly greater risk of adverse neonatal outcomes.