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 ¼ .02) and 1.6 (95% CI, 1.1-2.3; p ¼ .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.

Prognosis of COVID-19 in the middle eastern population, knowns and unknowns

“…In Israel, scarce studies exist on the prognosis of COVID-19 in pregnant women. Two studies have shown that the most common symptom observed in this population is cough ( Harel et al, 2021 ) and that the disease presents mostly as a mild or an asymptomatic one ( Rottenstreich et al, 2021 ). The majority of pregnant women were in their third trimester at the time of COVID-19 diagnosis and delivery ( Mohr-Sasson et al, 2020 ; Barber et al, 2021 ; Harel et al, 2021 ; Rottenstreich et al, 2021 ).…”

“…Two studies have shown that the most common symptom observed in this population is cough ( Harel et al, 2021 ) and that the disease presents mostly as a mild or an asymptomatic one ( Rottenstreich et al, 2021 ). The majority of pregnant women were in their third trimester at the time of COVID-19 diagnosis and delivery ( Mohr-Sasson et al, 2020 ; Barber et al, 2021 ; Harel et al, 2021 ; Rottenstreich et al, 2021 ). Vaginal delivery was the most common, followed by C-section that was mainly performed based on obstetric indication and not due to the SARS-CoV-2 infection ( Mohr-Sasson et al, 2020 ; Barber et al, 2021 ; Rottenstreich et al, 2021 ).…”

“…Furthermore, non-pregnant infected women are more likely to have chronic diseases and be hospitalized (Barber et al, 2021). With regard to neonates born to infected mothers, no vertical transmission was reported (Barber et al, 2021;Harel et al, 2021;Rottenstreich et al, 2021). In pregnant women, only one study was conducted to compare SARS-CoV-2 infected pregnant women vaccinated with a 1st dose of COVID-19 vaccine versus unvaccinated ones.…”