Maternal and Neonatal Outcomes Associated with Mild COVID-19 Infection in an Obstetric Cohort in Brazil

Abstract

Previous coronavirus epidemics were associated with increased maternal morbidity, mortality, and adverse obstetric outcomes. Reports for SARS-CoV-2 indicate that the obstetric population is at increased risk for severe illness, although there are still limited data on mild COVID-19 infection during pregnancy. To determine the association between mild COVID-19 infection during pregnancy, and maternal and neonatal outcomes, we performed a prospective cohort study among pregnant women with COVID-19 and a control group. Postnatal depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale. We recruited 84 pregnant women with mild COVID-19 and 88 pregnant women without COVID-19. All participants were unvaccinated. The most common acute COVID-19 symptoms were headache (82.1%), loss of smell (81%), and asthenia (77.4%). The median duration of long COVID symptoms was 60 days (interquartile range, 130). Pregnant women with a COVID-19 diagnosis were at greater risk for obstetric ultrasound abnormalities—mainly, fetal growth restriction (relative risk [RR], 12.40; 95% CI, 1.66–92.5), premature birth (RR, 2.62; 95% CI, 1.07–6.43), and postpartum depression (RR, 2.28; 95% CI, 1.24–4.21). Our results alert clinicians to the consequences of COVID-19 during pregnancy, even in mild cases, given the increased risk of ultrasound abnormalities, premature birth, long COVID symptoms, and postpartum depression. National guidelines on preventive measures and treatments should be based on scientific evidence, including attention to the impact on health and family needs during and after the COVID-19 pandemic.

A retrospective observational study on maternal and neonatal outcomes of COVID-19: Does the mild SARS-CoV-2 infection affect the outcome?

“…In this study, all SARS-CoV-2 infections occurred during the third trimester of pregnancy, with an average gestational age of 246.7 ± 21.56 days at the time of SARS-CoV-2 infection. These findings are consistent with other studies conducted during the same period ( Antoun et al, 2020 ; Kumari, Anand & Vidyarthi, 2022 ; Santos et al, 2022 ; Yan et al, 2020 ), highlighting the importance of continued prophylaxis throughout pregnancy. Approximately 15.6% of pregnant women with COVID-19 were diagnosed with gestational diabetes mellitus (GDM), compared to 10.4% in the control group.…”

Female reproductive health impacts of Long COVID and associated illnesses including ME/CFS, POTS, and connective tissue disorders: a literature review

“…A small but important control-matched prospective cohort study in Brazil (n = 88) followed pregnant women after testing positive for COVID-19 (n = 84), finding that 75.9% developed LC (31). This study also found that patients given glucocorticoids to treat COVID-19 during pregnancy were at higher risk (RR 6.92, 95% CI 1.70-28.07) of persistent fatigue (31), a key and debilitating LC symptom.…”

SARS-CoV-2 infection elucidates unique features of pregnancy-specific immunity

“…Second, we evaluated non-specific T cell responses during the acute and convalescent phases of COVID-19 without assessing SARS-CoV-2-specific T cell responses. Another important area for future study beyond the scope of the experiments performed here is to understand how maternal immune responses during acute SARS-CoV-2 infection and convalescence relate to longer-term immune function in individuals after pregnancy 118,120,122 (e.g., development of long COVID or other immune syndromes), and the short- and long-term health outcomes of their offspring. Members of our study team have examined both short-term neurodevelopmental 119,121 and cardiometabolic 123,124 outcomes in offspring of mothers infected with SARS-CoV-2 in pregnancy, demonstrating increased risk for neurodevelopmental diagnoses at 12 months particularly pronounced in male offspring, and increased risk for altered growth trajectories in the first year of life that may presage an increased risk for early-onset cardiometabolic complications.…”