Perinatal outcomes of pregnancies resulting from assisted reproduction technology in SARS-CoV-2-infected women: a prospective observational study

Abstract

Objective To evaluate the perinatal and maternal outcomes of pregnancies in SARS-CoV-2 infected women, comparing spontaneous and In Vitro Fertilization (IVF) pregnancies (with either own or donor oocytes). Design Multicentre, prospective, observational study. Setting 78 centres participating in the Spanish COVID19 Registry. Patients 1,347 SARS-CoV-2 positive pregnant women registered consecutively between February 26 th and November 5 th , 2020. Interventions Patient´s information was collected from their medical records, and multivariable regression analyses were performed, controlling for maternal age and the clinical presentation of infection. Main outcome measures Obstetrics and neonatal outcomes, pregnancy comorbidities, intensive care unit admission, mechanical ventilation need and medical conditions. Results The IVF group was composed of 74 (5.5%) women whereas the spontaneous group included 1,275 (94.5%) women. Operative delivery rate was high in all patients, especially in the IVF group, where C-section became the most frequent method of delivery (55.4%, compared to 26.1% of spontaneous). The reason for C-section was induction failure in 56.1% of IVF patients. IVF women had more gestational hypertensive disorders [16.2% vs 4.5% among spontaneous, adjusted Odds Ratio (aOR) 5.31, 95% Confidence Interval (CI) 2.45-10.93) irrespective of oocyte origin. The higher rate of ICU admittance observed in the IVF group (8.1% vs 2.4% spontaneous) was attributed to pre-eclampsia (aOR 11.82, 95% CI 5.25-25.87), not to the type of conception, Conclusions High rate of operative delivery has been observed in SARS-CoV-2 infected women, especially in IVF pregnancies; method of conception does not affect foetal or maternal outcomes, except for pre-eclampsia.

Impact of COVID-19 pandemic on clinical and embryological outcomes of assisted reproductive techniques

“…They noted a higher incidence of preeclampsia and ICU admission in these women compared to naturally conceived women with other maternal and neonatal outcomes being similar. [ 27 ] Recently, the ESHRE working group collected data from 80 cases from 32 countries from May 20 to June 21 and noted that medically assisted pregnancies are not differentially affected by COVID-19 infection compared to spontaneous pregnancies and that performing ART with due precautions and triaging can be advocated. [ 18 ]…”

Outcomes of SARS-CoV-2 infected pregnancies after medically assisted reproduction

“…In our dataset, C-section was reported for 61.1% of the deliveries. While these figures are higher than general Caesarean delivery rates, it is possible that concerns about transmission of the infection and potential deterioration of maternal status during labour have led to an increase in C-sections ( Engels Calvo et al , 2021 ). Other possible explanations for the high rate of C-sections are physicians having a lower threshold for C-section for MAR pregnancies or random variation in this small sample.…”

Preeclampsia and severe acute respiratory syndrome coronavirus 2 infection: a systematic review

“…A multicentric observational study evaluated totally 1347 SARS-CoV-2-infected pregnant women: 1273 spontaneous pregnancies and 74 IVF pregnancies. This study reported that hight ICU admittance rate of IVF pregnancies was because of preeclampsia but not to fertilization type suggesting that preeclampsia was caused by SARS-CoV-2 infection but not because of conception method [ 60 ].…”