Risk Factors Associated With COVID-19 Symptoms and Potential Vertical Transmission During Pregnancy: A Retrospective Cohort Study

Abstract

Objective The COVID-19 pandemic is of special concern for pregnant women. A growing body of evidence suggests the virus can have a deleterious impact upon outcomes related to birth and newborn health. There is a paucity of published research demonstrating the factors that influence disease severity among those who are pregnant, while a growing body of evidence demonstrates that vertical transmission occurs. Our study investigated the impact of maternal characteristics upon COVID-19 outcomes, as well as whether disease severity impacted pregnancy outcomes. Methods We conducted a retrospective cohort study of pregnant women with COVID-19 who were admitted to two public hospitals in our state between April-August, 2020. Pregnancy outcomes and clinical, laboratory, and placental data were collected. Results Thirty-four pregnant women tested positive for SARS-CoV-2. Among them, 55% (19/34) were symptomatic. Of those who were symptomatic, 68% (13/19) presented with fever and cough. Those with symptoms had a statistically significant higher pregestational mean body mass index (BMI) compared with asymptomatic women (35.7±7.9 vs 26.7±6.9, P =0.004). Screening of biochemical records demonstrated that symptomatic women had lower potassium levels compared with those who were asymptomatic (median: 3.70 mEq/L vs 4.30 mEq/L, P =0.009). The lowest potassium level (3.0 mEq/L) and one of the highest BMIs (42.4 kg/m 2 ) was observed in the only case of postpartum mortality among the symptomatic women. We did not observe any influence of maternal COVID-19 severity on placental histopathology/infant health or evidence of vertical transmission. Conclusion High pregestational BMI and lower potassium levels were associated with the presence of COVID-19 symptoms among pregnant women.

The Risk of SARS-CoV-2 Infection in Pregnant Women: An Observational Cohort Study Using the BIFAP Database

“…[ 33 ] Obesity leads to more adipose tissue and more angiotensin- converting enzyme 2 (ACE2) receptors on the cell surface, in which SARS-CoV-2 binds and penetrates in the cell [ 34 ]. Prior studies have also found a positive correlation among prenatal BMI and COVID-19 infection [ 35 ]. Likewise, diabetes involves a chronic inflammatory effect together with a prothrombotic stage that might play a worsen response to infections [ 36 , 37 ].…”

Effects of novel coronavirus Omicron variant infection on pregnancy outcomes: a retrospective cohort study from Guangzhou

“…No positive results for vertical transmission were observed. Previous studies have described positive rates of 2 to 4.4 percent of neonatal COVID-19 PCR tests at delivery ( 29 , 49–51 ), but vary widely, PCR tests of COVID-19 such as amniotic fluid, cord blood, placenta, and breast milk have found no evidence of vertical transmission ( 52–54 ), and further research is needed.…”

COVID-19 in Pregnancy: Influence of Body Weight and Nutritional Status on Maternal and Pregnancy Outcomes—A Review of Literature and Meta-Analysis

“…Further data are needed to better understand how body weight and nutrition can influence the prognosis of COVID-19 in pregnancy, and how pre-pregnancy normalization of BMI and tailored nutritional supplementation can affect pregnancy outcomes [ 24 , 26 , 34 , 35 , 36 , 37 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 ].…”