1. COVID-19 infection in late pregnancy was associated with adverse birth outcomes, such as cesarean section delivery and iatrogenic preterm birth.
2. Limited evidence was found for maternal-fetal vertical transmission of SARS-CoV-2.
Evidence Rating Level: 3 (Average)
Coronavirus disease 2019 (COVID-19) is an ongoing concern in the healthcare sector. However, little is currently known about the transmission of COVID-19 during pregnancy. This retrospective cohort study used the Maternal and Child Health Information System of Wuhan, China, aiming to investigate the association between maternal COVID-19 and adverse birth outcomes. Included in analyses were all pregnant women with singleton, live births occurring between January 13, 2020 and March 18, 2020. A total of 11,078 pregnant women were included in analyses, with 65 (0.587%) confirmed cases of COVID-19. Roughly 78% of COVID-19– and 83% of COVID-19+ women were between the ages of 25 and 34 years. Of the positive cases, 65% had a bachelor’s degree or higher. Compared to COVID-19- mothers, those with COVID-19 had 3.34 greater odds of preterm birth (adjusted OR = 3.34, 95% CI 1.60 to 7.00) and 3.63 higher odds of cesarean section birth (adjusted OR = 3.63, 95% CI 1.95 to 6.76). Mothers with COVID-19 also demonstrated greater odds for preterm birth with cesarean section delivery (adjusted OR = 3.71, 95% CI 1.70 to 8.03). No statistical differences between groups were found in low birth weight, premature rupture of membrane, or neonatal asphyxia. Further, none of the newborns born to mothers with COVID-19 were positive for SARS-CoV-2, nor did they have abnormal CT findings. Symptoms occurred in four children, one experiencing diarrhea and three experiencing fever. Overall, COVID-19 among pregnant women appears to increase the odds of adverse birth outcomes. However, maternal-fetal transmission of the virus does not seem to be a concern based on this study.
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