The New Indian Journal of OBGYN. 12(1):167-173

Prospective study of maternal and fetal outcome in pregnancy affected by Covid 19 infection, as well as risk of vertical transmission in pregnancy

Mamta Rajan, Shikha Sachan, Abhishek Abhinay, Rose Mary Basumatary, Munesh Kumar Gupta, TB Singh, Bhupendra Verma

ABSTRACT

Objective: To evaluate the impact of Covid-19 infection on maternal and fetal outcomes in a universally tested pregnant population admitted for delivery. Methods: We conducted a prospective cohort study of all delivery hospitalisations between May 1, 2020, to October 31, 2020. Maternal and fetal outcomes in Covid-19 infected pregnant women, confirmed by RT-PCR (Reverse Transcriptase Polymerase Chain Reaction), were compared with those without infection during the same study period. Results: 864 pregnant women admitted for delivery were studied, including 86 women with SARS‐CoV‐2 infection. Most of the patients in the Covid-19 group (96.5%) were asymptomatic or had mild symptoms. Mean gestational age, medical comorbidities, and rates of caesarian deliveries were similar in both groups. Preeclampsia/eclampsia was significantly higher in the pregnant women with SARS-CoV-2 infection (15.1% vs 6.9%, p<0.01), and the relative risk were 2.17 (95% CI,1.24 to 3.82). Preterm deliveries (23.2% vs 13.7%, p<0.01) and premature rupture of membranes (PROM) (12.8% vs 5.8%, p=0.01) also occurred more frequently in the infected pregnant women. Fetal outcomes, including fetal distress, intrauterine growth retardation (IUGR), and mean birthweight, were similar. However, stillbirths were significantly more common in Covid-19 positive pregnancies (5.8% vs 1.9%, p=0.05; RR:3.01, 95% CI, 1.12 to 8.09). Conclusion: The majority of pregnant women at delivery hospitalization were asymptomatic. However, still, they were at a considerably higher risk of unfavourable outcomes, including preeclampsia/eclampsia, preterm birth, PROM, and stillbirth.