Coronavirus disease 2019 in pregnancy: Maternal and perinatal outcome

Since the advent of coronavirus disease 2019 (COVID-19) infection, there is debate whether pregnancy outcome in COVID-19 is more severe as compared to general population. Pregnant population is particularly susceptible to viral infections due to altered immune response. H1N1 infection and Zika virus infection led to unfavorable maternal and fetal outcomes. SARS during pregnancy has been linked previously with high risk of spontaneous abortions, preterm births and intrauterine growth restriction. The effects of this novel virus need to be studied.

This is a single-center descriptive prospective observational study of 65 pregnant women with reverse transcriptase-polymerase chain reaction confirmed COVID-19 infection, regardless of gestational age at diagnosis, admitted from April 15 to June 30, 2020, at the COVID hospital in SN Medical college a tertiary center of Agra in North India. Maternal and perinatal outcomes were studied. Data were analyzed using the SPSS software for windows. Continuous variables were expressed as mean ± standard deviation. Categorical variables were expressed as numbers and percentages.

Majority 88.4% of the women were asymptomatic. Rest had mild illness only. Majority 94.23% were third-trimester pregnancies; preterm birth was not reported in any singleton pregnancy. Majority 85% were delivered by cesarean section done for obstetric indications. Maternal outcome of all patients was favourable, and only two women who had moderate pneumonia recovered. Maternal mortality was reported in only 1 case. All neonates were negative for COVID-19. Neonatal outcome was favorable.

COVID-19 in pregnancy led to mild symptoms only. Infection in the third trimester did not led to adverse obstetric outcome including preterm labor and premature membrane rupture. SARSCoV2 infection in pregnancy did not increase the risk of maternal mortality. Vertical transmission of COVID-19 was not found in neonates. The maternal, neonatal, and perinatal outcomes of COVID-19 patients infected in late pregnancy were favorable.