Vaginal delivery in pregnancies with active COVID-19 infection: a retrospective analysis

To investigate safety, risk and perinatal outcomes of vaginal delivery in women with active coronavirus disease 2019 (COVID-19) infection.

Three hundred and fifty-one women who gave birth between 7 December 2022 and 31 December 2022 were recruited. Women with a COVID-19 infection were considered to be cases (COVID-19 group), and those without COVID-19 infection were controls (non-COVID-19). The maternal demographic characteristics, intrapartum parameters, and perinatal outcomes were compared between both groups.

There was no significant difference regarding maternal demographic characteristics within two groups (p > 0.05). The rate of multiparity was significantly higher in non-COVID-19 group compared with COVID-19 group (p < 0.05); a prolonged first stage and total labor duration were more frequently seen in COVID-19 group (p < 0.05). Higher rate of fever during delivery was noted in the COVID-19 group as compared with non-COVID-19 group (p < 0.05). Generalized linear model analysis demonstrated that COVID-19 infection status was not correlated to the risk of a prolonged first stage and total labor duration; Multivariate logistic regression analysis found that COVID-19 infection was associated with an 8-fold increased risk of fever during delivery.

Vaginal delivery is an appropriate delivery option and associated with favorable outcomes among COVID-19-infected asymptomatic or mild individuals in late pregnancy who underwent vaginal birth; COVID-19 status alone is associated with increased risk of fever during delivery for COVID-19-infected women, and pregnant women would benefit from increased monitoring during delivery management.