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Obstetric Outcomes Following SARS-CoV-2 Infection Remote from Delivery: A Prospective Cohort Study
Sofia Soltsman1, Lia Novick2, Novick Yefet3
1Department of Obstetrics and Gynecology, Tzafon Medical Center, Lower Galilee, Israel, High Risk Pregnancy Clinic, Maccabi Health Services, Tiberias, Israel, High Risk Pregnancy Clinic, Leumit Health Care Services, Tiberias, Israel, Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.
The Israel Medical Association Journal : IMAJ
|August 6, 2026
Summary
Pregnant women with resolved COVID-19 infections face higher risks of placental complications. Close monitoring until delivery is recommended for these patients to ensure better obstetric outcomes.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Maternal-Fetal Medicine
Background:
- Coronavirus disease 2019 (COVID-19) can cause severe complications, particularly in pregnant individuals.
- Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) replicates in the decidua, posing risks to pregnancy.
- Many infected pregnant women continue pregnancies despite SARS-CoV-2 replication.
Purpose of the Study:
- To evaluate the impact of SARS-CoV-2 infection, occurring remotely from delivery, on obstetric outcomes.
- To compare pregnancy outcomes in women with past COVID-19 infection to a pre-pandemic cohort.
Main Methods:
- Prospective enrollment of women diagnosed with SARS-CoV-2 at least 14 days before delivery.
- Comparison of obstetric outcomes with a historical control group from the year prior to the pandemic.
- Primary endpoint: composite of hypertensive disorders, oligohydramnios, and fetal distress/meconium-stained fluid.
Main Results:
- A significantly higher rate of placental complications was observed in the SARS-CoV-2 infected group (41% vs. 17%), with an odds ratio of 3.4.
- Increased rates of labor induction or early cesarean delivery in the infected group (26% vs. 17%).
- No significant differences in Apgar score, cord pH, or gestational age at infection.
Conclusions:
- Pregnant women with resolved SARS-CoV-2 infection exhibit a persistent increased risk of placental complications.
- Close clinical monitoring of these patients throughout the remainder of their pregnancy is crucial.
- Further research may elucidate specific mechanisms linking SARS-CoV-2 to placental issues.
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