COVID-19 and Pregnancy Outcomes: An Increased Risk of Intrauterine Inflammation/Infection

Abstract

Objective: The objective of this study is to determine the association between COVID-19 infection and pregnancy outcomes at our institution when universal testing was implemented for all patients admitted to Labor & Delivery. Methods: This was an IRB-exempt, retrospective chart review of all obstetrical patients admitted and evaluated in L&D from March 30th to April 30th. COVID-19 testing was performed on all patients who were admitted and their support person, irrespective of the presence of symptoms. Data analysis was performed with baseline demographics compared. Continuous variables were compared via T-test and categorical values using Chi-square and Fisher exact. Significant values are those considered with p < .05. Results: There were no differences in delivery outcomes between the two groups with regards to mode of delivery, preterm labor, premature rupture of membranes, preeclampsia, placental abruption, or fetal demise. However, there was an increase in intrauterine infection/inflammation among COVID positive patients (8.8% compare to 1.4%, p < .05) ('Tables 1' and '2'). Conclusions: COVID positive patients were noted to have an increase in intrauterine infection/inflammation. Current published data demonstrates that SARS-Cov-2 infection during 3rd trimester of pregnancy is not associated with vertical transmission. “However, the possibility of viral load influencing the transmission risk should be of concern. Published studies have demonstrated a positive relationship between the viral load of some viruses and their ability to spread from mother to child” [1]. Given our findings, the possibility of SARS-CoV-2 infection resulting in intrauterine infection/inflammation should be further evaluated as the pandemic continues.

Keywords

• covid-19
• pregnancy
• intrauterine infection and inflammation