Perinatal outcomes among pregnant patients with peripartum coronavirus disease 2019 infection

Alla Saban; Noa Leybovitz Haleluya; Yael Geva; Neta Geva; Reli Hershkovitz

doi:10.1007/s00404-024-07536-9

Perinatal outcomes among pregnant patients with peripartum coronavirus disease 2019 infection

Arch Gynecol Obstet. 2024 May 6. doi: 10.1007/s00404-024-07536-9. Online ahead of print.

Authors

Alla Saban^#^{1

2}, Noa Leybovitz Haleluya^#^{3

4}, Yael Geva^{3

4}, Neta Geva^{4

5}, Reli Hershkovitz^{3

4}

Affiliations

¹ Department of Obstetrics and Gynecology, Soroka University Medical Center, PO Box 151, 84101, Beer Sheva, Israel. allakap1@gmail.com.
² Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel. allakap1@gmail.com.
³ Department of Obstetrics and Gynecology, Soroka University Medical Center, PO Box 151, 84101, Beer Sheva, Israel.
⁴ Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
⁵ Neonatal Department, Soroka University Medical Center, Beer Sheva, Israel.

^# Contributed equally.

PMID: 38709269
DOI: 10.1007/s00404-024-07536-9

Abstract

Purpose: Evaluate maternal and neonatal outcomes in peripartum coronavirus disease 2019 (COVID-19) positive women.

Methods: A retrospective cohort study was conducted, comparing outcomes between women with and without peripartum COVID-19. All singleton deliveries from June 2020 to January 2022 were included. Univariate analysis was followed by multivariate analysis.

Results: Of 26,827 singleton deliveries, 563 women had peripartum COVID-19, associated with preterm deliveries both near-term and remote from term [adjusted odds ratio (aOR) 1.6 and 2.0, respectively, p = 0.007 and 0.003]. Women with peripartum COVID-19 had a significantly higher rate of disseminated intravascular coagulation (DIC) (aOR 23.0, p < 0.001). Conversely, peripartum COVID-19 peripartum COVID-19 was negatively associated with premature rupture of membranes and prolonged maternal length of stay (aOR 0.7 and 0.5, respectively, p = 0.006 and <0.001). In cesarean delivery (CDs), patients with COVID-19 had higher rate of urgent CDs (75.5 vs. 56.1%, p < 0.001), higher rate of regional anesthesia (74.5 vs. 64.9%, p = 0.049), and longer anesthesia duration (86.1 vs. 53.4 min, p < 0.001). CD rate due to non-reassuring fetal heart rate (NRFHR) was significantly higher in women with COVID-19 (29.6 vs. 17.4%, p = 0.002). Conversely, CDs rate due to history of previous single CD was significantly higher in patients without COVID-19 diagnosis (13.6 vs. 4.1%, p = 0.006). Concerning neonatal outcomes, an association has been observed between COVID-19 and low one-minute APGAR score <5, as well as neonatal COVID-19 infection (aOR 61.8 and 1.7 respectively, p < 0.001 and p = 0.037).

Conclusions: Peripartum COVID-19 is associated with preterm deliveries, urgent CDs and DIC, potentially aligning with the infection's pathophysiology and coagulation alterations.

Keywords: COVID-19; Perinatal outcomes; Peripartum; Preterm delivery.