ArticleBMC pregnancy and childbirth2025
The impact of acute and prior SARS-CoV-2 infection on maternal and neonatal outcomes in pregnant women: a single-center retrospective cohort study.
Article in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSevere Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection in pregnant women have an adverse impact on perinatal outcomes, including cesarean section, preterm birth, fetal distress. However, it's uncertain whether these adverse consequences are caused by previous SARS-COV-2 infection during pregnancy or acute infection at the time of delivery.
methodsWe conducted a single-center retrospective cohort study among pregnant women with singleton pregnancy who delivered between 1 December 2022 and 1 February 2023 (n = 2472). Pregnancies were divided into three groups: non-infected group, acute SARS-CoV-2 infection group, prior SARS-CoV-2 infection group based on PCR or antigen test. The clinical data for mothers and neonates came from medical records on internal healthcare system. Follow-up time spanned from admission to discharge. We investigated the impact of acute and prior SARS-CoV-2 infection on maternal and neonatal outcome. Multivariable logistic models were used to assess the risk of adverse perinatal outcome in pregnant women with acute and prior SARS-CoV-2 infection.
resultsCompared to the non-infected pregnant women, acute SARS-CoV-2 infected pregnant women had significant higher rates of intrahepatic cholestasis of pregnancy (ICP) (26 women [4.4%] vs. 8 women [1.0%]; aOR, 4.9 [95% CI, 2.2-11.0]; P < 0.001), preterm birth (<37 wk) (53women [9.0%] vs. 45 women [5.7%]; aOR, 1.7 [95% CI, 1.1-2.7]; P < 0.05), fetal distress(106 women [18.1%] vs. 82 women [10.4%]; aOR,1.9 [95% CI, 1.4-2.6]; P < 0.01), primary cesarean delivery (216 women [36.9%] vs. 239women [30.3%]; aOR, 1.4[95% CI, 1.1-1.8]; P < 0.01) and neonatal unit admission (69 neonates [12%] vs. 64 neonates [8.3%]; aOR, 1.6 [95% CI, 1.1-2.3]; P < 0.05), prior SARS-CoV-2 infection were associated with an increased risk of ICP (40 women [3.7%] vs. 8 women [1.0%]; aOR, 3.9 [95% CI, 1.8-8.5]; P <0.001).
conclusionsPregnant women at delivery with acute SARS-CoV-2 infection were associated with higher risk of ICP, preterm birth, fetal distress, primary cesarean delivery and neonatal unit admission. Prior SARS-CoV-2 infection during pregnancy was associated with higher risk ICP. These findings emphasize the need for optimization of strategies for prevention of SARS-CoV-2 infection in pregnant women, especially for acute infection at delivery.
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