Maternal and Neonatal Outcomes in COVID-19 Infected Pregnancies: A Prospective Cohort Study

Background: In recent months and during the rapid outbreak of corona virus disease in 2019 (Covid-19) all around the world, many pregnant women, have been infected with this deadly virus. Nevertheless, no adequate data is available on the clinical characteristics, manifestations, outcomes, and complications of this virus in pregnancy. This study aimed to compare maternal and fetal consequences of Covid-19-infected pregnancies with non-infected pregnancies. Methods: In this prospective, single-center study, we included all pregnant women with COVID-19 who were admitted to Arash Hospital in Tehran, Iran from March 1 to April 20 2020. Women with positive Covid-19 PCR test and/or positive CT scan findings in the presence of very typical clinical symptoms were classified as confirmed group, women with typical clinical symptoms along with two or more of laboratory findings were classified as probable group and women who had no clinical symptoms of infection were classified as a control group. Clinical features, treatments, and maternal and fetal outcomes were assessed. Findings: One hundred and eighty-two women enrolled including 37 and 12 and 133 women in confirmed, probable and control groups prospectively. Caesarean Section was carried out in total 96 women (52.74%, 95%CI: 45.22, 68.31). No significant association was found between COVID-19 infection and preterm labour (aRR: 0.75, 95%CI: 0.30, 1.87, P=0.546), low birth weight (aRR: 1.15, 95%CI: 0.49, 2.73, P=0.737), gestational diabetes (aRR: 0.78, 95%CI: 0.26, 2.33, P=0.669), preeclampsia (aRR: 2.07, 95%CI: 0.50, 8.47, P=0.310) intrauterine growth restriction (aRR: 0.30, 95%CI: 0.02, 3.27, P= 0.327) preterm rupture of membrane (aRR: 0.38, 95%CI: 0.04, 3.30, P=0.383), stillbirth (aRR: 1.53, 95%CI: 0.15, 14.71, P=0.712), postpartum haemorrhage (aRR: 0.80, 95%CI: 0.11, 5.57, P=0.829), neonatal intensive care unit admission (aRR: 1.48, 95%CI: 0.38, 5.78, P=0.568), neonatal sepsis (aRR: 1.23, 95%CI: 0.68, 2.20, P= 0.481). Interpretation: We found no differences between Covid-19 infected and non-infected pregnant women according to delivery type, maternal and neonatal outcomes and also adverse pregnancy outcomes. Funding Statement: This research has been supported by a research grant, No: 99-1-101-47129 from Deputy of Research affairs, Tehran University of Medical Sciences, Tehran, Iran. Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: This study has been approved by the Ethics Committee of Tehran University of Medical Sciences. The ethical code is IR.TUMS.VCR.REC.1398.1057. Written informed consent was obtained from all participants for the publication of individual data from before enrolment when data were collected prospectively.