Subscribe to RSS
DOI: 10.1055/a-2358-9710
Are Neonatal Birth Weights Reduced in Low-Risk Patients Diagnosed with COVID-19 during Pregnancy?
![](https://www.thieme-connect.de/media/ajp/EFirst/lookinside/thumbnails/10-1055-a-2358-9710_24may0325-1.jpg)
Abstract
Objective Studies have shown that the 2019 novel coronavirus disease (COVID-19) may be associated with an increased risk of adverse pregnancy outcomes including preeclampsia, preterm birth, and stillbirth. However, the relationship between COVID-19 and abnormal fetal growth (i.e., low neonatal birth weight) has not been elucidated. Because other viruses affect fetal growth, obstetrical providers began to recommend ultrasound studies during the third trimester to assess fetal growth in patients with COVID-19 during pregnancy. The aim of this study was to determine if neonatal birth weight was different between low-risk patients diagnosed with COVID-19 during pregnancy and low-risk patients without COVID-19 in pregnancy, to ascertain if third trimester growth ultrasound is warranted in this patient population.
Study Design We performed a retrospective cohort study of low-risk pregnant patients (who had no other indications for sonographic fetal surveillance during the third trimester) with and without COVID-19 during pregnancy. Patient demographics, gestational dating, neonatal birth weights, and corresponding Alexander growth curve birth weight percentiles were collected. The primary outcome was small-for-gestational age (SGA) neonates, defined as birth weight < 10th percentile for gestational age at delivery (SGA10).
Results Our cohort (N = 513) included 248 COVID-19-exposed patients and 265 patients who did not have COVID-19 during pregnancy. Gestational age at delivery and average neonatal birth weights were similar in COVID-19-exposed (38 weeks 5 days, 3,266 g) and unexposed patients (38 weeks 4 days, 3,224 g; p = 0.434, 0.358). Rates of SGA10 neonates were similar in the COVID-19-exposed (22/248, 8.9%) and -unexposed (23/265, 8.7%, p = 0.939) groups. Timing and severity of COVID-19 during pregnancy also were not associated with rates of SGA neonates.
Conclusion In a cohort of low-risk patients, rates of SGA neonates were similar in patients with and without COVID-19 during pregnancy. These findings suggest that ultrasound surveillance to detect fetal growth restriction in low-risk patients with COVID-19 during pregnancy is not warranted.
Key Points
-
COVID-19 may be associated with fetal growth restriction.
-
There are normal infant weights in patients with COVID-19 in pregnancy.
-
Growth ultrasound is not needed in patients with COVID-19.
Publication History
Received: 21 May 2024
Accepted: 29 June 2024
Accepted Manuscript online:
02 July 2024
Article published online:
23 July 2024
© 2024. Thieme. All rights reserved.
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
References
- 1 Wei SQ, Bilodeau-Bertrand M, Liu S, Auger N. The impact of COVID-19 on pregnancy outcomes: a systematic review and meta-analysis. CMAJ 2021; 193 (16) E540-E548
- 2 Liu H, Wang LL, Zhao SJ, Kwak-Kim J, Mor G, Liao AH. Why are pregnant women susceptible to COVID-19? An immunological viewpoint. J Reprod Immunol 2020; 139: 103122
- 3 Zambrano LD, Ellington S, Strid P. et al; CDC COVID-19 Response Pregnancy and Infant Linked Outcomes Team. Update: characteristics of symptomatic women of reproductive age with laboratory-confirmed SARS-CoV-2 Infection by pregnancy status—United States, January 22–October 3, 2020. MMWR Morb Mortal Wkly Rep 2020; 69 (44) 1641-1647
- 4 Kirchengast S, Hartmann B. Pregnancy outcome during the first COVID 19 lockdown in Vienna, Austria. Int J Environ Res Public Health 2021; 18 (07) 3782
- 5 Fitzgerald E, Hor K, Drake AJ. Maternal influences on fetal brain development: the role of nutrition, infection and stress, and the potential for intergenerational consequences. Early Hum Dev 2020; 150: 105190
- 6 Wong SF, Chow KM, Leung TN. et al. Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome. Am J Obstet Gynecol 2004; 191 (01) 292-297
- 7 Lam CM, Wong SF, Leung TN. et al. A case-controlled study comparing clinical course and outcomes of pregnant and non-pregnant women with severe acute respiratory syndrome. BJOG 2004; 111 (08) 771-774
- 8 Manjunathachar HV, Singh KN, Chouksey V, Kumar R, Sharma RK, Barde PV. Prevalence of torch infections and its associated poor outcome in high-risk pregnant women of Central India: time to think for prevention strategies. Indian J Med Microbiol 2020; 38 (3 & 4): 379-384
- 9 Dileep A, ZainAlAbdin S, AbuRuz S. Investigating the association between severity of COVID-19 infection during pregnancy and neonatal outcomes. Sci Rep 2022; 12 (01) 3024
- 10 De A, Biswas P, Ray S, Hosen SF, Ghosh H, Bhowmik S. COVID-19 exposure during pregnancy and low birth weight in community development blocks, Purba Bardhaman: a retrospective cohort study. J Family Med Prim Care 2022; 11 (11) 7322-7327
- 11 Smith V, Seo D, Warty R. et al. Maternal and neonatal outcomes associated with COVID-19 infection: a systematic review. PLoS One 2020; 15 (06) e0234187
- 12 Naseef P, Elnour AA, Ramy A. Severity of COVID-19 infection in pregnancy and adverse maternal and neonatal outcomes: a retrospective study in a tertiary center. Reprod Female Child Health 2023; 2: 28-32
- 13 Smith ER, Oakley E, Grandner GW. et al; Perinatal COVID PMA Study Collaborators, Perinatal COVID PMA Study Collaborators. Adverse maternal, fetal, and newborn outcomes among pregnant women with SARS-CoV-2 infection: an individual participant data meta-analysis. BMJ Glob Health 2023; 8 (01) e009495
- 14 Singh N, Jaiswal J, Sherwani N, Nagaria T, Khandwal O, Neral A. Maternal and neonatal outcomes associated with COVID-19 infection in pregnant mothers admitted in tertiary care hospital in central state of India. Cureus 2023; 15 (04) e38235
- 15 Pérez-López FR, Savirón-Cornudella R, Chedraui P. et al. Obstetric and perinatal outcomes of pregnancies with COVID 19: a systematic review and meta-analysis. J Matern Fetal Neonatal Med 2022; 35 (25) 9742-9758
- 16 Martono FF, Fatmawati F, Mulyanti S. Risk factors associated with the severity of COVID-19. Malays J Med Sci 2023; 30 (03) 84-92
- 17 Fetal growth restriction: ACOG practice bulletin, number 227. Obstet Gynecol 2021; 137 (02) e16-e28
- 18 Sankaran S. Creasy and Resnik's maternal–fetal medicine: principles and practice sixth edition. Obstet Med 2012; 5 (02) 88-89
- 19 Donner C, Liesnard C, Content J, Busine A, Aderca J, Rodesch F. Prenatal diagnosis of 52 pregnancies at risk for congenital cytomegalovirus infection. Obstet Gynecol 1993; 82 (4 pt. 1): 481-486
- 20 Lambert JS, Watts DH, Mofenson L. et al. Risk factors for preterm birth, low birth weight, and intrauterine growth retardation in infants born to HIV-infected pregnant women receiving zidovudine. Pediatric AIDS Clinical Trials Group 185 Team. AIDS 2000; 14 (10) 1389-1399
- 21 Cailhol J, Jourdain G, Coeur SL. et al; Perinatal HIV Prevention Trial Group. Association of low CD4 cell count and intrauterine growth retardation in Thailand. J Acquir Immune Defic Syndr 2009; 50 (04) 409-413
- 22 Iqbal SN, Kriebs J, Harman C. et al. Predictors of fetal growth in maternal HIV disease. Am J Perinatol 2010; 27 (07) 517-523
- 23 Alexander GR, Himes JH, Kaufman RB, Mor J, Kogan M. A United States national reference for fetal growth. Obstet Gynecol 1996; 87 (02) 163-168
- 24 Vizheh M, Allahdadian M, Muhidin S. et al. Impact of COVID-19 infection on neonatal birth outcomes. J Trop Pediatr 2021; 67 (05) fmab094
- 25 Punjala-Patel A, Alvarado S, French A. et al. Impact of COVID-19 infection on neonatal birth parameters and outcomes. Am J Obstet Gynecol 2024; 230 (01) S585-S586