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

Introduction: Over a year has passed since severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) emerged as a worldwide pandemic, infecting over 100 million people around the world¹. As this virus continues to maintain its presence, understanding the impact of this virus in pregnancy remains important. Given the increased morbidity and mortality of COVID-19 in pregnancy, it is vital to continue to follow the maternal and fetal short and long term consequences.

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 and their partners who were admitted. 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% compared with 1.4%, p < 0.05).

Conclusion: 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.”² Pregnancy outcomes of COVID-19 have also been shown to increase the risk of preterm delivery; the mechanism could be attributed to intrauterine infection/inflammation that accounts for up to 40% of premature deliveries.³ Given our findings, the possibility of SARS-COV-2 infection resulting in intrauterine infection/inflammation and contributing to preterm delivery should be further evaluated as the pandemic continues.

Publication History

Article published online:
17 September 2021