Covid-19 infection after 20 weeks of pregnancy increases the risk for adverse obstetric outcomes, and infection after 26 weeks increases the risk for adverse neonatal outcomes, according to a new retrospective study from Europe.

PregOuTCOV, the international multicenter study examined the effect of gestational age at time of getting the Covid-19 infection on obstetric and neonatal outcomes. A total of 10,925 pregnant women with a live fetus from the 10th week of gestation and a known pregnancy outcome (167 had a pregnancy loss and 10,758 delivered a live neonate) were included in the trial. The exposed group included 393 pregnant women who had RT-PCR confirmed Covid-19. The unexposed group included women who had either a negative RT-PCR or were not tested due to lack of indication. The composite adverse obstetric outcome (CAOO) and a composite adverse neonatal outcome (CANO) were selected as the primary outcome measures.

Adverse obstetrical outcomes included preterm delivery, preeclampsia, cesarean section, IUD and even death of the pregnant woman. The adverse neonatal outcomes included low birth weight, respiratory distress, admission to NICU or neonatal death among others.

The study found that the incidence of adverse obstetric and neonatal outcomes was higher in Covid-positive pregnant women. The incidence of adverse obstetric outcomes was higher if they became infected after 20 weeks of gestation, whereas if they acquired the infection after 26 weeks of gestation, the incidence of adverse neonatal outcomes was higher.

Covid-19 during pregnancy is a risk factor for adverse obstetric and neonatal outcomes. And this risk is higher during the late second and early third trimesters, as shown in this study. There is data to show that vaccines are safe and effective during pregnancy. Hence, pregnant women should be encouraged to take the Covid-19 vaccine early in the pregnancy to protect themselves as well as their unborn baby and not defer taking the vaccine after the delivery.

Reference

1. Dominique A Badr, et al. Severe acute respiratory syndrome coronavirus 2 and pregnancy outcomes according to gestational age at time of infection. Emerg Infect Dis. 2021 Oct;27(10):2535-2543. doi: 10.3201/eid2710.211394.