COVID-19 during pregnancy not linked to stillbirth, infant death

Maternal COVID-19 infection during pregnancy was not associated with an increased risk for stillbirth or early infant death, according to research published in Ultrasound in Obstetrics and Gynecology.

“The finding that COVID-19 infection does not increase the risk of stillbirth or baby death is reassuring,” Christoph Lees, MD, professor of obstetrics and head of fetal medicine at the Centre for Fetal Care at Imperial College Healthcare NHS Trust in the U.K., said in a press release. “However, a suspected or confirmed COVID-19 diagnosis was linked to a higher risk of preterm birth, and it isn't entirely clear why.”

Lees and colleagues analyzed data from the PAN-COVID registry, which includes pregnant women with suspected or confirmed COVID-19 at any point of their pregnancy in the U.K., as well as the U.S. American Academy of Pediatrics Section on Neonatal Perinatal Medicine’s National Perinatal COVID-19 Registry (AAP SONPM), which includes pregnancies in which the mother tested positive for COVID-19 from 2 weeks before delivery to 3 days after delivery.

Both registries collected information on maternal, fetal, perinatal and neonatal outcomes.

A total of 4,005 women with confirmed or suspected COVID-19 — 1,606 from the PAN-COVID cohort and 2,399 from the AAP SONPM cohort — were assessed in the study.

Lees and colleagues found that maternal death occurred in 0.5% of women in the PAN-COVID group overall, 0.5% among those in the PAN-COVID group with confirmed COVID-19 infection, and 0.2% of those in the AAP SONPM group.

Additionally, they found that early neonatal death occurred in 0.2% of pregnancies in the PAN-COVID group overall, 0.3% in those in the PAN-COVID group with confirmed infection, and 0.3% of those in the AAP SONPM group.

According to the researchers, stillbirth occurred in 0.5% of pregnancies in the PAN-COVID group overall, 0.6% of those in the PAN-COVID group with confirmed infection, and 0.4% of those in the AAP SONPM group.

Lees and colleagues found that preterm delivery — defined as delivery before 37 weeks gestation — occurred in 12% of women overall in the PAN-COVID group, 16.2% of women in the PAN-COVID group with confirmed infection, and 15.7% of women in the AAP SONPM group.

Neonatal COVID-19 infection occurred in 0.8% of pregnancies in the PAN-COVID group, 2% in the PAN-COVID group with confirmed infection and 1.8% in the AAP SONPM.

Th researchers noted that the elevated rate of preterm birth among women in the study may have been influenced by providers’ decisions to deliver infants early to prevent potential maternal or infant morbidities with COVID-19 infection.

“The study's findings, that there is no increased risk of stillbirth and early neonatal death in women who contracted COVID-19 while pregnant, are reassuring,” Fiona Watt, executive chair of the Medical Research Council in the U.K., said in the press release. “However, the study highlights the need for more research to determine if, or how, COVID-19 affects maternal outcomes or premature birth.”

References:

Newswise. COVID-19 infection in pregnancy not linked with still birth or baby death. https://www.newswise.com/coronavirus/covid-19-infection-in-pregnancy-not-linked-with-still-birth-or-baby-death/. Accessed March 5, 2021.

Mullins E, et al. Ultrasound Obstet Gynecol. 2021;doi: 10.1002/uog.23619.