Preterm Birth Outcomes in COVID-positive and COVID-negative Pregnancies during SARS-CoV-2 Pandemic in a Tertiary Care Center in India: A Cohort Study

Abstract

Objective: To compare the maternal and neonatal outcomes, particularly the incidence of preterm birth, and identify their risk among pregnant women who were seropositive or seronegative for SARS-CoV-2, during the pandemic. Method: Pregnant women who got admitted to an urban tertiary care center for delivery during the period August 1, 2020, to October 30, 2020, and consented to participate in the study were recruited and followed up until delivery. Among 230 women, 73 pregnant women who tested positive for SARS-CoV-2 were included in the positive cohort and the remaining in the negative cohort. Demographic details, symptoms at presentation, gestational age, laboratory tests done, and treatment given were noted. The outcome measures studied were the incidence of preterm birth, gestational age at admission and delivery, risk factors for preterm birth (PTB), obstetrics/medical complications, drugs given, mode of delivery, and neonatal outcomes, such as birth weight, Apgar scores at 1 and 5 minutes, neonatal complications, need for NICU admission, and SARS-CoV-2 positivity. Results: Among the 73 SARS-CoV-2 pregnant women, 95% were asymptomatic. The incidence of preterm birth was similar in the SARS-CoV-2-positive and SARS-CoV-2-negative cohorts (20.5 vs 22.5%). There were four SARS-CoV-2-positive babies in the positive cohort and none in the negative cohort. The distribution of known risk factors of preterm births and other maternal and neonatal outcomes were also comparable between the positive and negative cohorts. Conclusion: There is no increase in incidence of preterm births in SARS-CoV-2-positive compared to SARS-CoV-2-negative cohort, during the pandemic. Majority of them have asymptomatic infection, and good pregnancy outcomes can be anticipated.