Pregnancy Outcomes and Neonatal Complications in Asymptomatic Deliveries Complicated by COVID-19

Background: This study aims to compare pregnancy outcomes and neonatal complications in asymptomatic COVID-19 positive pregnancies and COVID-negative pregnancies.

Methods and findings: This was a retrospective cohort study of patients in an urban community hospital. Institutional review board approval was obtained. Asymptomatic COVID-19 positive and COVID-negative pregnant patients who were admitted for delivery were identified via electronic medical records from April to May 2020. Cases were confirmed with nasopharyngeal polymerase chain reaction. Maternal and neonatal outcomes and complications were collected. Continuous variables were compared with Student t-test and dichotomous variables with chi square analysis with statistical significance considered at p<.05.

Results and discussion: 43 COVID-19 positive and 225 negative patients met criteria. The incidence of asymptomatic COVID-19 maternal infection at the time of delivery was 16% (43/268). 25.6% of asymptomatic COVID-19 patients developed symptoms during the intrapartum period. There was no significant difference in maternal demographics. There was no significant difference in maternal outcomes on admission such as estimated blood loss, indication for cesarean section, cesarean section incidence rate, maternal length of stay, maternal fever, or lymphocyte count. However, significant differences were noted in WBC count, cough, shortness of breath, gastrointestinal symptoms, initial oxygen saturation, and oxygen requirement. There was no significant difference in neonatal outcomes including birth weight, preterm delivery rate, respiratory distress syndrome, and NICU admission rate, but there was a significant difference in neonatal length of stay.

Conclusion: No significant differences were observed in mode of delivery or neonatal outcomes. Given the ongoing pandemic, this study may guide us in counseling patients.


Ivan M. Ngai

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