Publication:

Maternal and fetal outcomes in cases of mild SARS-CoV-2 infections in pregnant women at a tertiary teaching hospital: a retrospective observational study

Background The COVID-19 pandemic has posed unprecedented challenges including for pregnant women, a physiologically vulnerable group. There is limited data specifically on mild or asymptomatic SARS-CoV-2 infections during pregnancy and their effect on maternal and fetal outcomes. To analyse maternal and fetal outcomes in cases of mild SARS-CoV-2 infections in pregnant women hospitalized at a tertiary teaching hospital and to determine the rate of possible vertical transmission.

Methods A retrospective observational study was conducted from June 2020 to June 2022 at the Department of Obstetrics and Gynaecology of Nowrosjee Wadia Maternity Hospital, a tertiary teaching hospital. Data of 152 pregnant women with confirmed mild or asymptomatic SARS-CoV-2 infection were retrospectively analysed from medical records. Statistical analysis used Chi-Square test, Fisher’s Exact test and Mann-Whitney U test. Significance was set at p≤0.05.

Results A total of 152 hospitalized pregnant women were included. Majority (80.9%) were asymptomatic; 19.1% had mild symptoms (cough 5.3%, fever 4.6%). The live birth rate was 97.4%. LSCS was performed in 61.8% of cases. Perinatal COVID-19 infection was confirmed in only 1.3% of neonates (vertical transmission rate). NICU admission rate was 9.9%. Statistically significant differences between symptomatic and asymptomatic women were found in pulse rate (p=0.007), D-dimer levels (p=0.009), ECG findings (sinus tachycardia, p<0.0001) and neonatal birth weight (p=0.034). No significant differences were observed in mode of delivery, APGAR scores or NICU admission rates between the two groups.

Conclusions Most pregnant women with mild or asymptomatic COVID-19 had favourable maternal and fetal outcomes. Symptomatic women showed significantly higher D-dimer levels, pulse rates and lower birth weights, indicating a need for targeted monitoring. Vertical transmission was rare. Routine COVID-19 screening of all pregnant women remains essential.