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Observational Study
. 2022 Feb;48(2):393-401.
doi: 10.1111/jog.15105. Epub 2021 Nov 23.

Obstetric and neonatal outcomes after SARS-CoV-2 infection in the first trimester of pregnancy: A prospective comparative study

Stefano Cosma  1 , Andrea Roberto Carosso  1 , Jessica Cusato  2 , Fulvio Borella  1 , Luca Bertero  3 , Marialuisa Bovetti  1 , Federica Bevilacqua  1 , Giulio Mengozzi  4 , Raffaela Mazzone  4 , Valeria Ghisetti  5 , Giovanni Di Perri  6 , Chiara Benedetto  1
Affiliations
Observational Study

Obstetric and neonatal outcomes after SARS-CoV-2 infection in the first trimester of pregnancy: A prospective comparative study

Stefano Cosma et al. J Obstet Gynaecol Res. 2022 Feb.

Abstract

Objective(s): This prospective observational cohort study aimed to evaluate whether women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during the first trimester of pregnancy are at higher risk of adverse obstetric and neonatal outcomes compared to negative patients.

Study design: Seromolecular testing for SARS-CoV-2 was performed at 12, 16, 21 weeks, and at delivery; the cohort was then subdivided into a first-trimester SARS-CoV-2-positive (case) group and a SARS-CoV-2-negative (control) group. The primary outcome was a composite adverse obstetric outcome, defined as the presence of either abortion, preterm delivery, preterm prelabor rupture of membranes, preeclampsia, intrauterine growth restriction, stillbirth; and a composite measure of adverse neonatal events, including either 1- and 5-min Apgar score ≤ 7, neonatal intensive care unit admission and congenital birth defects. Maternal symptoms and antibody titer were secondarily assessed.

Results: A total of 17 of 164 women tested positive for SARS-CoV-2 (10.3%) in the first trimester. One SARS-CoV-2-positive patient who gave birth at another hospital was excluded. Composite adverse obstetric outcome was observed in 6.2% (1/16) SARS-CoV-2-positive and 10.5% (11/105) SARS-CoV-2-negative women; composite adverse neonatal outcome in 12.5% (2/16) and 7.6% (8/105), respectively. In the newborns of women who had developed IgG antibodies, the same antibodies were detected in arterial cord blood and the nasopharyngeal swab tested negative for SARS-CoV-2. No maternal pneumonia or hospital admission due to coronavirus disease-19 were recorded.

Conclusion: Asymptomatic or mildly symptomatic women during the first trimester of pregnancy did not experience significantly more adverse events than SARS-CoV-2-negative women.

Keywords: COVID-19; SARS-CoV-2; outcome; pregnancy; vertical transmission.

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Conflict of interest statement

None declared.

Figures

FIGURE 1
FIGURE 1
Last menstruation criterion for inclusion and recruitment. Blue area: recruitment period; dotted black line: first case of COVID‐19 reported in Piedmont, Italy; dotted red line: COVID‐19 outbreak cases in Turin, weekly case increase; vertical orange line: date of the last menstruation upper limit of inclusion
FIGURE 2
FIGURE 2
Study flow diagram: Case ascertainment and control selection. Blue box, COVID‐19 negative patients; green box, patients excluded; nNAbs, non‐neutralizing antibodies; NAbs, neutralizing antibodies; NP, nasopharyngeal; red box, COVID‐19 positive patients; orange arrow, patients excluded; WKS, weeks gestation
See this image and copyright information in PMC

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