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Observational Study
. 2022 Sep;227(3):495.e1-495.e11.
doi: 10.1016/j.ajog.2022.04.021. Epub 2022 Apr 19.

Maternal and neonatal outcomes of pregnancies with COVID-19 after medically assisted reproduction: results from the prospective COVID-19-Related Obstetrical and Neonatal Outcome Study

Yvonne Ziert  1 , Michael Abou-Dakn  2 , Clara Backes  3 , Constanze Banz-Jansen  4 , Nina Bock  5 , Michael Bohlmann  6 , Charlotte Engelbrecht  7 , Teresa Mia Gruber  7 , Antonella Iannaccone  8 , Magdalena Jegen  9 , Corinna Keil  10 , Ioannis Kyvernitakis  11 , Katharina Lang  12 , Angela Lihs  13 , Jula Manz  14 , Christine Morfeld  15 , Manuela Richter  16 , Gregor Seliger  17 , Marina Sourouni  18 , Constantin Sylvius von Kaisenberg  19 , Silke Wegener  20 , Ulrich Pecks  21 , Frauke von Versen-Höynck  22 ; COVID-19-Related Obstetric and Neonatal Outcome Study (CRONOS) Network
Affiliations
Observational Study

Maternal and neonatal outcomes of pregnancies with COVID-19 after medically assisted reproduction: results from the prospective COVID-19-Related Obstetrical and Neonatal Outcome Study

Yvonne Ziert et al. Am J Obstet Gynecol. 2022 Sep.

Abstract

Background: Severe acute respiratory syndrome coronavirus type 2 infections in pregnancy have been associated with maternal morbidity, admission to intensive care, and adverse perinatal outcomes such as preterm birth, stillbirth, and hypertensive disorders of pregnancy. It is unclear whether medically assisted reproduction additionally affects maternal and neonatal outcomes in women with COVID-19.

Objective: To evaluate the effect of medically assisted reproduction on maternal and neonatal outcomes in women with COVID-19 in pregnancy.

Study design: A total of 1485 women with COVID-19 registered in the COVID-19 Related Obstetric and Neonatal Outcome Study (a multicentric, prospective, observational cohort study) were included. The maternal and neonatal outcomes in 65 pregnancies achieved with medically assisted reproduction and in 1420 spontaneously conceived pregnancies were compared. We used univariate und multivariate (multinomial) logistic regressions to estimate the (un)adjusted odds ratios and 95% confidence intervals for adverse outcomes.

Results: The incidence of COVID-19-associated adverse outcomes (eg, pneumonia, admission to intensive care, and death) was not different in women after conceptions with COVID-19 than in women after medically assisted reproduction pregnancies. Yet, the risk of obstetrical and neonatal complications was higher in pregnancies achieved through medically assisted reproduction. However, medically assisted reproduction was not the primary risk factor for adverse maternal and neonatal outcomes including pregnancy-related hypertensive disorders, gestational diabetes mellitus, cervical insufficiency, peripartum hemorrhage, cesarean delivery, preterm birth, or admission to neonatal intensive care. Maternal age, multiple pregnancies, nulliparity, body mass index >30 (before pregnancy) and multiple gestation contributed differently to the increased risks of adverse pregnancy outcomes in women with COVID-19 independent of medically assisted reproduction.

Conclusion: Although women with COVID-19 who conceived through fertility treatment experienced a higher incidence of adverse obstetrical and neonatal complications than women with spontaneous conceptions, medically assisted reproduction was not the primary risk factor.

Keywords: COVID-19; SARS-CoV-2 infection; assisted reproduction; cohort study; fertility treatment; maternal outcomes; neonatal outcomes; pregnancy; preterm birth.

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Figures

Figure
Figure
Flowchart of the study cohort Ziert et al. Adverse pregnancy outcomes by mode of conception in women with COVID-19. Am J Obstet Gynecol 2022.
See this image and copyright information in PMC

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