Relationship between coronavirus disease 2019 in pregnancy and maternal and fetal outcomes: Retrospective analytical cohort study.
Zahra Alipour, Parisa Samadi, Narges Eskandari and 4 others
PMID 34474247WHAT IT FOUND
Pregnant women hospitalized with COVID-19 had higher ICU admission, fetal distress, preterm birth and NICU admission than women without COVID-19.
Maternal death and Apgar scores showed no clear difference after adjustment.
Key findings
01Adjusted analysis linked COVID-19 in pregnancy with caesarean section (adjusted OR 0.45, 95% CI 0.20-1.03) and ICU admission (adjusted OR 6.16, 95% CI 1.23-31).
02Adjusted analysis linked COVID-19 in pregnancy with higher fetal distress (adjusted OR 5.7, 95% CI 2.13-15.59), preterm birth (adjusted OR 3.01, 95% CI 1.4-6.54) and NICU admission (adjusted OR 3.04, 95% CI 1.21-7.70).
03After adjustment, maternal death, postpartum haemorrhage and Apgar scores were not significantly associated.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Retrospective design meant some variables were not available. Only 133 of 312 pregnant women with confirmed COVID-19 had available medical records, so the analysed group may not represent all hospitalized cases. The comparison group was 165 pregnant women without COVID-19 selected from approximately 1120 hospitalized women, and baseline differences remained in trimester and ethnicity. Adjusted analysis reported a caesarean section odds ratio of 0.45 while describing it as higher risk, making the direction hard to interpret. Several outcomes were tested, and some adjusted estimates had wide confidence intervals, including maternal mortality and postpartum haemorrhage. The study was conducted at a tertiary referral hospital in Qom, Iran, so generalizability to other settings may be limited. Long-term maternal and neonatal outcomes were not assessed.
Declared interests
This study was supported by Qom University of Medical Sciences. The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that COVID-19 in pregnancy caused preterm birth, fetal distress or NICU admission. This was a retrospective association study with missing records, baseline differences and adjusted analyses that did not show significant associations for several outcomes.