The relationship between maternal COVID-19 with fetal and neonatal complications and intrauterine vertical transmission: A cohort study on pregnant women.

<h4>Background</h4>The clinical features, maternal and fetal complications, and the potential for vertical transmission of SARS-CoV-2 infection in pregnant women are still unknown. This cohort study aimed to determine the relation of coronavirus infection to the incidence of fetal and ne...

Full description

Saved in:
Bibliographic Details
Main Authors: Zahra Shafizadeh, Zahra Akbarian-Rad, Fatemeh Nasiri-Amiri, Mostafa Javanian, Hamid Reza Nouri, Mehdi Rajabnia, Zahra Geraili, Shanaz Barat, Jamileh Aqatabar Roudbari
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0326450
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849429735018332160
author Zahra Shafizadeh
Zahra Akbarian-Rad
Fatemeh Nasiri-Amiri
Mostafa Javanian
Hamid Reza Nouri
Mehdi Rajabnia
Zahra Geraili
Shanaz Barat
Jamileh Aqatabar Roudbari
author_facet Zahra Shafizadeh
Zahra Akbarian-Rad
Fatemeh Nasiri-Amiri
Mostafa Javanian
Hamid Reza Nouri
Mehdi Rajabnia
Zahra Geraili
Shanaz Barat
Jamileh Aqatabar Roudbari
author_sort Zahra Shafizadeh
collection DOAJ
description <h4>Background</h4>The clinical features, maternal and fetal complications, and the potential for vertical transmission of SARS-CoV-2 infection in pregnant women are still unknown. This cohort study aimed to determine the relation of coronavirus infection to the incidence of fetal and neonatal complications by comparing outcomes in pregnant women with COVID-19 to those in non-infected pregnant women.<h4>Method</h4>This prospective cohort study was conducted on all pregnant women who gave birth between September 2020 to September 2021 at Rouhani Hospital, Iran. The case group included pregnant women infected with SARS-CoV-2, confirmed by clinical signs, symptoms and positive result of Real-time polymerase chain reaction (real-time PCR), who were followed up until 72 hours after birth. All fetal and neonatal complications, such as premature birth, oligohydramnios, fetal growth restriction, perinatal death and vertical transmission were recorded. Risk ratios for adverse pregnancy outcomes were analyzed by a modified Poisson regression model adjusted for relevant variables.<h4>Results</h4>The final sample included 234 pregnant women (100 COVID-19 infected and 134 non-infected). The mean age was 29.42 ± 6.16 years (p = 0.12), and the mean BMI (body mass index) was 26.51 ± 4.16) Kg/m2 (p = 0.30). Cesarean delivery was more common among women with COVID -19 [adjusted risk ratio (aRR): 1.12, 95% confidence interval (CI): 1.09-1.25, p = 0.03]. A significant increase was observed in neonatal intensive care unit (NICU) admission in SARS-CoV-2 infected pregnant women compared to non-infected pregnant women [adjusted risk ratio (aRR):2.46, 95% confidence interval (CI): 1.06-5.42, P = 0.034]. Neonate born to women with COVID-19 had significantly higher rate of preterm birth (22% versus 11.2%) and low 5 minutes APGAR score (2% versus 0%) significantly (P < 0.05). Nearly all newborns tested negative for SARS-CoV-2 infection after birth (97.94%). Of 76 cord blood samples tested, 16 (21.05%) and 4 (5.26%) cases of infants born to mothers infected with COVID-19 had positive IgG and IgM antibodies, respectively.<h4>Conclusions</h4>Neonates born to mothers with COVID-19 faced a significantly higher risk of cesarean delivery and NICU admission, but no significant differences in other pregnancy complications were observed between COVID-19 and non-infected groups, highlighting the complex effects of the virus on pregnancy outcomes.
format Article
id doaj-art-c194fa0c0f214b7cadea29b0c8589b4c
institution Kabale University
issn 1932-6203
language English
publishDate 2025-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj-art-c194fa0c0f214b7cadea29b0c8589b4c2025-08-20T03:28:14ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01207e032645010.1371/journal.pone.0326450The relationship between maternal COVID-19 with fetal and neonatal complications and intrauterine vertical transmission: A cohort study on pregnant women.Zahra ShafizadehZahra Akbarian-RadFatemeh Nasiri-AmiriMostafa JavanianHamid Reza NouriMehdi RajabniaZahra GerailiShanaz BaratJamileh Aqatabar Roudbari<h4>Background</h4>The clinical features, maternal and fetal complications, and the potential for vertical transmission of SARS-CoV-2 infection in pregnant women are still unknown. This cohort study aimed to determine the relation of coronavirus infection to the incidence of fetal and neonatal complications by comparing outcomes in pregnant women with COVID-19 to those in non-infected pregnant women.<h4>Method</h4>This prospective cohort study was conducted on all pregnant women who gave birth between September 2020 to September 2021 at Rouhani Hospital, Iran. The case group included pregnant women infected with SARS-CoV-2, confirmed by clinical signs, symptoms and positive result of Real-time polymerase chain reaction (real-time PCR), who were followed up until 72 hours after birth. All fetal and neonatal complications, such as premature birth, oligohydramnios, fetal growth restriction, perinatal death and vertical transmission were recorded. Risk ratios for adverse pregnancy outcomes were analyzed by a modified Poisson regression model adjusted for relevant variables.<h4>Results</h4>The final sample included 234 pregnant women (100 COVID-19 infected and 134 non-infected). The mean age was 29.42 ± 6.16 years (p = 0.12), and the mean BMI (body mass index) was 26.51 ± 4.16) Kg/m2 (p = 0.30). Cesarean delivery was more common among women with COVID -19 [adjusted risk ratio (aRR): 1.12, 95% confidence interval (CI): 1.09-1.25, p = 0.03]. A significant increase was observed in neonatal intensive care unit (NICU) admission in SARS-CoV-2 infected pregnant women compared to non-infected pregnant women [adjusted risk ratio (aRR):2.46, 95% confidence interval (CI): 1.06-5.42, P = 0.034]. Neonate born to women with COVID-19 had significantly higher rate of preterm birth (22% versus 11.2%) and low 5 minutes APGAR score (2% versus 0%) significantly (P < 0.05). Nearly all newborns tested negative for SARS-CoV-2 infection after birth (97.94%). Of 76 cord blood samples tested, 16 (21.05%) and 4 (5.26%) cases of infants born to mothers infected with COVID-19 had positive IgG and IgM antibodies, respectively.<h4>Conclusions</h4>Neonates born to mothers with COVID-19 faced a significantly higher risk of cesarean delivery and NICU admission, but no significant differences in other pregnancy complications were observed between COVID-19 and non-infected groups, highlighting the complex effects of the virus on pregnancy outcomes.https://doi.org/10.1371/journal.pone.0326450
spellingShingle Zahra Shafizadeh
Zahra Akbarian-Rad
Fatemeh Nasiri-Amiri
Mostafa Javanian
Hamid Reza Nouri
Mehdi Rajabnia
Zahra Geraili
Shanaz Barat
Jamileh Aqatabar Roudbari
The relationship between maternal COVID-19 with fetal and neonatal complications and intrauterine vertical transmission: A cohort study on pregnant women.
PLoS ONE
title The relationship between maternal COVID-19 with fetal and neonatal complications and intrauterine vertical transmission: A cohort study on pregnant women.
title_full The relationship between maternal COVID-19 with fetal and neonatal complications and intrauterine vertical transmission: A cohort study on pregnant women.
title_fullStr The relationship between maternal COVID-19 with fetal and neonatal complications and intrauterine vertical transmission: A cohort study on pregnant women.
title_full_unstemmed The relationship between maternal COVID-19 with fetal and neonatal complications and intrauterine vertical transmission: A cohort study on pregnant women.
title_short The relationship between maternal COVID-19 with fetal and neonatal complications and intrauterine vertical transmission: A cohort study on pregnant women.
title_sort relationship between maternal covid 19 with fetal and neonatal complications and intrauterine vertical transmission a cohort study on pregnant women
url https://doi.org/10.1371/journal.pone.0326450
work_keys_str_mv AT zahrashafizadeh therelationshipbetweenmaternalcovid19withfetalandneonatalcomplicationsandintrauterineverticaltransmissionacohortstudyonpregnantwomen
AT zahraakbarianrad therelationshipbetweenmaternalcovid19withfetalandneonatalcomplicationsandintrauterineverticaltransmissionacohortstudyonpregnantwomen
AT fatemehnasiriamiri therelationshipbetweenmaternalcovid19withfetalandneonatalcomplicationsandintrauterineverticaltransmissionacohortstudyonpregnantwomen
AT mostafajavanian therelationshipbetweenmaternalcovid19withfetalandneonatalcomplicationsandintrauterineverticaltransmissionacohortstudyonpregnantwomen
AT hamidrezanouri therelationshipbetweenmaternalcovid19withfetalandneonatalcomplicationsandintrauterineverticaltransmissionacohortstudyonpregnantwomen
AT mehdirajabnia therelationshipbetweenmaternalcovid19withfetalandneonatalcomplicationsandintrauterineverticaltransmissionacohortstudyonpregnantwomen
AT zahrageraili therelationshipbetweenmaternalcovid19withfetalandneonatalcomplicationsandintrauterineverticaltransmissionacohortstudyonpregnantwomen
AT shanazbarat therelationshipbetweenmaternalcovid19withfetalandneonatalcomplicationsandintrauterineverticaltransmissionacohortstudyonpregnantwomen
AT jamilehaqatabarroudbari therelationshipbetweenmaternalcovid19withfetalandneonatalcomplicationsandintrauterineverticaltransmissionacohortstudyonpregnantwomen
AT zahrashafizadeh relationshipbetweenmaternalcovid19withfetalandneonatalcomplicationsandintrauterineverticaltransmissionacohortstudyonpregnantwomen
AT zahraakbarianrad relationshipbetweenmaternalcovid19withfetalandneonatalcomplicationsandintrauterineverticaltransmissionacohortstudyonpregnantwomen
AT fatemehnasiriamiri relationshipbetweenmaternalcovid19withfetalandneonatalcomplicationsandintrauterineverticaltransmissionacohortstudyonpregnantwomen
AT mostafajavanian relationshipbetweenmaternalcovid19withfetalandneonatalcomplicationsandintrauterineverticaltransmissionacohortstudyonpregnantwomen
AT hamidrezanouri relationshipbetweenmaternalcovid19withfetalandneonatalcomplicationsandintrauterineverticaltransmissionacohortstudyonpregnantwomen
AT mehdirajabnia relationshipbetweenmaternalcovid19withfetalandneonatalcomplicationsandintrauterineverticaltransmissionacohortstudyonpregnantwomen
AT zahrageraili relationshipbetweenmaternalcovid19withfetalandneonatalcomplicationsandintrauterineverticaltransmissionacohortstudyonpregnantwomen
AT shanazbarat relationshipbetweenmaternalcovid19withfetalandneonatalcomplicationsandintrauterineverticaltransmissionacohortstudyonpregnantwomen
AT jamilehaqatabarroudbari relationshipbetweenmaternalcovid19withfetalandneonatalcomplicationsandintrauterineverticaltransmissionacohortstudyonpregnantwomen