The impact of acute and prior SARS-CoV-2 infection on maternal and neonatal outcomes in pregnant women: a single-center retrospective cohort study

Abstract Background Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection in pregnant women have an adverse impact on perinatal outcomes, including cesarean section, preterm birth, fetal distress. However, it’s uncertain whether these adverse consequences are caused by previous SARS...

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Main Authors: Yujie Tang, Liang Chen, Tao Han, Cuixia Hu, Pan Li, Jing Tang, Aiyuan Li, Xianglian Peng, Jie Zhang
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Pregnancy and Childbirth
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Online Access:https://doi.org/10.1186/s12884-025-07301-z
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author Yujie Tang
Liang Chen
Tao Han
Cuixia Hu
Pan Li
Jing Tang
Aiyuan Li
Xianglian Peng
Jie Zhang
author_facet Yujie Tang
Liang Chen
Tao Han
Cuixia Hu
Pan Li
Jing Tang
Aiyuan Li
Xianglian Peng
Jie Zhang
author_sort Yujie Tang
collection DOAJ
description Abstract Background Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection in pregnant women have an adverse impact on perinatal outcomes, including cesarean section, preterm birth, fetal distress. However, it’s uncertain whether these adverse consequences are caused by previous SARS-COV-2 infection during pregnancy or acute infection at the time of delivery. Methods We conducted a single-center retrospective cohort study among pregnant women with singleton pregnancy who delivered between 1 December 2022 and 1 February 2023 (n = 2472). Pregnancies were divided into three groups: non-infected group, acute SARS-CoV-2 infection group, prior SARS-CoV-2 infection group based on PCR or antigen test. The clinical data for mothers and neonates came from medical records on internal healthcare system. Follow-up time spanned from admission to discharge. We investigated the impact of acute and prior SARS-CoV-2 infection on maternal and neonatal outcome. Multivariable logistic models were used to assess the risk of adverse perinatal outcome in pregnant women with acute and prior SARS-CoV-2 infection. Results Compared to the non-infected pregnant women, acute SARS-CoV-2 infected pregnant women had significant higher rates of intrahepatic cholestasis of pregnancy (ICP) (26 women [4.4%] vs. 8 women [1.0%]; aOR, 4.9 [95% CI, 2.2–11.0]; P < 0.001), preterm birth (<37 wk) (53women [9.0%] vs. 45 women [5.7%]; aOR, 1.7 [95% CI, 1.1–2.7]; P < 0.05), fetal distress(106 women [18.1%] vs. 82 women [10.4%]; aOR,1.9 [95% CI, 1.4–2.6]; P < 0.01), primary cesarean delivery (216 women [36.9%] vs. 239women [30.3%]; aOR, 1.4[95% CI, 1.1–1.8]; P < 0.01) and neonatal unit admission (69 neonates [12%] vs. 64 neonates [8.3%]; aOR, 1.6 [95% CI, 1.1–2.3]; P < 0.05), prior SARS-CoV-2 infection were associated with an increased risk of ICP (40 women [3.7%] vs. 8 women [1.0%]; aOR, 3.9 [95% CI, 1.8–8.5]; P <0.001). Conclusions Pregnant women at delivery with acute SARS-CoV-2 infection were associated with higher risk of ICP, preterm birth, fetal distress, primary cesarean delivery and neonatal unit admission. Prior SARS-CoV-2 infection during pregnancy was associated with higher risk ICP. These findings emphasize the need for optimization of strategies for prevention of SARS-CoV-2 infection in pregnant women, especially for acute infection at delivery.
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spelling doaj-art-eac081b6a9ab49e0a889ab4151618d722025-08-20T03:10:54ZengBMCBMC Pregnancy and Childbirth1471-23932025-02-012511810.1186/s12884-025-07301-zThe impact of acute and prior SARS-CoV-2 infection on maternal and neonatal outcomes in pregnant women: a single-center retrospective cohort studyYujie Tang0Liang Chen1Tao Han2Cuixia Hu3Pan Li4Jing Tang5Aiyuan Li6Xianglian Peng7Jie Zhang8Department of Anesthesiology, Hunan Provincial Maternal and Child Health Care Hospital, Nanhua UniversityDepartment of Anesthesiology, Hunan Provincial Maternal and Child Health Care Hospital, Nanhua UniversityDepartment of Anesthesiology, Hunan Provincial Maternal and Child Health Care Hospital, Nanhua UniversityDepartment of Anesthesiology, Hunan Provincial Maternal and Child Health Care Hospital, Nanhua UniversityDepartment of Anesthesiology, Hunan Provincial Maternal and Child Health Care Hospital, Nanhua UniversityDepartment of Anesthesiology, Hunan Provincial Maternal and Child Health Care Hospital, Nanhua UniversityDepartment of Anesthesiology, Hunan Provincial Maternal and Child Health Care Hospital, Nanhua UniversityDepartment of Neonatology, Hunan Provincial Maternal and Child Health Care Hospital, Nanhua UniversityDepartment of Anesthesiology, Hunan Provincial Maternal and Child Health Care Hospital, Nanhua UniversityAbstract Background Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection in pregnant women have an adverse impact on perinatal outcomes, including cesarean section, preterm birth, fetal distress. However, it’s uncertain whether these adverse consequences are caused by previous SARS-COV-2 infection during pregnancy or acute infection at the time of delivery. Methods We conducted a single-center retrospective cohort study among pregnant women with singleton pregnancy who delivered between 1 December 2022 and 1 February 2023 (n = 2472). Pregnancies were divided into three groups: non-infected group, acute SARS-CoV-2 infection group, prior SARS-CoV-2 infection group based on PCR or antigen test. The clinical data for mothers and neonates came from medical records on internal healthcare system. Follow-up time spanned from admission to discharge. We investigated the impact of acute and prior SARS-CoV-2 infection on maternal and neonatal outcome. Multivariable logistic models were used to assess the risk of adverse perinatal outcome in pregnant women with acute and prior SARS-CoV-2 infection. Results Compared to the non-infected pregnant women, acute SARS-CoV-2 infected pregnant women had significant higher rates of intrahepatic cholestasis of pregnancy (ICP) (26 women [4.4%] vs. 8 women [1.0%]; aOR, 4.9 [95% CI, 2.2–11.0]; P < 0.001), preterm birth (<37 wk) (53women [9.0%] vs. 45 women [5.7%]; aOR, 1.7 [95% CI, 1.1–2.7]; P < 0.05), fetal distress(106 women [18.1%] vs. 82 women [10.4%]; aOR,1.9 [95% CI, 1.4–2.6]; P < 0.01), primary cesarean delivery (216 women [36.9%] vs. 239women [30.3%]; aOR, 1.4[95% CI, 1.1–1.8]; P < 0.01) and neonatal unit admission (69 neonates [12%] vs. 64 neonates [8.3%]; aOR, 1.6 [95% CI, 1.1–2.3]; P < 0.05), prior SARS-CoV-2 infection were associated with an increased risk of ICP (40 women [3.7%] vs. 8 women [1.0%]; aOR, 3.9 [95% CI, 1.8–8.5]; P <0.001). Conclusions Pregnant women at delivery with acute SARS-CoV-2 infection were associated with higher risk of ICP, preterm birth, fetal distress, primary cesarean delivery and neonatal unit admission. Prior SARS-CoV-2 infection during pregnancy was associated with higher risk ICP. These findings emphasize the need for optimization of strategies for prevention of SARS-CoV-2 infection in pregnant women, especially for acute infection at delivery.https://doi.org/10.1186/s12884-025-07301-zSARS-CoV-2 infectionCorona virus disease 2019 (COVID-19)Pregnant womenNeonatesPreterm birthCesarean delivery
spellingShingle Yujie Tang
Liang Chen
Tao Han
Cuixia Hu
Pan Li
Jing Tang
Aiyuan Li
Xianglian Peng
Jie Zhang
The impact of acute and prior SARS-CoV-2 infection on maternal and neonatal outcomes in pregnant women: a single-center retrospective cohort study
BMC Pregnancy and Childbirth
SARS-CoV-2 infection
Corona virus disease 2019 (COVID-19)
Pregnant women
Neonates
Preterm birth
Cesarean delivery
title The impact of acute and prior SARS-CoV-2 infection on maternal and neonatal outcomes in pregnant women: a single-center retrospective cohort study
title_full The impact of acute and prior SARS-CoV-2 infection on maternal and neonatal outcomes in pregnant women: a single-center retrospective cohort study
title_fullStr The impact of acute and prior SARS-CoV-2 infection on maternal and neonatal outcomes in pregnant women: a single-center retrospective cohort study
title_full_unstemmed The impact of acute and prior SARS-CoV-2 infection on maternal and neonatal outcomes in pregnant women: a single-center retrospective cohort study
title_short The impact of acute and prior SARS-CoV-2 infection on maternal and neonatal outcomes in pregnant women: a single-center retrospective cohort study
title_sort impact of acute and prior sars cov 2 infection on maternal and neonatal outcomes in pregnant women a single center retrospective cohort study
topic SARS-CoV-2 infection
Corona virus disease 2019 (COVID-19)
Pregnant women
Neonates
Preterm birth
Cesarean delivery
url https://doi.org/10.1186/s12884-025-07301-z
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