Clinical Characteristics and Incidence of Spontaneous Preterm Birth in Symptomatic COVID-19 Pregnant Women: An Observational Study

Author(s): Shruti Yarra, Sindy Carolina Moreno, Justin K To, David Garry, Ivan M Ngai

Background: There is limited data regarding COVID-19 and preterm birth. Most published studies do not exclude induced preterm deliveries or women at higher risk for preterm birth.

Objective (s): To determine the incidence of spontaneous preterm delivery in pregnancies complicated by maternal COVID-19 infection with no other independent risk factors for preterm birth.

Study design: This was an observational study of symptomatic women diagnosed with COVID-19 during the third trimester of pregnancy who delivered at Flushing Hospital Medical Center in Queens, New York between March 1 and May 1, 2020. IRB approval was obtained. Charts of symptomatic women who were confirmed COVID-19 positive by RT-PCR in the third trimester were reviewed. Patient information collected included gestational age at diagnosis of COVID-19, obstetrical history, comorbidities, x-ray findings, and blood work. Women with a history of preterm birth, short cervix in current pregnancy, and multiple gestations were excluded. Statistical evaluation for normally distributed continuous variables was done using a student’s t-test, and for dichotomous variables, a Chi-square analysis or Fisher’s exact test was used. A multiple regression analysis model was used to correlate the relationship of clinical variables to the gestational age at delivery.

Results: 24 pregnant women met initial criteria, 17 of which delivered in the time period stated. Preterm delivery rate in our sample size was 29% (n=5). Our institution’s preterm delivery rate for a similar time-period in 2019, using the same exclusion and inclusion criteria, was 2.7%. When comparing COVID-19 positive women that delivered preterm to COVID-19 positive women who delivered at term, the gestational age on admission was lower in the preterm cohort (weeks 34.1 ± 1.5 weeks versus 38.0 ± 1.7; p<0.001). M

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