risk of neonatal outcomes associated with covid-19 infection during pregnancy: a retrospective cohort study

Background: since its announcement as a pandemic, covid-19 has been shown to be associated with more severe outcomes among pregnant women. infected mothers may develop intrauterine growth retardation (iugr), stillbirth, premature labor, and disseminated intravascular coagulation when carrying a child (dic). the present study aimed to estimate the risk of severe covid-19 and its correlation with adverse neonatal outcomes among pregnant women.methods: this was a population-based, retrospective cohort study of all pregnancies with a live birth or fetal death in mashhad, iran, from february 20, 2020, to june 21, 2020, on 460 patients who tested positive for covid-19. the assessed neonatal outcomes included preterm birth, iugr, stillbirth, severe neonatal asphyxia, and neonatal death. modified poisson and multinomial logistic regression models were used to derive relative risk estimates.results: 460 patients identified with covid-19 during pregnancy were assessed in the study. overall, the most prevalent complication was preterm birth, with a total of 119 (25.9) cases. in multivariable analysis, the risk of preterm labor, low birth weight, severe neonatal asphyxia, icu-admitted mother, the length of hospitalization> 7 days and iugr were significantly increased in the stillbirth. the risk of global preterm birth had also significantly increased in the stillbirth group compared to the other group (91.7% versus 23.7%, aor = 3.66, 95% ci [8.85- 165.87], p < 0.001).conclusion: along with the possibility of more severe covid-19 infection among pregnant women, five complicated outcomes were described in the present study, including preterm birth, iugr, stillbirth, severe neonatal asphyxia, and neonatal deaths as risk factors of covid-19 infection in pregnancy.