Maternal and perinatal outcomes of pregnant women with SARS-CoV-2 infection at the time of birth in England: national cohort study

ABSTRACT Objective The aim of this study was to determine the association between SARS-CoV-2 infection at the time of birth and maternal and perinatal outcomes. Methods This is a population-based cohort study in England. The inclusion criteria were women with a recorded singleton birth between 29th May 2020 and 31st January 2021 in a national database of hospital admissions. Maternal and perinatal outcomes were compared between pregnant women with a laboratory-confirmed SARS-CoV-2 infection recorded in the birth episode and those without. Study outcomes were fetal death at or beyond 24 weeks’ gestation (stillbirth), preterm birth ( Results The analysis included 342,080 women, of whom 3,527 had laboratory-confirmed SARS-CoV-2 infection. Laboratory-confirmed SARS-CoV-2 infection was more common in women who were younger, of non-white ethnicity, primiparous, residing in the most deprived areas, or had comorbidities. Fetal death (aOR, 2.21, 95% CI 1.58-3.11; P Risk of neonatal adverse outcome (aOR 1.45, 95% CI 1.27-1.66; P Conclusions SARS-CoV-2 infection at the time of birth is associated with higher rates of fetal death, preterm birth, preeclampsia and emergency Cesarean delivery. There were no additional adverse neonatal outcomes, other than those related to preterm delivery. Pregnant women should be counseled regarding risks of SARS-COV-2 infection and should be considered a priority for vaccination.