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Infectious Diseases

Poster Session 4

(1115) The Impact of COVID-19 Infection on Neonatal Birth Parameters and Outcomes

Wednesday, February 14, 2024
1:00 PM – 2:30 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective:

We aimed to estimate the association between antenatal maternal COVID-19 (C-19) infection and the risk for small-for-gestational-age (SGA) neonatal birthweight. We also sought to assess if gestational timing or severity of C-19 infection differentially impacts the risk of SGA.

Study Design:

This retrospective cohort study included all pregnant patients with C-19 infection and randomly selected unexposed controls who delivered at a tertiary care center from 10/1/2020 to 6/1/2022. We also assessed C-19 exposure by trimester of infection and disease severity. The primary outcome, SGA, was defined as neonatal birthweight < 10th percentile for gestational age based on a standard growth curve. Secondary outcomes included birth length and head circumference (HC) percentiles, APGAR scores and neonatal hospital length of stay (LOS). We used chi-squared and t-tests to estimate differences between C-19 exposed and unexposed groups, and multivariable logistic regression analysis to estimate the association between C-19 and SGA.

Results:

Among 1011 patients, 502 had C-19 infection and 509 did not. Baseline demographics between groups were similar.  Overall C-19 was not associated with increased risk of SGA adjusting for confounding by maternal age, hypertension and race.  Among patients with C-19, 15.2%, 31.1% and 53.7% had infection in the 1st, 2nd, and 3rd trimester and 68.4%, 25.4% and 6.2% had mild, moderate, or severe disease respectively.  First trimester C-19 infection was associated with a 2-fold increase in SGA (aOR 2.3, 95% CI 1.1-5.1), compared to 2nd or 3rd trimester infection. Stratifying by C-19 disease severity, moderate-severe disease was associated with a 2-fold increase in SGA (aOR 2.1, 95% CI 1.1-3.5), but mild disease did not increase this risk. C-19 exposure was not associated with increased risk of any other secondary neonatal outcomes (Table 1).

Conclusion:

When stratifying by antenatal C-19 disease severity and timing of infection, we observed a two-fold increased risk of SGA in patients with severe C-19 disease and with infection in the 1st trimester.