Effect of Covid-19 Infection on Maternal and Fetal Outcomes of Pregnancy: a Systematic Review

Division

North Florida

Hospital

West Florida Hospital

Document Type

Manuscript

Publication Date

3-10-2026

Keywords

COVID-19, Fetal growth restriction, Gestational hypertension, Intrauterine fetal demise, Preeclampsia, Preterm delivery, SARS-CoV2, Stillbirth

Disciplines

Female Urogenital Diseases and Pregnancy Complications | Medicine and Health Sciences | Obstetrics and Gynecology | Virus Diseases

Abstract

OBJECTIVES: This study aims to investigate the rates and statistical significance of maternal and neonatal complications in subjects with a positive COVID-19 diagnosis in pregnancy in comparison to subjects without a diagnosis of COVID-19 in pregnancy. We aim to improve the literature and patient information regarding the impact of COVID-19 on maternal and fetal outcomes to help draw conclusions or guide management.

STUDY DESIGN: Clinical outcomes were identified using International Classification of Diseases, Tenth Revision (ICD-10) billing codes. The control group included a sample of 15,000 patients delivered between 4/1/2019-12/31/2019. The COVID group included 10,608 patients from 4/1/2020-4/1/2022 who were confirmed COVID-19 positive within the 9 months prior to delivery. Binary logistic regression, Chi-square, and Fisher's exact test were used for statistical analysis.

RESULTS: Having COVID-19 during pregnancy is significantly associated with increased risk for preterm delivery (PTD), placental abnormalities, hypertensive disorders, and neonatal intensive care (NICU) admission. Rates of maternal mortality, fetal growth restriction (FGR) and intrauterine growth restriction (IUGR) were not significantly impacted by COVID-19. While the overall rate of FGR was not impacted, patients with 2nd trimester infection are at increased risk for FGR compared to patients with 3rd trimester infection.

CONCLUSIONS: This study demonstrates a statistically significant increased rate of preterm delivery, hypertensive disorders, placental abnormalities, and NICU admission for pregnancies affected by COVID-19. These findings can help guide recommendations for increased surveillance and counseling in pregnancies affected by COVID-19.

Publisher or Conference

Pregnancy Hypertension

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