Associations of COVID-19 Pandemic with Clinical Manifestations among the
Uninfected Pregnant Women in China: A Combined Cohort Study
Abstract
Objective: To investigate whether the COVID-19 pandemic would
significantly affect pregnancy-associated factors in uninfected pregnant
women in China. Design: A combined cohort study Setting: Six sites in
China Population: Uninfected pregnant women participating in the
programs with a singleton birth and delivery or termination from January
1 to May 31 2019 (pre-pandemic period, P-2019) and from January 1 to May
31 2020 (pandemic period, P-2020) (n = 32,277). Methods: The
associations of pregnancy-associated outcomes and the COVID-19 were
assessed by poisson regression, linear regression or log-binomial
regression. Main Outcomes Measures: The number of prenatal examinations
(NPE), delivery gestational week (DGW), caesarean section (CS), preterm
birth, macrosomia. Results: For Hubei, the NPE and DGW were negatively
associated with the COVID-19 pandemic, whereas the CS and preterm birth
rates were positively associated with the COVID-19, with adjusted
relative risks (aRRs) of 1.11 [95% confidence interval (CI)
1.06–1.17] and 1.37 (95% CI: 1.02–1.84) respectively. For
Guangdong, the associations of CS and preterm birth with the COVID-19
were similar in Hubei. Limited associations were evident in other areas
while a positive association with macrosomia was observed in Beijing
[aRR = 1.26 (95% CI: 1.03–1.55)]. Conclusions: The CS and preterm
birth rates increased slightly in areas that were more affected by the
pandemic than other areas. NPEs were not significantly interrupted and
most maternal and neonatal clinical characteristics were within the
normal ranges. Appropriate interventions should be considered to protect
pregnant women. Keywords: COVID-19, pregnancy outcome, neonatal outcome,
uninfected pregnant women