Maternal and Neonatal Outcomes in Pregnancies with PCR-Confirmed SARS-CoV-2 Infection Ending in Live Birth: A Single-Centre Turkish Cohort Benchmarked Against National Reference Data.

Background/

Objectives

Most evidence on SARS-CoV-2 infection in pregnancy comes from hospitalised or symptomatic cohorts sampled early in the pandemic. We described maternal and neonatal outcomes in an unselected cohort of PCR-confirmed infections ending in live birth, identified characteristics associated with neonatal intensive care unit (NICU) admission and with prolonged maternal hospitalisation, and benchmarked event rates against national data.

Methods

A retrospective cohort of all pregnant women with a positive nasopharyngeal SARS-CoV-2 RT-PCR result at a Turkish tertiary centre between March 2020 and May 2023. Of 151 women identified, 133 had retrievable records; eight pregnancies did not end in a live birth, leaving 125. Prespecified subgroups (NICU admission; maternal stay > 3 days) were compared using Mann-Whitney U and χ2/Fisher exact tests, and cohort proportions with 2024 Turkish national rates by one-sample exact binomial tests.

Results

The mean maternal age was 29.9 ± 5.5 years and gestational age at delivery was 38.0 ± 2.0 weeks; 19 women (15.2%) delivered preterm and 76 (60.8%) were diagnosed in the third trimester. Sixteen neonates (12.8%) required NICU care and two mothers (1.6%) intensive care; there were no maternal deaths or stillbirths. NICU admission was associated with preterm birth (56.2% vs. 9.2%, p < 0.001) and lower Apgar scores, and prolonged maternal stay with preterm birth, pregnancy-related comorbidity, and caesarean delivery (all p ≤ 0.001). Neither the trimester of infection nor vaccination status was associated with either outcome. Caesarean (64.0%) and preterm birth (15.2%) rates did not exceed national values (p = 0.58 and p = 0.42).

Conclusions

Adverse outcomes clustered with preterm delivery and pre-existing pregnancy complications rather than with the timing of infection. Without a matched control group, and with power limited to large effects, these descriptive findings cannot exclude a clinically important effect of SARS-CoV-2.