Does Fever Caused by the COVID-19 Virus Before Labor Increase the Rate of MSAF and Affect Maternal and Fetal Outcomes?

Objective: The main objective of this study is to investigate whether there is a difference in the occurrence of MSAF between fever and nonfever-pregnant women during the COVID-19 pandemic. Study Design: We conducted a multicenter retrospective study including pregnant women during the COVID-19 pandemic. Among the 400 pregnant women included in the final data analysis, 238 had fever during delivery, while 162 nonfever-pregnant women met the inclusion and exclusion criteria and served as controls. We collected various obstetric and neonatal parameters for both groups of patients, compared, and statistically tested the significance of these parameters. For parameters with significant statistical differences and clinical significance, we performed logistic regression analysis to explore potential risk factors for MSAF. Result: In a sample of 400 parturients, a total of 69 individuals (17.25%) were discovered to have MSAF with the prevalence increasing to 21.85% in the fever population. A statistically significant association was observed between fever during pregnancy and MSAF, with a higher risk of development observed in fever-pregnant women compared to nonfever ones. Specifically, the odds of developing MSAF increased by a factor of 0.979 in fever-pregnant women compared to nonfever ones, as determined by a logistic regression model (OR = 1.979, 95% CI = 1.061∼3.693, p=0.032). Moreover, pregnant women with COVID-19 infection had a significantly higher risk of developing MSAF, with the odds increasing by a factor of 2.567 compared to uninfected pregnant women (OR = 3.567, 95% CI = 1.622∼7.845, p=0.002). In addition, the study also identified abnormal fetal heart monitoring (p < 0.05) and gestational age (p < 0.05) as independent risk factors for the occurrence of MSAF. Conclusion: For pregnant women infected with COVID-19, the rate of MSAF disturbance significantly increases, therefore, it is necessary to pay more attention to fetal heart changes and amniotic fluid conditions, and actively managing labor is beneficial for improving delivery outcomes.