Association of prenatal ultrasonographic findings with neonatal outcomes

Association of prenatal ultrasonographic findings with neonatal outcomes in pregnant women with SARS-CoV-2 infection

“As we all know, pregnant patients remain at risk for SARS-CoV-2 infection and the clinical spectrum of COVID-19 is variable,” began Rashmi Rao, MD, assistant clinical professor, Division of Maternal-Fetal Medicine at the University of California, Los Angeles, at a poster presentation of the study, “Association of prenatal ultrasonographic findings with neonatal outcomes in pregnant women with SaRS-CoV-2 infection” at the virtual SMFM conference on February 3, 2022.¹ The objective of the study, which was to describe the sonographic characteristics of pregnancies after confirmed SARS-CoV-2 infection and assess association of prenatal ultrasound (US) findings with adverse neonatal outcomes, was conducted at a tertiary care center of 103 women diagnosed during pregnancy with SARS-CoV-2 between March 2020 and May 2021. Standard fetal measurements, umbilical artery and middle cerebral artery Dopplers, as well as placental thickness and amniotic fluid volume were collected. The primary outcome was a composite adverse neonatal outcome.

Of the 103 mother-infant pairs, 45 (43.7%) had normal results with 58 (56.3%) with abnormal results on prenatal US examination, with the most common abnormal findings being placentomegaly (34.1%) and fetal growth restriction (9.7%). There was no significant differences in baseline characteristics, trimester of infection or disease severity. 93 pregnancies had known neonatal outcomes; of these, 30 (32%) had a composite adverse neonatal outcome. Furthermore, pregnancies that developed fetal growth restriction following SARS-CoV-2 infection had a significantly higher rate of a composite adverse neonatal outcome (p<0.001).

The investigators concluded that abnormal US findings occurred in over half of the pregnancies with confirmed SARS-CoV-2 infection, but an abnormal US overall is not associated with development of an adverse neonatal outcome. The researchers did, however, suggest athat SARS-CoV-2 affected pregnancies that develop fetal growth restriction may be at an increased risk for adverse neonatal outcomes and require close surveillance

Reference

1. Mok TM, Mei J, Cambou MC, et al. Association of prenatal ultrasonographic findings with neonatal outcomes in pregnant women with SARS-CoV-2 infection. Poster session. 2022 Virtual SMFM Annual Meeting. February 2, 2022.