Fetal and Perinatal Outcome Following First and Second Trimester COVID-19 Infection: Evidence from a Prospective Cohort Study

A novel coronavirtוs termed severe acute respiratory syndrome coronavirus 2 (SARS­ CoV-2) is a new strain of coronavirus causing coronavirtוs disease 2019 (COVID-19) disease, which emerged as a global pandemic. Data regardiתg the irnplications of COVID-19 disease at early gestation on fetal and obstetric outcomes is scarce. Thus, our airn was to investigate the effect of first and second trirnester matemal COVID-19 disease on fetal and perinatal outcomes. This was a prospective cohort study of pregnant women with a laboratory-proven SARS-COV-2 infection contracted prior to 26 weeks gestation. Women were followed at a single tertiary medical center by serial sonographic examinations every 4-6 weeks to assess fetal well being, growth, placental function, anatomic evaluation and signs of fetal infection. Amniocentesis was offered to assess arnniotic fluid SARS-COV-2-PCR (polymerase chain reaction) and fetal brain magnetic resonance irnaging (MRl) was offered at 30-32 weeks gestation. Demographic, obstetric and neonatal data were collected from history intake, medical charts or by telephone survey. Perinatal semoct1tסwere compared between women infected at first vs. second trimester. 55 women with documented COVID- 19 disease at early gestation were included and followed at our center. The mean maternal age was 29.6 ::1: 6.2 years and the mean gestational age at viral infection was 14.2 ::1: 6.7 weeks with 28 (51 %) women infected at the fust trirnester and 27 (49%) at the second trirnester. All patients bt1t one experienced asymptomatic to mild symptoms. Of 22 patients who underwent arnniocentesis, none had evidence of vertical transrnission. None of the fetuses exhibited signs of central nervous system (CNS) disease, growth restriction and placental dysfunction on serial dmtסsartluexarninations and fetal MRl.