The Association Between Covid19 Infection And Umbilical Artery Dopplers In Growth-Restricted Pregnancies

The effect of COVID19 infection on pregnancies affected by fetal growth restriction (FGR) is unknown. We aim to determine whether COVID19 infection worsens the severity of fetal growth restriction as characterized by umbilical artery Doppler studies (UADs). This was a retrospective cohort study of women who delivered at a single New York City tertiary care center from 3/1/2020-8/12/2020 with antenatal diagnosis of FGR, defined as an estimated fetal weight<10%, abdominal circumference (AC)<5% (prior to 7/1/2020), or AC<10% (after 7/1/2020). The change in FGR definition during our study period was based on SMFM recommendations. At our institution, UADs are performed at least weekly after FGR is diagnosed. Multiple gestations and fetal anomalies were excluded. The primary exposure was antenatal diagnosis of COVID19, defined as positive SARS-CoV-2 RT-PCR on nasopharyngeal swab or positive COVID-19 IgG on immunoassay. The primary outcome was abnormal UADs, defined as a composite of elevated S/D ratio, absent end-diastolic velocity, or reversed end-diastolic velocity. Data were collected via chart abstraction and compared between women with normal and abnormal UADs. 91 women met inclusion criteria. 7 (7.7%) women had COVID19 during pregnancy and 27 (29.7%) had abnormal UADs. COVID19 was diagnosed in 6 women with normal UADs and 1 with abnormal UADs (9.4% vs 4.0%, p=0.67) (Table 1). Controlling for age, race, body mass index, smoking, and maternal disease, there was no difference in abnormal UADs between COVID19 positive and negative patients (aOR 0.94, 95% CI 0.09-10.00). Of maternal factors evaluated, only maternal hypertensive disease of pregnancy was associated with abnormal UADs (aOR 4.68, 95% CI 1.36-16.07) (Table 2). We did not find a significant association between COVID19 infection and umbilical artery Dopplers in pregnancies affected by FGR. Maternal hypertensive disease of pregnancy may increase the risk of abnormal UADs in these pregnancies.View Large Image Figure ViewerDownload Hi-res image Download (PPT)