Risk Of Cervical Shortening And Spontaneous Preterm Births During The Covid19 Pandemic

Data are mixed regarding preterm birth (PTB) rates during the COVID19 pandemic, with many reports suggesting a decrease in PTB. We sought to determine the rates of short cervix and PTB in our cohort during the pandemic. This was a retrospective cohort study of women with singleton gestations presenting for anatomical survey between 16 and 24 weeks and delivering at a single-institution in NYC, where universal transvaginal cervical length (TVCL) screening is performed at anatomical survey and universal testing for COVID19 is performed at delivery. Included women had TVCL measurements between March and May, 2020 and delivered before 8/17/2020. Women with incomplete outcome data were excluded. Our primary outcome, cervical shortening, defined as TVCL <2.5cm was compared between exposure groups: women who ever tested positive for SARS-CoV-2 by RT-PCR or IgG positive by serology at any time during the pregnancy and those testing negative. Secondary outcomes included spontaneous PTB (sPTB), preterm prelabor rupture of membranes (PPROM) and other adverse perinatal outcomes. Data were abstracted from electronic medical records and compared between groups. The rate of sPTB was then compared to a historical cohort in the same delivery time period. 316 women were included. Hispanics were disproportionally affected by COVID19 (Table 1). Of 60 COVID+ women, 33 (55%) women had positive RT-PCR, most with mild symptoms, and 53 (88%) women had positive IgG near delivery. There were no cases of short cervix in the positive group. The data suggest a higher rate of PPROM in the positive group but after controlling for confounders, our numbers were too small to confirm this difference (aOR 2.34, 95% CI 0.84-6.46) (Table 2). Similarly, there was no difference in sPTB rates between the groups (aOR 1.35, 95% CI 0.48-3.75). Further, there was no difference in sPTB relative to the same time period in 2019 (2.9% vs 3.1%, p=0.68). In our cohort, COVID19 RT-PCR or IgG positive patients had a similar to slightly increased odds of cervical shortening, sPTB, and PPROM compared to negative patients.View Large Image Figure ViewerDownload Hi-res image Download (PPT)