Maternal and neonatal outcomes of French prospective multicenter cohort study COVIPREG during the first two COVID-19 waves

Background SARS-CoV-2 infection on pregnant women was the subject of many questions since the COVID-19 pandemic. Methods We aim to assess maternal and neonatal outcomes of SARS-CoV-2 infection contracted during 2nd and 3rd trimesters of pregnancy during the first two COVID-19 waves across a prospective French multicenter cohort study. Patients were included between April 2020 and January 2021 in 10 maternity hospitals in Paris area with two groups (i) pregnant women with a positive SARS-CoV-2 nasopharyngeal RT-PCR between [14WG; 37WG[(symptomatic infection), (ii) pregnant women with a negative serology (or equivocal) at delivery and without a positive SARS-CoV-2 nasopharyngeal RT-PCR at any time during pregnancy (G2 group) Main findings 2410 pregnant women were included, of whom 310 had a positive SARS-CoV-2 nasopharyngeal RT-PCR and 217 between [14WG; 37WG[. Most infections occurred between 28 and 37 weeks of gestation (56%). Most patients could be managed as outpatients, while 23% had to be hospitalized. Among women with a positive RT-PCR, multiparous women were over-represented (OR=2.45[1.52;3.87]); were more likely to deliver before 37 weeks of gestation (OR=2.19[1.44;3.24]) and overall cesarean deliveries were significantly increased (OR=1.53[1.09;2.13]). Conclusions This study highlights the maternal, obstetrical, and neonatal burden associated with SARS-CoV-2 infections during the first two pandemic waves before availability of vaccines. Trial registration NCT04355234 (registration date: 21/04/2020)