Fetal growth in covid pregnancy: Better than expected?

ABSTRACT

INTRODUCTION The COVID pandemic has widely affected the pregnancy experience, being a novel risk factor for maternalfetal morbidity/mortality, preterm birth and, as recently hypothesized, preeclampsia. The aim of our study was to investigate the impact of COVID in pregnancy on fetal growth. METHODS Data from ultrasound reports of 73 consecutive pregnancies enrolled in the local ItOSS surveillance on COVID and pregnancy were analyzed. All patients had experienced COVID in pregnancy at various stages of severity. Eight cases were excluded as they did not fit the aim of the study. Fetal abdominal circumference (AC) in 2nd and 3rd trimester were compared for each case, and then with the neonatal birthweight, in order to clarify the possible presence of growth defects/accelerations. RESULTS No case of AC <10° centile was reported neither in the 2nd nor in the 3rd trimester. Interestingly, the percentage of SGA at birth was 5.6%. The same percentage of neonates had pH <7.10 at birth. Only one case presented an AC drop >40 centiles. LGA neonates, with AC >90° centile, accounted for 22.5%, including 8.4% of cases that presented an acceleration of growth velocity from 2nd to 3rd trimester. During the 3rd trimester to birth interval, we observed 8.4% of decrease and 2.8% increase of growth velocity, respectively, in terms of percentiles of expected birthweight vs neonatal birthweight. CONCLUSIONS Data about fetal growth in COVID pregnancies are overall encouraging. No case of defined FGR was observed. Conversely, acceleration of growth from 2nd to 3rd trimester was higher than expected. This may be accountable on poor metabolic status due to the prolonged use of corticosteroids or on lack of regular glycemic screening/nutrition due to pandemic.