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Objective  To determine the impact of maternal coronavirus disease 2019 (COVID‐19) on prematurity, birthweight and obstetric complications.    Design  Nationwide, population‐based retrospective cohort study.    Setting  National  Programme de Médicalisation des Systèmes d'Information  database in France.    Population  All single births from March to December 2020: 510 387 deliveries, including 2927 (0.6%) with confirmed COVID‐19 in the mother and/or the newborn.    Methods  The group with COVID‐19 was compared with the group without COVID‐19 using the chi‐square test or Fisher's exact test, and the Student's  t  test or Mann–Whitney  U  test. Logistic regressions were used to study the effect of COVID‐19 on the risk of prematurity or macrosomia (birthweight ≥4500 g).    Main outcome measures  Prematurity less than 37, less than 28, 28–31, or 32–36 weeks of gestation; birthweight; obstetric complications.    Results  In singleton pregnancies, COVID‐19 was associated with obstetric complications such as hypertension (2.8% versus 2.0%,  p  < 0.01), pre‐eclampsia (3.6% versus 2.0%,  p  < 0.01), diabetes (18.8% versus 14.4%,  p  < 0.01) and caesarean delivery (26.8% versus 19.7%,  p  < 0.01). Among pregnant women with COVID‐19, there was more prematurity between 28 and 31 weeks of gestation (1.3% versus 0.6%,  p  < 0.01) and between 32 and 36 weeks of gestation (7.7% versus 4.3%,  p  < 0.01), and more macrosomia (1.0% versus 0.7%, p = 0.04), but there was no difference in small‐for‐gestational‐age newborns (6.3% versus 8.7%,  p  = 0.15). Logistic regression analysis for prematurity showed an adjusted odds ratio (aOR) of 1.77 (95% CI 1.55–2.01) for COVID‐19. For macrosomia, COVID‐19 resulted in non‐significant aOR of 1.38 (95% CI 0.95–2.00).    Conclusions  COVID‐19 is a risk factor for prematurity, even after adjustment for other risk factors.    Tweetable Abstract  The risk of prematurity is twice as high in women with COVID‐19 after adjustment for factors usually associated with prematurity.

bjog: an international journal of obstetrics and gynaecology

Impact of  SARS‐CoV‐ 2 infection on risk of prematurity, birthweight and obstetric complications: A multivariate analysis from a nationwide, population‐based retrospective cohort study