Incidence of Spontaneous Abortions During the COVID-19 Pandemic in a Regional County Hospital in Romania: A Retrospective Cohort Study

<b>Background</b>: The first trimester of pregnancy is known for its proinflammatory state, so it is considered a challenging period due to increased maternal vulnerability to viral infections. The main purpose of the current study was to evaluate the incidence trend of early miscarriages and whether there was any possible influence of the COVID-19 pandemic on pregnancy outcomes. <b>Materials and Methods</b>: We conducted a retrospective cohort study in which we included all pregnant women who had been admitted to our hospital between January 2018 and December 2022. Our aim was to compare the percentage of early miscarriages occurring in the pre-pandemic period (January 2018-February 2020) and during the pandemic (March 2020-December 2022). We decided to measure the total number and percentage of early pregnancy outcomes, including all viable pregnancies, ectopic pregnancies, and both medical and spontaneous abortions. <b>Results</b>: The annual incidence of registry-identified early miscarriages declined from 5.4% of 12-46-year-old women in 2018 to 3.6% in 2022 (<i>p</i> = 0.008). An overall incidence rate of 3.66% [95% C.I. 3.26-4.05] was calculated, with 4.25% [95% C.I. 3.35-4.41] in the pre-pandemic period and 3.24% [95% C.I. 2.82-3.57] during the pandemic. The highest incidence rate (<i>p</i> < 0.0001) was identified among nulliparous women (36.9%). <b>Conclusions</b>: To conclude, this study proved that the increase in the early miscarriage incidence rate could be assigned to an advanced maternal age, irrespective of one's reproductive history. This study proved that no significant increase in the incidence rate of early miscarriage during the COVID-19 pandemic was noted, suggesting that this viral infection does not alter the risk of miscarriages. We hope that these findings help women deal with emotional stress and offer them reassurance about bearing children during pandemic periods.