Observational study of fetomaternal outcome in pregnancy with COVID-19 infection

Authors

  • Pragyan Dash Department of Obstetrics and Gynecology, Hi-Tech Medical College and Hospital, Bhubaneswar, Odisha, India
  • Sobhan K. Padhi Department of Obstetrics and Gynecology, Hi-Tech Medical College and Hospital, Bhubaneswar, Odisha, India
  • Rabindra N. Behera Department of Obstetrics and Gynecology, Hi-Tech Medical College and Hospital, Bhubaneswar, Odisha, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20220391

Keywords:

COVID-19, SARS CoV-2, Pregnancy, Pneumonia, Preterm

Abstract

Background: According to World Health Organization (WHO) COVID-19 is declared as an infection of international health emergency on 11 March 2020. It is not clear whether clinical characteristics of pregnant women with COVID-19 infection differ from those of non-pregnant women and whether it aggravates its symptoms.

Methods: This is a prospective observational study of 75 cases based on compiled clinical data of pregnant women with COVID-19 infection admitted to Hi-Tech Medical College from June 2020 to July 2021. All laboratory confirmed positive cases were included.

Results: The most common symptoms reported was fever (24%) followed by myalgia, cough and shortness of breath, while 60% patients were asymptomatic. there were total 57 deliveries, out of which 46 were live birth. The incidence of preterm birth was 26.3%. Maternal mortality was maximum between 25-34 weeks of GA. 96.9% of new-born were tested for SARS CoV-2 and only 10 were found to be positive (17.5%).

Conclusions: At present there is no evidence regarding increased risk of pregnant women succumbed to COVID-19 infection and experience severe pneumonia. The risk of preterm birth and spontaneous abortion not increased as reported in this study but shows possibilities of vertical transmission. COVID-19 infection in pregnancy with or without any comorbidities can cause complication to both mother and fetus irrespective of treatment. We aim to evaluate the association between SARS CoV-2 infection during pregnancy and adverse pregnancy outcomes.

References

Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. China novel coronavirus investigating and research team. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382:727-33.

Weiss SR, Leibowitz JL. Coronavirus pathogenesis. Adv Virus Res. 2011;81:85-6.

Masters PS, Perlman S. Coronaviridae. In: Knipe DM, Howley PM, editors. Fields virology. 6th edition. Lippincott Williams and Wilkins. 2013:825-58.

Tang P, Wang J, Song Y. Characteristics and pregnancy outcomes of patients with severe pneumonia complicating pregnancy: a retrospective study of 12 cases and a literature review. BMC Pregnancy and Childbirth. 2018;18(1).

Wenling Y, Junchao Q, Xiao Z, Ouyang S. Pregnancy and COVID-19: management and challenges. Rev Inst Med Trop Sao Paulo. 2020;62.

Dorélien A. The effects of in utero exposure to influenza on birth and infant outcomes in the US. Popul Dev Rev 45: 489–523, 2019. doi:10.1111/padr.12232. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

Mosby LG, Rasmussen SA, Jamieson DJ. 2009 pandemic influenza A (H1N1) in pregnancy: a systematic review of the literature. Am J Obstet Gynecol. 2011;205:10-8.

Su S, Wong G, Shi W, Liu J, Lai AC, Zhou J, et al. Epidemiology, genetic recombination, and pathogenesis of coronaviruses. Trends Microbiol. 2016;24:490-502.

Cui J, Li F, Shi ZL. Origin and evolution of pathogenic coronaviruses. Nat Rev Microbiol. 2019;17:181-92.

Chan JF, Kok KH, Zhu Z, Chu H, To KK, Yuan S, et al. Genomic characterization of the 2019 novel human-pathogenic coronavirus isolated from a patient with atypical pneumonia after visiting Wuhan. Emerg Microbes Infect. 2020;9:221-36.

Royal College of Obstetricians Gynaecologists, Royal College of Midwives. Coronavirus infection in pregnancy: Information for healthcare professionals. 2020. Available at: https://www.rcog.org.uk/global. Accessed on 13 April 2021.

Centers for Disease Control and Prevention. Coronavirus Disease (COVID-19). People who need extra precautions: Pregnancy and Breastfeeding. Available at: https://www.cdc.gov/coronaviru. Accessed on 13th April 2020.

Hui DS, Zumla A. Severe acute respiratory syndrome: historical, epidemiologic, and clinical features. Infect Dis Clin. 2019;33(4):869-89.

Silasi M, Cardenas I, Kwon JY, Racicot K, Aldo P, Mor G. Viral infections during pregnancy. Am J Reprod Immunol. 2015;73(3):199-213.

Schwartz DA, Graham AL. Potential maternal and infant outcomes from (Wuhan) coronavirus 2019-nCoV infecting pregnant women: lessons from SARS, MERS, and other human coronavirus infections. Viruses. 2020;12(2):194.

Maxwell C, McGeer A, Tai KFY, Sermer M. No. 225-Management guidelines for obstetric patients and neonates born to mothers with suspected or probable Severe Acute Respiratory Syndrome (SARS). J Obstet Gynaecol Canada. 2017;39(39):130-7.

Allotey J, Stallings E, Bonet M, Yap M, Chatterjee S, Kew T, et al. Clinical manifestations, risk factors,and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ (Clinical research ed). 2020;370:3320.

World Health Organization. Laboratory testing for 2019 novel coronavirus (2019-nCoV) in suspected human cases. Interim guidance. Available at: https://www.who.int/publications-detail/laboratory-testing-for-2019-novel-coro-navirus-in-suspected-human-cases-20200117. Accessed on 24 March 2020.

Ministry of health and family welfare. Revised discharged policy, dated 8th May, 2020. Available at: https://www.mohfw.gov.in/pdf/FAQsonRevisedDischargePolicy.pdf. Accessed on 10 June 2020.

Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-20.

Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese center for disease control and prevention. JAMA. 2020;323(13):1239-42.

Chawla D, Chirla D, Dalwai S, Deorari AK, Ganatra A, Gandhi A, et al. Perinatal-neonatal management of COVID-19 infection-guidelines of the federation of obstetric and gynaecological societies of India (FOGSI), National neonatology forum of India (NNF), and Indian Academy of Pediatrics (IAP). Indian Pediatr. 2020;57(6):536-48.

Madinger NE, Greenspoon JS, Ellrodt AG. Pneumonia during pregnancy: has modern technology improved maternal and fetal outcome? Am J Obstet Gynecol. 1989;161:657-62.

Chen YH, Keller J, Wang IT, Lin CC, Lin HC. Pneumonia and pregnancy outcomes: a nationwide population-based study. Am J Obstet Gynecol. 2012;207:288.

Dashraath P, Wong JLJ, Lim MXK. Coronavirus disease 2019 (COVID-19) pandemic and pregnancy. Am J Obstet Gynecol. 2020;222:521-31.

Knight M, Bunch K, Vousden N, Morris E, Simpson N, Gale C, et al. Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: national population based cohort study. BMJ (Clinical research ed). 2020;369:2107.

Wong SF, Chow KM, Leung TN, Ng WF, Ng TK, Shek CC, et al. Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome. Am J Obstet Gynecol. 2004;191:292-7.

Al Wattar B, Murugesu N, Tobias A, Zamora J, Khan KS. Management of first-trimester miscarriage: a systematic review and network meta-analysis. Hum Reprod Update. 2019;25:362-74.

Zeng H, Xu C, Fan J. Antibodies in infants born to mothers with COVID-19 pneumonia. JAMA. 2020;323(18):1848-9.

Dong L, Tian J, He S, Zhu C, Wang J, Liu C, et al. Possible vertical transmission of SARS-CoV-2 from an infected mother to her newborn. JAMA. 2020;323(18):1846-8.

Wang L, Shi Y, Xiao T, Fu J, Feng X, Mu D, et al. Working committee on perinatal and neonatal management for the prevention and control of the 2019 novel coronavirus infection. Chinese expert consensus on the perinatal and neonatal management for the prevention and control of the 2019 novel coronavirus infection (First edition). Ann Transl Med. 2020;8:1-8.

Poon LC, Yang H, Lee JCS, Copel JA, Leung TY, Zhang Y, et al. ISUOG Interim Guidance on 2019 novel coronavirus infection during pregnancy and puerperium: information for healthcare professionals. Ultrasound Obstet Gynecol. 2020;55:700-8.

World Health Organization. Frequently asked questions: Breastfeeding and COVID-19. 2020. Available at: https://www.who.int/docs/default-source/maternal-health/faqs-breastfeeding-and-covid-19.pdf?sfvrsn=d839e6c0_5. Accessed on 10 June 2021.

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Published

2022-02-25

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Original Research Articles