DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20221677

Changing trends in fetomaternal outcome in COVID-19 in pregnancy

Purvi M. Parikh, Rupa C. Vyas, Rekha K. Bhatiya, Sapana R. Shah, Tanmay J. Chudasama

Abstract


Background: This study is to provide an overview of the clinical course and outcome of COVID in pregnancy in both first wave and second wave, to study about different parameters affected significantly in both waves.

Methods: This is a retrospective comparative study that was conducted by dividing the patients into group 1 and group 2. Group 1 was treated in 2020 (wave 1) whereas group 2 in 2021 (wave 2). A laboratory confirmed positive cases of COVID-19 infection in pregnant women were included. All the patients were further categorized into mild, moderate and severe subgroups according to the ICMR criteria. 

Results: The study of the first (2020) and second (2021) wave of COVID-19. In group 1 and group 2, there were a total of 359 cases and 145 cases respectively. In group 1, there were 54/359 (15.04%) moderate cases and in group 2 there were 17/145 (11.72%) moderate cases. While there were 101/359 (28.13%) and 106/145 (73.10%) severe cases in group 1 and group 2 respectively. Most of severe cases of second group associated with breathlessness, tachypnoea and fall in oxygen saturation level ended with mechanical ventilation by O2 mask (7.54%), NRBM (8.49%), HFNC (14.15%), BIPAP (12.26%), invasive ventilation (22.64%). 

Conclusions: The results of study show that hospitalized patients in the second wave were younger, required hospitalization, and had higher mortality rates.


Keywords


COVID-19, Pregnancy, Maternal morbidity, Mortality

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References


Coronavirus disease (COVID-2019) situation reports 2020. Available at: https://www.who.int/ emergencies/diseases/novel-coronavirus-2019/ situationreports. Accessed on 01 June 2020.

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 centre for disease control and prevention. JAMA. 2020;323(13):1239-42.

Cucinotta D, Vanelli M. WHO declares COVID-19 a pandemic. Acta Biomed. 2020;91(1):157-60.

Ellington S, Strid P, Tong VT. Characteristics of women of reproductive age with laboratory-confirmed SARS-CoV-2 infection by pregnancy status - United States, January 22-June 7, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(25):769-75.

Rasmussen SA, Kissin DM, Yeung LF. Preparing for influenza after 2009 H1N1: special considerations for pregnant women and new-borns. Am J Obstet Gynecol. 2011;204(1):S13-20.

Garg S, Kim L, Whitaker M. Hospitalization rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease 2019 COVID-NET, 14 states, March 1-30, 2020. MMWR Morb Mortal Wkly Rep. 2020;69:458-64.

Revised Guidelines on Clinical Management of COVID-19. Available at: ttps://www.mohfw.gov.in/ pdf/RevisedNationalClinicalManagementGuidelineforCOVID1931032020.pdf. Accessed on 20 April 2020.

Jain VK, Iyengar KP, Vaishya R. Differences between first wave and second wave of COVID-19 in India. Diabetes Metab Syndr. 2021;15:1047-8.

Mathad JS, Gupta A. Pulmonary infections in pregnancy. Semin Respir Crit Care Med. 2017;38(2):174-84.

Iftimie S, López-Azcona AF, Vallverdú I, Hernández-Flix S, de Febrer G, Parra S, et al. First and second waves of coronavirus disease-19: A comparative study in hospitalized patients in Reus, Spain. PLoS One. 2021;16(3):e0248029.

Villoutreix BO, Calvez V, Marcelin AG, Khatib AM. In silico investigation of the new UK (B.1.1.7) and South African (501y.v2) SARS-CoV-2 variants with a focus at the ace2–spike rbd interface. Int J Mol Sci. 2021;22:1-13.

Davies NG, Jarvis CI, Edmunds WJ, Jewell NP, Diaz-Ordaz K, Keogh RH, et al. Increased hazard of death in community-tested cases of SARS-CoV-2 variant of concern 202012/01. MedRxiv 2021;2021:12-9.

Wibmer CK, Ayres F, Hermanus T. SARS-CoV-2 501Y.V2 escapes neutralization by South African COVID-19 donor plasma. Nat Med. 2021;10:23-9.

Zucman N, Uhel F, Descamps D, Roux D, Ricard JD, et al. Severe reinfection with South African SARS-CoV-2 variant 501Y.V2: a case report. Clin Infect Dis. 2021;12:51-8.

Impact of COVID on pregnant women. Available at: https://www.indiatoday.in/india/story/pregnant-postpartum-women-second-covid-wave-first-icmr-study-1815762-2021-06-17. Accessed on 20 October 2021.

Vousden N, Bunch K, Morris E. The incidence, characteristics and outcomes of pregnant women hospitalized with symptomatic and asymptomatic SARS-CoV-2 infection in the UK from March to September 2020: a national cohort study using the UK Obstetric Surveillance System (UKOSS). MedRxiv. 2021;2021:72-9.

Turan O, Hakim A, Dashraath P, Jeslyn WJL, Wright A, Abdul-Kadir R. Clinical characteristics, prognostic factors, and maternal and neonatal outcomes of SARS-CoV-2 infection among hospitalized pregnant women: A systematic review. Int J Gynaecol Obstet. 2020;151(1):7-16

DeBolt CA, Bianco A, Limaye MA. Pregnant women with severe or critical coronavirus disease 2019 have increased composite morbidity compared with nonpregnant matched controls. Am J Obstet Gynecol. 2020;20:9378.

Knight M, Bunch K, Vousden N. Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: national population based cohort study. BMJ. 2020; 369:m2107.

Jering KS, Claggett BL, Cunningham JW. Clinical characteristics and outcomes of hospitalized women giving birth with and without COVID-19. JAMA Intern Med. 2021;e209241.

D’Onofrio BM, Class QA, Rickert ME, Larsson H, Långström N, Lichtenstein P, et al. Preterm birth and mortality and morbidity: a population-based quasi-experimental study. JAMA Psychiatry. 2013;70(11):1]

Khalil A, von Dadelszen P, Draycott T, Ugwumadu A, O’Brien P, Magee L, et al. Change in the incidence of stillbirth and preterm delivery during the COVID-19 pandemic. JAMA. 2020;324:705-6.

de Souza R, Mhatre S, Qayyumi B. Clinical course and outcome of patients with COVID-19 in Mumbai City: an observational study. BMJ Open. 2021;11(5): e042943.