COVID-19 and pregnancy outcomes: a retrospective study from a tertiary health care center of Uttarakhand, India

Authors

  • Purnima Upreti Department of Obstetrics and Gynaecology, Himalayan Institute of Medical Sciences, Jolly Grant, Dehradun, Uttarakhand, India
  • Punam Godara Department of Obstetrics and Gynaecology, Himalayan Institute of Medical Sciences, Jolly Grant, Dehradun, Uttarakhand, India https://orcid.org/0000-0001-7645-068X

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20230792

Keywords:

Pregnancy outcome, Mode of delivery, Vertical transmission, Premature birth, COVID-19

Abstract

Background: Information regarding the effects of COVID-19 on pregnancy outcomes evolved rapidly in the recent years. This study aims to present the outcomes in COVID-19 positive pregnant women.

Methods: This retrospective cohort study was conducted in a tertiary health care center of Uttarakhand, India from April 2021 to June 2021. The maternal and neonatal data for the included cases were extracted from hospital records and appropriately analysed.

Results: The positivity rate of COVID-19 among obstetric population was 7.9% by universal screening protocol. 55.2% participants were in the age group of 25-30 years. Gestation age at presentation ranged from 6 weeks to 41 weeks. 47.3% participants had pre-existing comorbidities. 26.4% study subjects had pregnancy related comorbidities, the most common being gestational diabetes mellitus (14.7%), followed by pre-eclampsia (8.8%). Only 21.1% participants were symptomatic at presentation. Most common presenting symptom was fever (87.5%) followed by breathlessness (62.5%). 7.5% required invasive ventilation and 10.5% cases required intensive care unit (ICU) admission and 76.5% participants underwent caesarean section which was done for obstetric indications only. 3.9% participants died due to COVID-related complications. Nearly 35% neonates were preterm, 29.4% had low birth weight and 24.1% needed neonatal intensive care unit (NICU) admission. Nasopharyngeal swab for COVID reverse transcriptase-polymerase chain reaction (RT-PCR) after 24 hours of birth was negative in all neonates. There were 10 (14.7%) stillbirths.

Conclusions: COVID-19 in pregnancy was associated with higher risks of gestational diabetes mellitus, preeclampsia and higher rates of invasive ventilation, ICU admission, caesarean sections, maternal mortality specially in women with pre-existing comorbidities, stillbirths, preterm births and NICU admission.

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References

Rasmussen SA, Smulian JC, Lednicky JA, Wen TS, Jamieson DJ. Coronavirus Disease 2019 (COVID-19) and pregnancy: what obstetricians need to know. Am J Obstet Gynecol. 2020;222(5):415-26.

Lopez M, Gonce A, Meler E, Plaza A, Hernández S, Martinez-Portilla RJ, et al. Coronavirus Disease 2019 in Pregnancy: A Clinical Management Protocol and Considerations for Practice. Fetal Diagn Ther. 2020;47(7):519-28.

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. 2020;370:m3320.

Collin J, Byström E, Carnahan A, Ahrne M. Public Health Agency of Sweden's Brief Report: Pregnant and postpartum women with severe acute respiratory syndrome coronavirus 2 infection in intensive care in Sweden. Acta Obstet Gynecol Scand. 2020;99(7):819-22.

Nayak AH, Kapote DS, Fonseca M, Chavan N, Mayekar R, Sarmalkar M, et al. Impact of the Coronavirus Infection in Pregnancy: A Preliminary Study of 141 Patients. J Obstet Gynaecol India 2020;70(4):256-61.

Antoun L, Taweel NE, Ahmed I, Patni S, Honest H. Maternal COVID-19 infection, clinical characteristics, pregnancy, and neonatal outcome: A prospective cohort study. Eur J Obstet Gynecol Reprod Biol. 2020;252:559-62.

Sutton D, Fuchs K, D' Alton M, Goffman D. Universal Screening for SARS-CoV-2 in Women Admitted for Delivery. N Engl J Med. 2020;382(22):2163-4.

Prabhu M, Cagino K, Matthews KC, Friedlander RL, Glynn SM, Kubiak JM, et al. Pregnancy and postpartum outcomes in a universally tested population for SARS-CoV-2 in New York City: a prospective cohort study. BJOG. 2020;127(12):1548-56.

Singh V, Choudhary A, Datta MR, Ray A. Maternal and Neonatal Outcomes of COVID-19 in Pregnancy: A Single-Center Observational Study. Cureus. 2021;13(2):e13184.

Antsaklis P, Tasias K, Psarris A, Theodora M, Daskalakis G, Rodolakis A. Covid-19 and pregnancy: the experience of a tertiary maternity hospital. J Perinat Med. 2021;49(6):686-90.

Villar J, Ariff S, Gunier RB, Thiruvengadam R, Rauch S, Kholin A, et al. Maternal and Neonatal Morbidity and Mortality Among Pregnant Women with and without COVID-19 Infection: The INTERCOVID Multinational Cohort Study. JAMA Pediatr. 2021;175(8):817-26.

Mattar CN, Kalimuddin S, Sadarangani SP, Tagore S, Thain S, Thoon KC, et al. Pregnancy Outcomes in COVID-19: A Prospective Cohort Study in Singapore. Ann Acad Med Singap. 2020;49(11):857-69.

Yee J, Kim W, Han JM, Yoon HY, Lee N, Lee KE, et al. Clinical manifestations and perinatal outcomes of pregnant women with COVID-19: a systematic review and meta-analysis. Sci Rep. 2020;10(1):18126.

Karimi L, Makvandi S, Vahedian-Azimi A, Sathyapalan T, Sahebkar A. Effect of COVID-19 on Mortality of Pregnant and Postpartum Women: A Systematic Review and Meta-Analysis. J Pregnancy. 2021;8870129.

Chen L, Li Q, Zheng D, Jiang H, Wei Y, Zou L, et al. Clinical Characteristics of Pregnant Women with Covid-19 in Wuhan, China. N Engl J Med. 2020;382(25):e100.

Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet. 2020;395(10226):809-15.

Yu N, Li W, Kang Q, Xiong Z, Wang S, Lin X, et al. Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-center, descriptive study. Lancet Infect Dis. 2020;20(5):559-64.

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.

Ciapponi A, Bardach A, Comandé D, Berrueta M, Argento FJ, Rodriguez Cairoli F, et al. COVID-19 and pregnancy: An umbrella review of clinical presentation, vertical transmission, and maternal and perinatal outcomes. PLoS One. 2021;16(6):e0253974.

Ferrazzi E, Frigerio L, Savasi V, Vergani P, Prefumo F, Barresi S, et al. Vaginal delivery in SARS-CoV-2-infected pregnant women in Northern Italy: a retrospective analysis. BJOG. 2020;127(9):1116-21.

Zambrano LD, Ellington S, Strid P, Galang RR, Oduyebo T, Tong VT, et al. Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status-United States, January 22-October 3, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(44):1641-7.

Molteni E, Astley CM, Ma W, Sudre CH, Magee LA, Murray B, et al. SARS-CoV-2 (COVID-19) infection in pregnant women: characterization of symptoms and syndromes predictive of disease and severity through real-time, remote participatory epidemiology. medRxiv. 2020.

Takemoto M, Menezes MO, Andreucci CB, Knobel R, Sousa L, Katz L, et al. Clinical characteristics and risk factors for mortality in obstetric patients with severe COVID-19 in Brazil: a surveillance database analysis. BJOG. 2020;127(13):1618-26.

Gajbhiye RK, Mahajan NN, Waghmare RB, Zala S, Chaaithanya IK, Kuppusamy P, et al. Clinical characteristics, outcomes, & mortality in pregnant women with COVID-19 in Maharashtra, India: Results from PregCovid registry. Indian J Med Res. 2021;153:629-36.

Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA. 2020;323(20):2052-9.

Mendoza M, Garcia-Ruiz I, Maiz N, Rodo C, Garcia-Manau P, Serrano B, et al. Pre-eclampsia-like syndrome induced by severe COVID-19: a prospective observational study. BJOG. 2020;127(11):1374-80.

Yan J, Guo J, Fan C, Juan J, Yu X, Li J, et al. Coronavirus disease 2019 in pregnant women: a report based on 116 cases. Am J Obstet Gynecol. 2020;223(1):111.

Di Mascio D, Khalil A, Saccone G, Rizzo G, Buca D, Liberati M, et al. Outcome of coronavirus spectrum infections (SARS, MERS, COVID-19) during pregnancy: a systematic review and meta-analysis. Am J Obstet Gynecol. 2020;2(2):100107.

Li Y, Zhou W, Yang L, You R. Physiological and pathological regulation of ACE2, the SARS-CoV-2 receptor. Pharmacol Res. 2020;157:104833.

Figueiro-Filho EA, Yudin M, Farine D. COVID-19 during pregnancy: an overview of maternal characteristics, clinical symptoms, maternal and neonatal outcomes of 10,996 cases described in 15 countries. J Perinat Med. 2020;48(9):900-11.

UNICEF. Neonatal Mortality. Available at: https://data.unicef.org/topic/child-survival/neonatal- mortality. Accessed on 05 April 2020.

COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. National Institutes of Health. Available at: https://www.covid19treatmentguidelines.nih.gov/overview/clinial-spectrum/. Accessed on 05 April 2020.

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Published

2023-03-28

How to Cite

Upreti, P., & Godara, P. (2023). COVID-19 and pregnancy outcomes: a retrospective study from a tertiary health care center of Uttarakhand, India. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 12(4), 946–954. https://doi.org/10.18203/2320-1770.ijrcog20230792

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Original Research Articles