Effect of COVID-19 on pregnant women and its relation to pregnancy outcomes
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20252186Keywords:
Pregnancy, COVID-19, Pregnancy outcomes, Maternal and neonatal health, Vertical transmissionAbstract
Background: To evaluate the pregnancy outcomes and clinical characteristics of pregnant women infected with SARS-CoV-2 and their neonates, highlighting COVID-19’s potential impact on maternal and neonatal health.
Methods: A retrospective cohort study was conducted which included 50 pregnant women, aged 18-40 years, hospitalized with strongly suspected or confirmed COVID-19 based on RT-PCR or clinical/imaging findings. Data on maternal symptoms, delivery mode, laboratory findings, and neonatal outcomes were collected and then analyzed. Pregnancies complicated by cancers or inflammatory diseases were excluded. Neonatal health was assessed using the Apgar score, NICU admissions, and SARS-CoV-2 testing.
Results: The mean gestational age at diagnosis was 35.85±4 weeks, with 50% vaginal deliveries and 50% cesarean sections (30% elective, 20% emergency). Adverse outcomes included 2 preterm births (4%) and 5 cases of premature rupture of membranes (10%). Three neonates (6%) tested positive for SARS-CoV-2, with a mean birth weight of 3506 gm, and Apgar scores of 4±2.1 (1 minute) and 8±1.2 (5 minutes). NICU admission was required for 14% of newborns, with no reported neonatal deaths. The majority of women experienced mild symptoms, and no severe maternal illness or death occurred.
Conclusions: In pregnant women, COVID-19 infection was associated with mild maternal symptoms and favorable neonatal outcomes, although vertical transmission of SARS-CoV-2 was observed in 6% of cases. Further research is required in order to assess long-term effects and better understand the mechanisms behind vertical transmission.
Metrics
References
Mao R, Liang J, Shen J, Ghosh S, Zhu LR, Yang H, et al. Implications of COVID-19 for patients with pre-existing digestive diseases. The lancet Gastroenterol Hepatol. 2020;5(5):425-7. DOI: https://doi.org/10.1016/S2468-1253(20)30076-5
Rasmussen SA, Jamieson DJ. Coronavirus Disease 2019 (COVID-19) and Pregnancy: Responding to a Rapidly Evolving Situation. Obstetr Gynecol. 2020;135(5):999-1002. DOI: https://doi.org/10.1097/AOG.0000000000003873
Jamieson DJ, Honein MA, Rasmussen SA, Williams JL, Swerdlow DL, Biggerstaff MS. H1N1 2009 influenza virus infection during pregnancy in the USA. Lancet. 2009;374 (9688):0-458. DOI: https://doi.org/10.1016/S0140-6736(09)61304-0
Wang S, Guo L, Chen L, Liu W, Cao Y, Zhang J, et al. A case report of neonatal COVID-19 infection in China. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America. Clin Infect Dis. 2020;71(15):853-857. DOI: https://doi.org/10.1093/cid/ciaa225
Qiao J. What are the risks of COVID-19 infection in pregnant women?. Lancet (London, England). 2020;395(10226):760–2. DOI: https://doi.org/10.1016/S0140-6736(20)30365-2
Santoso A, Pranata R, Wibowo A, Al-Farabi MJ, Huang I, Antariksa B. Cardiac injury is associated with mortality and critically ill pneumonia in COVID-19: A meta-analysis. Am J Emerg Med. 2021;44:352-7. DOI: https://doi.org/10.1016/j.ajem.2020.04.052
Yenerçağ M, Arslan U, Doğduş M, Günal Ö, Öztürk ÇE, Aksan G, et al. Evaluation of electrocardiographic ventricular repolarization variables in patients with newly diagnosed COVID-19. J Electrocardiol. 2020;62:5-9. DOI: https://doi.org/10.1016/j.jelectrocard.2020.07.005
Ece İ, Koçoğlu M, Kavurt AV, Bağrul D, Gül AEK, Koca S, et al. Assessment of Cardiac Arrhythmic Risk in Children With COVID-19 Infection. Pediatr Cardiol. 2021;42(2):264-8. DOI: https://doi.org/10.1007/s00246-020-02474-0
Bianco M, Biolè CA, Campagnuolo S, Pietrangiolillo F, Spirito A, Galluzzo A, et al. COVID-19 therapies and their impact on QT interval prolongation: A multicentre retrospective study on 196 patients. Int J Cardiol Heart Vasc. 2020;30:100637. DOI: https://doi.org/10.1016/j.ijcha.2020.100637
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. 2020;369:m2107. DOI: https://doi.org/10.1136/bmj.m2107
Muhidin S, Behboodi Moghadam Z, Vizheh M. Analysis of maternal coronavirus infections and neonates born to mothers with 2019-nCoV; a systematic review. Arch Acad Emerg Med. 2020;8:e49.
Petrilli CM, Jones SA, Yang J, Rajagopalan H, O'Donnell L, Chernyak Y, et al. Factors associated with hospital admission and critical illness among 5279 people with coronavirus disease 2019 in New York City: prospective cohort study. BMJ. 2020;369:m1966. DOI: https://doi.org/10.1136/bmj.m1966
Breslin N, Baptiste C, Gyamfi-Bannerman C, Miller R, Martinez R, Bernstein K, et al. COVID-19 infection among asymptomatic and symptomatic pregnant women: two weeks of confirmed presentations to an affiliated pair of New York City hospitals. Am J Obstet Gynecol MFM. 2020;2:100118. DOI: https://doi.org/10.1016/j.ajogmf.2020.100118
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu J, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. DOI: https://doi.org/10.1016/S0140-6736(20)30183-5
Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. New Eng J Med. 2020;382(8):727-33. DOI: https://doi.org/10.1056/NEJMoa2001017
Shah PS, Diambomba Y, Acharya G, Morris SK, Bitnun A. Classification system and case definition for SARS-CoV-2 infection in pregnant women, fetuses, and neonates. Acta Obstetriciaet Gynecol Scandinavica. 2020;99(5):565-8. DOI: https://doi.org/10.1111/aogs.13870
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. DOI: https://doi.org/10.1016/S0140-6736(20)30360-3
Smith V, Seo D, Warty R, Payne O, Salih M, Chin KL, et al. Maternal and neonatal outcomes associated with COVID-19 infection: a systematic review. Plos One. 2020;15(6):e0234187. DOI: https://doi.org/10.1371/journal.pone.0234187