Maternal COVID-19 infection, clinical characteristics, pregnancy and neonatal outcome: a prospective cohort study at a tertiary care center in Central India
DOI:
https://doi.org/10.18203/2320-6012.ijrms20212229Keywords:
COVID-19, Cohort study, Medical morbidity, Pregnancy related morbidity, Maternal and neonatal outcomeAbstract
Background: COVID-19 caused by severe acute respiratory syndrome coronavirus-2 is a global public health emergency as declared by WHO. Currently how it affects pregnancy very little is known. To identify maternal and neonatal risks associated with COVID-19 in pregnancy and to describe outcome a prospective cohort study was done. Associations were evaluated for all COVID-19 patients and for disease classified as mild versus moderate/severe disease.
Methods: In this study COVID RT-PCR positive women who were admitted from 1 May to 31 August were included. Cases were classified according to their severity, investigations done and treated according to MOHFW (ministry of health and family welfare), India guidelines. Data was collected, analysed in terms of maternal and neonatal outcome.
Results: Total 221 COVID-19 cases were admitted and 181 delivered during study period. There were 215 (97.28%) mild, 5 (2.71%) moderate and 1 (0.45%) severe cases. 210 (95.02%) were diagnosed in third trimester. Mean gestational age was 36.79±5.24 weeks and 3 out of 4 in moderate/severe category delivered preterm. 132 (59.73%) were asymptomatic. There was 1 ICU admission and 1 maternal death. Mean birth weight was 2.7±0.59 kg. There were 7 stillbirths, 14 NICU admission and 1 neonatal death.
Conclusions: Majority of the covid infected women are asymptomatic are in mild category and there is no adverse maternal and neonatal outcome due to disease. Adversity of maternal and neonatal outcome depends on severity of disease and severity of disease is dependent on presence of co-morbidities.
References
World Health Organization. Coronavirus disease 2019 (COVID19) Situation Report—48. World Health Organization. 2020. https :// www.who.int/docs/defaultsource/coronavirus/situation- reports/20200 308-sitrep-48-covid-19.pdf?sfvrs n=16f7ccef_4. Accessed on 9 March 2020.
Worldometer. Fact sheet: COVID-19 Coronavirus Pandemic, 2020. Available at: https://www.worldometers.info/coronavirus/. Accessed on 4 April 2021.
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(1):292-7.
Su S, Wong G, Shi W, Liu J, Lai ACK, Zhou J, et al. Epidemiology, genetic recombination, and pathogenesis of coronaviruses. Trends Microbiol. 2016;24(6):490-502.
Liu H, Liub F, Li J, Zhanga T, Wanga D, Lan W. Clinical and CT Imaging features of the COVID-19 pneumonia: focus on pregnant women and children. J Infect. 2020;80(5):7-13.
Zhu H, Wang L, Fang C, Peng S, Zhang L, Chang G, et al. Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia. Translat Paediatr. 2020;9(1):51-60.
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 Obstetr Gynecol India. 2020;70(4):256-61.
https://www.mohfw.gov.in/pdf/ClinicalManagementProtocolforCOVID19dated27062020.pdf. Accessed on 4 April 2020.
Li N, Han L, Peng M, Lv Y, Ouyang Y, Liu K, et al. Maternal and neonatal outcomes of pregnant women with COVID-19 pneumonia: a case-control study. Clin Infect Dis. 2020;71(16):2035-41.
Liu D, Li L, Wu1 X, Zheng D, Wang J, Yang L, et al. Pregnancy and perinatal outcomes of women with coronavirus disease (COVID-19) pneumonia: a preliminary analysis. Am J Roentgenol. 2020;215(1):127-35.
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):100.
Sahin D, Tanacan A, Erol SA, Anuk AT, Eyi EGY, Ozgu- Erdinc AS, et al. A pandemic centre’s experience of managing pregnant women with COVID‐19 infection in Turkey: A prospective COHORT study. Int J Gynecol Obstet. 2020;151(1):1-9.
Yang J, Zheng Y, Gou X, Pu K, Chen Z, Guo Q, et al. Prevalence of comorbidities in the novel Wuhan coronavirus (COVID‐19) infection: a systematic review and meta‐analysis. Int J Infect Dis. 2020;94:91-5.
Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382:1708-20.
Wang Z, Wang Z, Xiong G. Clinical characteristics and laboratory results of pregnant women with COVID‐19 in Wuhan, China. Int J Gynecol Obstet. 2020;150(3):312-7.
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-centre, descriptive study. Lancet Infect Dis. 2020;20(5):559-64.
Wu Y, Liu J, Xu J, Chen Y, Yang W, Chen Y, et al. Neonatal outcome in 29 pregnant women with COVID-19: A retrospective study in Wuhan, China. PLoS Med. 2020;17(7):1003195.
Antoun L, Taweelb NE, Ahmed I, Patni S, Honest H, et al. Maternal COVID-19 infection, clinical characteristics, pregnancy, and neonatal outcome: a prospective COHORT study. Eur J Obstet Gynecol Reprod Biol. 2020;252:559-62.
Brandt JS, Hill J, Reddy A, Schuster M, Patrick HS, Rosen T, et al. Epidemiology of COVID-19 in Pregnancy: risk factors and associations with adverse maternal and neonatal outcomes. Am J Obstetr Gynecol. 2020;224(4):1-9.
Patricia R, Barbero P, Fernández-Ruiz M, López-Medrano F, Lizasoáin M, Hernández-Jiménez P, et al. Incidence and clinical profiles of COVID-19 pneumonia in pregnant women: A single-centre cohort study from Spain. E Clinic Med. 2020;23:100407.
Panahi L, Amiri M, Pouy S. Risks of novel coronavirus disease (COVID-19) pregnancy; a narrative review. Arch Acad Emerg Med. 2020;8(1):34.
Khan MMA, Khan MN, Mustagir MG, Rana J, Md. Haque R, Rahm MM, et al, COVID-19 infection during pregnancy: a systematic review to summarize possible symptoms, treatments and pregnancy outcomes. MedRxiv. 2020.
Vakilia S, Savardashtakib A, Jamalniac S, Tabrizid R, Nematollahief MH, Jafariniag M, et al laboratory findings of COVID-19 infection are conflicting in different age groups and pregnant women: a literature review. Arch Med Res. 2020;51(7):603-7.