E-ISSN: 2619-9467

Contents    Cover    Publication Date: 22 Jun 2022
Year 2022 - Volume 32 - Issue 2

Open Access

Peer Reviewed

ORIGINAL RESEARCH
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Clinical Features and Outcomes of 124 Pregnant Women Hospitalized with COVID-19: A Prospective Observational Study

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JCOG. 2022;32(2):46-55
DOI: 10.5336/jcog.2022-88470
Article Language: EN
Copyright Ⓒ 2020 by Türkiye Klinikleri. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: Pregnancy is known to worsen the clinical course of coronavirus disease-2019 (COVID-19) compared to non-pregnant women of the same age. The aim of this study is to evaluate maternofetal and neonatal clinical features and outcomes of pregnant women with COVID-19. Material and Methods: For this prospective single-center study, data of 124 pregnant women who were hospitalized and treated for COVID-19 between April 20, 2020 and March 20, 2021 were collected. Clinical, laboratory and obstetric characteristics of pregnant women during hospitalization were recorded. Results: Of the pregnant women, 61% were symptomatic while hospitalized. Nine of the pregnant women were admitted to the intensive care unit, 4 required invasive mechanical ventilation, and two died during the hospitalization associated with COVID-19. Abortion occurred in 3 pregnant women. As maternofetal outcomes, 18% of pregnant women had preterm labor and 10% had fetal distress. The polymerase chain reaction (PCR) test of 46 pregnant women was positive during delivery, and the PCR test of 37 pregnant women was negative. Neonatal intensive care unit was required in 19% of newborns. COVID-19 PCR was positive in 2 newborns. Non-COVID-19 related death was observed in 1 premature newborn. Conclusion: Pregnancies complicated by COVID-19 infection should be followed closely due to the risk of adverse maternal and fetal outcomes.
REFERENCES:
  1. Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579(7798):270-3. [PubMed]  [PMC] 
  2. Ge XY, Li JL, Yang XL, Chmura AA, Zhu G, Epstein JH, et al. Isolation and characterization of a bat SARS-like coronavirus that uses the ACE2 receptor. Nature. 2013;503(7477):535-8. [Crossref]  [PubMed]  [PMC] 
  3. Zaim S, Chong JH, Sankaranarayanan V, Harky A. COVID-19 and multiorgan response. Curr Probl Cardiol. 2020;45(8):100618. [Crossref]  [PubMed]  [PMC] 
  4. Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ; HLH Across Speciality Collaboration, UK. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020;395(10229):1033-4. [Crossref]  [PubMed]  [PMC] 
  5. Siston AM, Rasmussen SA, Honein MA, Fry AM, Seib K, Callaghan WM, et al; Pandemic H1N1 Influenza in Pregnancy Working Group. Pandemic 2009 influenza A(H1N1) virus illness among pregnant women in the United States. JAMA. 2010;303(15):1517-25. [Crossref]  [PubMed]  [PMC] 
  6. Liang H, Acharya G. Novel corona virus disease (COVID-19) in pregnancy: what clinical recommendations to follow? Acta Obstet Gynecol Scand. 2020;99(4):439-42. [Crossref]  [PubMed] 
  7. Ellington S, Strid P, Tong VT, Woodworth K, Galang RR, Zambrano LD, et al. 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. [Crossref]  [PubMed]  [PMC] 
  8. 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. [Crossref]  [PubMed]  [PMC] 
  9. Haye MT, Cartes G, Gutiérrez J, Ahumada P, Krause B, Merialdi M, et al. Maternal and perinatal outcomes in pregnant women with confirmed severe and mild COVID-19 at one large maternity hospital in Chile. J Matern Fetal Neonatal Med. 2021:1-6. [Crossref]  [PubMed] 
  10. Alonso Díaz C, López Maestro M, Moral Pumarega MT, Flores Antón B, Pallás Alonso CR. Primer caso de infección neonatal por SARS-CoV-2 en Espa-a [First case of neonatal infection due to SARS-CoV-2 in Spain]. An Pediatr (Engl Ed). 2020;92(4):237-8. [Crossref]  [PubMed]  [PMC] 
  11. Li N, Han L, Peng M, Lv Y, Ouyang Y, Liu K, et al. Maternal and neonatal outcomes of pregnant women with coronavirus disease 2019 (COVID-19) pneumonia: a case-control study. Clin Infect Dis. 2020;71(16):2035-41. [Crossref]  [PubMed]  [PMC] 
  12. Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS. Williams Obstetrics. 25th ed. New York, N.Y.: McGraw Hill Medical; 2018.
  13. 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. Erratum in: Lancet. 2020;395(10229):1038. Erratum in: Lancet. 2020;395(10229):1038. [Crossref]  [PubMed]  [PMC] 
  14. Liu D, Li L, Wu X, Zheng D, Wang J, Yang L, et al. Pregnancy and perinatal outcomes of women with coronavirus disease (COVID-19) pneumonia: a preliminary analysis. AJR Am J Roentgenol. 2020;215(1): 127-32. Erratum in: AJR Am J Roentgenol. 2020;215(1):262. [Crossref]  [PubMed] 
  15. 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. [Crossref]  [PubMed]  [PMC] 
  16. Goodnight WH, Soper DE. Pneumonia in pregnancy. Crit Care Med. 2005;33(10 Suppl):S390-7. [Crossref]  [PubMed] 
  17. O'Day MP. Cardio-respiratory physiological adaptation of pregnancy. Semin Perinatol. 1997;21(4):268-75. [Crossref]  [PubMed] 
  18. Nelson-Piercy C. Handbook of Obstetric Medicine. 6th ed. Boca Raton: CRC Press; 2020. [Crossref] 
  19. 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. [Crossref]  [PubMed]  [PMC] 
  20. Alfaraj SH, Al-Tawfiq JA, Memish ZA. Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection during pregnancy: report of two cases & review of the literature. J Microbiol Immunol Infect. 2019;52(3):501-3. [Crossref]  [PubMed]  [PMC] 
  21. 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.e1-111.e14. [Crossref]  [PubMed]  [PMC] 
  22. 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. Transl Pediatr. 2020;9(1):51-60. [Crossref]  [PubMed]  [PMC] 
  23. Badr DA, Mattern J, Carlin A, Cordier AG, Maillart E, El Hachem L, et al. Are clinical outcomes worse for pregnant women at ≥20 weeks' gestation infected with coronavirus disease 2019? A multicenter case-control study with propensity score matching. Am J Obstet Gynecol. 2020;223(5):764-8. [Crossref]  [PubMed]  [PMC] 
  24. Savasi VM, Parisi F, Patanè L, Ferrazzi E, Frigerio L, Pellegrino A, Spinillo et al. Clinical findings and disease severity in hospitalized pregnant women with coronavirus disease 2019 (COVID-19). Obstet Gynecol. 2020;136(2):252-8. [Crossref]  [PubMed] 
  25. van Well GTJ, Daalderop LA, Wolfs T, Kramer BW. Human perinatal immunity in physiological conditions and during infection. Mol Cell Pediatr. 2017;4(1):4. [Crossref]  [PubMed]  [PMC] 
  26. Soheili M, Moradi G, Baradaran HR, Soheili M, Mokhtari MM, Moradi Y. Clinical manifestation and maternal complications and neonatal outcomes in pregnant women with COVID-19: a comprehensive evidence synthesis and meta-analysis. J Matern Fetal Neonatal Med. 2021:1-14. [Crossref]  [PubMed] 
  27. Alay I, Yildiz S, Kaya C, Yasar KK, Aydin OA, Karaosmanoglu HK, et al. The clinical findings and outcomes of symptomatic pregnant women diagnosed with or suspected of having coronavirus disease 2019 in a tertiary pandemic hospital in Istanbul, Turkey. J Obstet Gynaecol Res. 2020. [Crossref]  [PubMed]  [PMC] 
  28. Yassa M, Birol P, Mutlu AM, Tekin AB, Sandal K, Tug N. Lung ultrasound can ınfluence the clinical treatment of pregnant women with COVID-19. J Ultrasound Med. 2021;40(1):191-203. [Crossref]  [PubMed]  [PMC]