DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20214329

COVID-19 and pregnancy- review of cases from a tertiary public hospital in Mumbai

Reena Wani, Sachin Paprikar, Hema Relwani, Sumaiya Ansari

Abstract


Background: In December 2019 a novel strain of coronavirus, was first isolated by the Chinese Center for Disease Control and Prevention. This strain connected to the cluster of acute respiratory illness cases from Wuhan, China was later officially named as severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2). On 30th January 2020, WHO declared the outbreak of SARS-Cov-2 a public health emergency of international concern, and on 11th March 2020 declared it to be a pandemic. Pregnant women are known to be at higher risk of severe morbidity and mortality from respiratory infections such as influenza and SARS, making a strong case for pregnant women to be considered an at-risk population for COVID-19. This study aimed to assess the clinical picture, obstetric outcome and neonatal outcome in COVID positive pregnant cases.

Methods: We did a retrospective observational cohort study in the department of Obstetrics and Gynecology at a tertiary teaching hospital in Mumbai.

Results: In the study duration, 148 were diagnosed as COVID positive (~12%). 9 patients had COVID related symptoms on admission. The obstetric outcome in symptomatic patients was noted to be good. We noted 79.01% of the pregnancies reached term. Cesarean section rate in COVID positive patients was comparable to non-COVID patients in the study duration. Neonatal outcome was only 4 babies of COVID positive mothers were diagnosed positive.

Conclusions: Our study shows pregnancy outcomes are not significantly worsened by the COVID-19 infection in spite of the risk factors associated with pregnancy per se and influenza infection in pregnancy.


Keywords


Childbirth in COVID times, COVID babies, COVID Maternal health, COVID moms, COVID pregnancy

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References


WHO Coronavirus Disease (COVID-19) Dashboard. World Health Organization. Available from: https://covid19.who.int/?gclid=EAIaIQobChMI_ZHvi4Li7AIVRaSWCh30dwgTEAAYASABEgIK6_D_BwE. Accessed on 01 November 2020.

COVID-19 INDIA Dashboard. Ministry of Health and Family Welfare, GOI. Available from: https://www.mohfw.gov.in/. Accessed on 01 November 2020.

Mertz D, Lo CK, Lytvyn L, Ortiz JR, Loeb M. Pregnancy as a risk factor for severe influenza infection: an individual participant data meta-analysis. BMC Infect Dis. 2019;19(1):1-10.

Guidance for Management of Pregnant Women in COVID-19 Pandemic. Available from: https://icmr.nic.in/sites/default/files/upload_documents/Guidance_for_Management_of_Pregnant_Women_in_COVID19_Pandemic_12042020.pdf. Accessed on 24 April 2020.

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.

Coronavirus (COVID-19) infection and pregnancy. Royal College of Obstetricians and Gynaecologists. Available from: https://www.rcog.org.uk/en/ guidelines-research-services/guidelines/coronavirus-pregnancy/. Accessed on 01 November 2020.

Delahoy MJ, Whitaker M, O’Halloran A, Chai SJ, Kirley PD, Alden N, et al. Characteristics and maternal and birth outcomes of hospitalized pregnant women with laboratory-confirmed COVID-19- COVID-NET, 13 States, March 1- August 22, 2020. Morb Mortal Week Rep. 2020;69:1347-54.

Pregnancy, Breastfeeding, and Caring for Newborns if you have Covid-19. Centers for Disease Control and Prevention. Available from: https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/pregnancy-breastfeeding.html. Accessed on 01 November 2020.

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;99:819-22.

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. Morbid Mortal Week Rep. 2020;69(25):769.

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 Pediatr. 2020;9(1):51-60.

Coronavirus (COVID-19) infection and pregnancy. Royal College of Obstetricians and Gynaecologists. Available from: https://www.rcog.org.uk/en/ guidelines-research-services/guidelines/coronavirus-pregnancy/. Accessed on 01 November 2020.

Zeng H, Xu C, Fan J, Tang Y, Deng Q, Zhang W, et al. Antibodies in infants born to mothers with COVID-19 pneumonia. JAMA. 2020;323(18):1848-9.

Dong L, Tian J, He S, Zhu C, Wang J, Liu C, et al. Possible vertical transmission of SARS-CoV-2 from an infected mother to her newborn. JAMA. 2020;323(18):1846-8.

Guidance for Management of Pregnant Women in COVID-19 Pandemic. Available from: https://www.icmr.gov.in/pdf/covid/techdoc/Guidance_for_Management_of_Pregnant_Women_in_COVID19_Pandemic_12042020.pdf. Accessed on 01 November 2020.

Coronavirus disease (COVID-19): Pregnancy and childbirth. World Health Organization. Available from: https://www.who.int/news-room/q-a-detail/q-a-on-covid-19-pregnancy-childbirth-and-breastfeeding. Accessed on 01 November 2020.

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.

Wani RJ, Paprikar SS. COVID-19 and Women’s Health- Conception to Delivery. The Indian Practitioner. 2020. Available from: https://theindianpractitioner.com/2020/05/06/covid-19-and-womens-health-conception-to-delivery/. Accessed on 02 December 2020.