DOI: https://dx.doi.org/10.18203/2320-1770.ijrcog20214334
Published: 2021-10-27

Maternal and neonatal outcome in COVID-19 pregnancy: an ongoing review of first wave in a tertiary care center in North India

Swati Kashyap, Dilpreet K. Pandher, Alka Sehgal, Suksham Jain

Abstract


Background: This study analyzed the clinical outcomes in the obstetric patients with COVID-19 and their neonates in first wave of COVID-19 pandemic in North India, 2020.

Methods: This prospective study was conducted between 10 May 2020 to 31 December 2020 on 83 obstetric patients with COVID-19 and their 52 neonates.

Results: 36.14% obstetric patients presented with COVID-19 like symptoms with most common symptom as fever in 60% and cough in 53.33%. 4.81% patients were admitted in HDU and 1/83 (1.20%) patient who required ICU had mortality due post-operative complications. 20.48% had pre-existing medical diseases. Amongst (78) antenatal patients, 21.79% had pregnancy related hypertensive disorders, 12.82% had deranged liver function tests without hypertension and 8.97% had gestational diabetes mellitus. More probability of pre-term labour pains 2.4 (95% CI, 1.37-4.18) and IUFD 2.18 (1.13-4.20) were observed in symptomatic patients as compared to asymptomatic patients. Neonates born to COVID-19 symptomatic mothers had 1.81 (95% CI, 0.73-4.49) times the risk of being symptomatic, 1.37 (95% CI, 0.54-3.41) times the risk of getting admitted to NICU and 1.57 (95% CI, 0.48-5.09) times the risk of getting infected by SARS-CoV-2 and increased morbidity in neonates. 8% neonates had perinatal and 1.5% had horizontal transmission of SARS-CoV-2.

Conclusions: First wave of COVID-19 pandemic did not cause significant adverse outcome in pregnant patients and mother-newborn dyads in our tertiary care centre when active and intensive management of mothers and newborns were done but still there is possibility of severe morbidity and mortality due to COVID-19.

 


Keywords


COVID-19 in pregnancy, COVID-19 in neonate, First wave of COVID-19

Full Text:

PDF

References


Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382:727-33.

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395 (10223):497-506.

WHO Director-General’s opening remarks at the media briefing on COVID-19-11 March, 2020. Available at: https://www.who.int/director-general/ speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020. Accessed on 1 Jan 2021.

Human Coronavirus Types, 2020. Available at: https://www.cdc.gov/coronavirus/types.html. Accessed on 1 Jan 2021.

Coronavirus infection (COVID-19) in pregnancy:Information for healthcare professionals, 2020. Available at: https://www.rcog.org.uk/ globalassets/documents/guidelines/2021-02-19-coronavirus-covid-19-infection-in-pregnancy-v13.pdf. Accessed on 18 May 2021.

Greenhalgh T, Jimenez JL, Prather KA, Tufekci Z, Fisman D, Schooley R. Ten scientific reasons in support of airborne transmission of SARS-CoV-2. lancet 2021;397(10285):1603-5.

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.

Alfaraj SH, Al-Tawfiq JA, Memish ZA. Middle East respiratory syndrome coronavirus (MERS-CoV) infection during pregnancy: report of two cases and review of the literature. J Microbiol Immunol Infect. 2019;52:501-03.

Rasmussen SA, Jamieson DJ, Uyeki TM. Effects of influenza on pregnant women and infants. Am J Obstet Gynecol. 2012;207(3):3-8.

Silasi M, Cardenas I, Racicot K, Kwon J-Y, Aldo P, Mor G. Viral infections during pregnancy. Am J Reprod Immunol. 2015;73(3):199-213.

Gottfredsson M. The Spanish flu in Iceland 1918. Lessons in medicine and history. Laeknabladid. 2008;94:737-45.

Nelson-Piercy C. Respiratory disease. In: Handbook of Obstetric Medicine. 5th ed. Boca Raton: CRC Press; 2015:371.

van Well GTJ, Daalderop LA, Wolfs T, Kramer BW. Human perinatal immunity in physiological conditions and during infection. Mol Cell Pediatr. 2017;4:4.

Vousden N, Bunch K, Morris E, Simpson N, Gale C, O’Brien P, et al. The incidence, characteristics and outcomes of pregnant women hospitalized with symptomatic and asymptomatic SARS-CoV-2 infection in the UK from March to September 2020: a national cohort study using the UK Obstetric Surveillance System (UKOSS). Plos One 2021; 16(5):0251123.

Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of coronavirus disease 2019 in China. NEMJ. 2020;382:1708-20.

Zaigham M, Andersson O. Maternal and perinatal outcomes with COVID‐19: a systematic review of 108 pregnancies. Acta Obstet Gynecol Scand. 2020;99(7): 823-9.

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.

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.

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;370:3320.

Jering KS, Claggett BL, Cunningham JW, Rosenthal N, Vardeny O, Greene MF, et al. Clinical characteristics and outcomes of hospitalized women giving birth with and without COVID-19. JAMA Intern Med. 2021;181(5):714-7.

Raschetti R, Vivanti AJ, Vauloup-Fellous C, Loi B, Benachi A, De Luca D. Synthesis and systematic review of reported neonatal SARS-CoV-2 infections. Nat Commun. 2020;11(1):5164.

Kumar P, More K, Chawla D, Murki S, Tandur B, Deorari AK, et al. Outcomes of Neonates Born to Mothers With Coronavirus Disease 2019 (COVID-19)-National Neonatology Forum (NNF) India COVID-19 Registry. Indian Pediatr. 2021;58(6):525-31.

Khalil A, Kalafat E, Benlioglu C, O'Brien P, Morris E, Draycott T, et al. SARS-CoV-2 infection in pregnancy: A systematic review and meta-analysis of clinical features and pregnancy outcomes. E Clin Med. 2020;25:100446.