DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20203843

Fetomaternal outcome in COVID-19 infected pregnant women: a preliminary clinical study

Parul T. Shah, Sapana R. Shah, Sushma R. Shah, Pushpa A. Yadava, Babulal S. Patel, Tanmay J. Chudasama

Abstract


Background: WHO has declared COVID-19 infection a health emergency of international concern on 11th March, 2020. It is not clear whether clinical characteristics of pregnant women with COVID-19 differ from those of nonpregnant women and whether it aggravates COVID-19 symptoms and whether antiviral therapy is necessary for COVID-19 infected pregnant women.

Methods: This is prospective study of 125 cases based on the compiled clinical data for pregnant women with COVID-19 between 15th April 2020 and 10th June 2020. A laboratory confirmed positive case of COVID-19 infection in pregnant women were included.

Results: The most common symptoms at presentation were cough in 61.6% (77/125) and fever in 46.4% (58/125). Other reported symptoms were sore throat in 13.6% (17/125), myalgia in 10.4% (13/125) while 38.4% (48/125) were asymptomatic. There were total 97 deliveries (including 2 twins’ deliveries) among which 3 cases had IUD. Present study reported 96 live births. The incidence of missed abortion was 2.4% (3/125). The incidence of preterm birth before 37 weeks was 8.2% (8/97). Ninety-six (96.9%) of neonates were tested for SARS-CoV-2 viral nucleic acid on nasopharyngeal and pharyngeal samples and 16.67% (16/96) were resulted positive.

Conclusions: At present, there is no evidence regarding the greater risk of pregnant women to succumb to COVID-19 infection and experience severe pneumonia. The risks of spontaneous abortion and preterm birth are not increased as reported in this study but shows possibility of vertical transmission when it manifests during the third trimester of pregnancy.


Keywords


COVID-19, Maternal morbidity, Pneumonia, Pregnancy, SARS-CoV-2

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References


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

Weiss SR, Leibowitz JL. Coronavirus pathogenesis. Adv Virus Res. 2011;81:85-164.

Masters PS, Perlman S. Coronaviridae. In: Knipe DM, Howley PM, eds. Fields virology. 6th ed. Lippincott Williams and Wilkins; 2013:825-858.

Su S, Wong G, Shi W, Liu J, Lai AC, Zhou J, et al. Epidemiology, genetic recombination, and pathogenesis of coronaviruses. Trends Microbiol. 2016;24:490-502.

Cui J, Li F, Shi ZL. Origin and evolution of pathogenic coronaviruses. Nat Rev Microbiol. 2019;17:181-92.

Chan JF, Kok KH, Zhu Z, Chu H, To KK, Yuan S, et al. Genomic characterization of the 2019 novel human-pathogenic coronavirus isolated from a patient with atypical pneumonia after visiting Wuhan. Emerg Microbes Infect. 2020;9:221-36.

Royal College of Obstetricians Gynaecologists, Royal College of Midwives. Coronavirus infection in pregnancy: Information for healthcare professionals. Available at: https://www.rcog.org.uk/global.... Published April 9, 2020. Accessed on 13th 2020.

Centers for Disease Control and Prevention. Coronavirus Disease (COVID-19). People who need extra precautions: Pregnancy and Breastfeeding. Available at: https://www.cdc.gov/coronaviru. Accessed on 13th April 2020.

World Health Organization. Laboratory testing for 2019 novel coronavirus (2019-nCoV) in suspected human cases. Interim guidance. Available at: https://www.who.int/publications-detail/laboratory-testing-for-2019-novel-coro-navirus-in-suspected-human-cases-20200117. Accessed on 24th March 2020.

Ministry of health and family welfare. Revised discharged policy, dated 8th May, 2020. Available at: https://www.mohfw.gov.in/pdf/FAQsonRevisedDischargePolicy.pdf Accessed on 10th June 2020.

Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical char-acteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-20.

Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese center for disease control and prevention. JAMA. 2020;323(13):1239-42.

Chawla D, Chirla D, Dalwai S, Deorari AK, Ganatra A, Gandhi A, et al. Perinatal-neonatal management of COVID-19 infection-guidelines of the federation of obstetric and gynaecological societies of India (FOGSI), National neonatology forum of India (NNF), and Indian Academy of Pediatrics (IAP). Indian Pediatr. 2020;57(6):536-48.

Naccasha N, Gervasi MT, Chaiworapongsa T. Phenotypic and meta-bolic characteristics of monocytes and gran-ulocytes in normal pregnancy and maternal infection. Am J Obstet Gynecol. 2001;185:1118-23.

Alattar R, Ibrahim TBH, Shaar SH, Abdalla S, Shukri K, Daghfal JN, et al. Tocilizumab for the treatment of severe COVID-19. J Med Virol. 2020;1-8.

Madinger NE, Greenspoon JS, Ellrodt AG. Pneumonia during pregnancy: has modern technology improved maternal and fetal outcome? Am J Obstet Gynecol. 1989;161:657-62.

Chen YH, Keller J, Wang IT, Lin CC, Lin HC. Pneumonia and pregnancy outcomes: a nationwide population-based study. Am J Obstet Gynecol. 2012;207:288.e1-7.

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;191:292-7.

Al Wattar B, Murugesu N, Tobias A, Zamora J, Khan KS. Management of first-trimester miscarriage: a systematic review and network meta-analysis. Hum Reprod Update. 2019;25:362-74.

Zeng H, Xu C, Fan J, et al. Antibodies in in-fants 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.

Wang L, Shi Y, Xiao T, Fu J, Feng X, Mu D, et al. Working committee on perinatal and neonatal management for the prevention and control of the 2019 novel coronavirus infection. Chinese expert consensus on the perinatal and neonatal management for the prevention and control of the 2019 novel coronavirus infection (First edition). Ann Transl Med. 2020;8:1-8.

Poon LC, Yang H, Lee JCS, Copel JA, Leung TY, Zhang Y, et al. ISUOG Interim Guidance on 2019 novel coronavirus infection during pregnancy and puerperium: information for healthcare professionals. Ultrasound Obstet Gynecol. 2020;55:700-8.

World Health Organization. Frequently asked questions: Breastfeeding and COVID-19, dated 12th May, 2020. Available at: https://www.who.int/docs/default-source/maternal-health/faqs-breastfeeding-and-covid-19.pdf?sfvrsn=d839e6c0_5. Accessed on 10th June 2020.