CLINICAL CHARACTERISTICS, OUTCOMES, & MORTALITY IN PREGNANT WOMEN WITH COVID-19

MA RANA; MRO SIDDIQI; MH SIDDIQUI; B ARIF; R PERVAIZ; AHA AWAD; S RAZA

doi:10.54112/bcsrj.v2023i1.238

Authors

MA RANA Department of Critical Care Medicine, Amna Inayat Medical College & Bahria International Hospital, Lahore, Pakistan
MRO SIDDIQI Department of Cardiology, United Medical and dental college/ Family care hospital Karachi, Pakistan
MH SIDDIQUI Department of Medicine, Akhtar Saeed Medical and dental college, Lahore, Pakistan
B ARIF Department of Critical care Bahria International Hospital, Lahore, Pakistan
R PERVAIZ Department of Critical care Bahria International Hospital, Lahore, Pakistan
AHA AWAD Department of Intensive Care, Rashid Hospital, United Arab Emirates
S RAZA Department of Critical care Bahria International Hospital, Lahore, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2023i1.238

Keywords:

Pregnancy, COVID-19, Clinical Characteristics, Mortality, Severity of Disease

Abstract

The COVID-19 pandemic has significantly impacted global health, with pregnant women being identified as a vulnerable population. As the pandemic continues, there is a need to understand the clinical characteristics, outcomes, and mortality rates of pregnant women with COVID-19 to inform clinical decision-making and optimize care. This study aims to evaluate the clinical characteristics, outcomes, and mortality in pregnant women with COVID-19. The retrospective cohort analysis was conducted at the Bahria town international hospital Lahore and Family care hospital, Karachi from September 17, 2020, to September 30, 2021. A total of 109 records were evaluated. 69 patients infected with covid-19 diseases and had mid to moderate symptoms were included for further analysis. From the medical record, the data regarding the severity of the disease, clinical presentation at the time of admission, including signs and symptoms, the outcome of the pregnancy, and the mortality of pregnant women were noted. The most common clinical characteristics, fever, cough, throat pain, and shortness of breath, were noted at admission after confirmation of COVID-19 infection in mild to moderate cases of pregnant women. The most common co-morbid conditions were anemia (65%), hypertension, and diabetes (4.5% and 3.5%, respectively). The most common outcome was pre-term delivery 12 (18%). In our study population, there was only one miscarriage. The mortality rate in our study was zero. All the patients were discharged alive from the hospital. Only 3 patients were shifted to ICU and discharged after recovery. The caesarian section was done in more than half of the study group. Based on the results, pregnant women with COVID-19 are at increased risk of adverse outcomes, including pre-term delivery, cesarean delivery, and admission to the ICU. Mortality was zero in our study. Early detection and management of COVID-19 in pregnant women are essential to improve maternal and fetal outcomes. Healthcare providers should continue to monitor and evaluate the clinical characteristics, outcomes, and mortality rates in pregnant women with COVID-19 to inform clinical decision-making and optimize care.

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References

Acter, T., Uddin, N., Das, J., Akhter, A., Choudhury, T. R., and Kim, S. (2020). Evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as coronavirus disease 2019 (COVID-19) pandemic: A global health emergency. Science of the Total Environment 730, 138996.

Antoun, L., El Taweel, N., Ahmed, I., Patni, S., and Honest, H. (2020). Maternal COVID-19 infection, clinical characteristics, pregnancy, and neonatal outcome: A prospective cohort study. European Journal of Obstetrics & Gynecology and Reproductive Biology 252, 559-562.

Asalkar, M., Thakkarwad, S., Rumani, I., and Sharma, N. (2021). Prevalence of maternal mortality and clinical course of maternal deaths in covid-19 pneumonia-a cross-sectional study. The Journal of Obstetrics and Gynecology of India, 1-10.

Gajbhiye, R. K., Mahajan, N. N., Waghmare, R. B., Zala, S., Chaaithanya, I. K., Kuppusamy, P., Bhurke, A. V., Pious, M., Surve, S., and Modi, D. N. (2021). Clinical characteristics, outcomes, & mortality in pregnant women with COVID-19 in Maharashtra, India: Results from PregCovid registry. The Indian Journal of Medical Research 153, 629.

Jha, M., Tak, M., Gupta, R., Sharma, P., Rajpurohit, V., Mathur, P., and Gaur, N. (2022). Relationship of anemia with COVID-19 deaths: A retrospective cross-sectional study. Journal of Anaesthesiology Clinical Pharmacology 38, S115-S119.

Lucas, D. N., and Bamber, J. (2021). Pandemics and maternal health: the indirect effects of COVID‐19. Anaesthesia 76, 69-75.

Mazur-Bialy, A. I., Kołomańska-Bogucka, D., Tim, S., and Opławski, M. (2020). Pregnancy and childbirth in the COVID-19 era—the course of disease and maternal–fetal transmission. Journal of Clinical Medicine 9, 3749.

Mendez-Dominguez, N., Santos-Zaldívar, K., Gomez-Carro, S., Datta-Banik, S., and Carrillo, G. (2021). Maternal mortality during the COVID-19 pandemic in Mexico: a preliminary analysis during the first year. BMC Public Health 21, 1-9.

Panagiotakopoulos, L., Myers, T. R., Gee, J., Lipkind, H. S., Kharbanda, E. O., Ryan, D. S., Williams, J. T., Naleway, A. L., Klein, N. P., and Hambidge, S. J. (2020). SARS-CoV-2 infection among hospitalized pregnant women: reasons for admission and pregnancy characteristics—eight US health care centers, March 1–May 30, 2020. Morbidity and Mortality Weekly Report 69, 1355.

Pham, A., Aronoff, D. M., and Thompson, J. L. (2021). Maternal COVID-19, vaccination safety in pregnancy, and evidence of protective immunity. Journal of Allergy and Clinical Immunology 148, 728-731.

Salem, D., Katranji, F., and Bakdash, T. (2021). COVID‐19 infection in pregnant women: Review of maternal and fetal outcomes. International Journal of Gynecology & Obstetrics 152, 291-298.

Siqueira, T. S., Silva, J. R. S., do Rosário Souza, M., Leite, D. C. F., Edwards, T., Martins-Filho, P. R., Gurgel, R. Q., and Santos, V. S. (2021). Spatial clusters, social determinants of health and risk of maternal mortality by COVID-19 in Brazil: a national population-based ecological study. The Lancet Regional Health-Americas 3, 100076.

Yu, N., Li, W., Kang, Q., Xiong, Z., Wang, S., Lin, X., Liu, Y., Xiao, J., Liu, H., and Deng, D. (2020). Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre, descriptive study. The Lancet Infectious Diseases 20, 559-564.

Zaigham, M., and Andersson, O. (2020). Maternal and perinatal outcomes with COVID-19: A systematic review of 108 pregnancies. Acta Obstet Gynecol Scand. 99(7):823-829.