Complications in Pregnant Women and Newborns Before and During the COVID 19 Pandemic

Fariba Zare, Arezoo Karimi, Salman Daliri

Abstract


Background: One of the high‑risk groups exposed to the coronavirus disease 2019 (COVID‑19) pandemic was pregnant women at risk of pregnancy complications due to a weakened immune system and inability to use various drugs to treat COVID‑19. Accordingly, this study was conducted to investigate the complications in pregnancy before and during the COVID‑19 pandemic.

Material and Methods: This cross‑sectional study was performed on all pregnant women in Shahroud, Iran. The time interval from February 18, 2019, to February 17, 2020, was considered before the COVID‑19 pandemic and from February 18, 2020, to February 17, 2021, was considered the COVID‑19 pandemic. Sampling was conducted by census and included 6851 pregnant women. The required information was extracted from hospitals’ health deputy registration system and high‑risk pregnancy registration program.

Result: Based on the findings, hypertension disorder, gestational diabetes, placental abruption, pre‑eclampsia, cesarean section, hospitalization in neonatal intensive care unit (NICU), preterm birth, and hospitalization in other hospital wards increased by 1.88%, 1.93%, 0.12%, 0.45%, 5.45%, 1.00%, 1.20%, and 1.40%, respectively, in 2020 compared to 2019. A statistically significant difference was also observed between them (p < 0.05). Also, the regression results showed that the chances of high blood pressure, Gestational Diabetes Mellitus (GDM), placental abruption, and cesarean section were increased by 10.91, 1.53, 5.51, and 2.83 times, respectively. Conclusions: Pregnancy complications have increased during the COVID‑19 pandemic. As a result, there is a need to take appropriate health and medical measures to reduce the risks associated with the COVID‑19 epidemic for pregnant women and neonates.



Keywords


COVID‑19, newborn, pandemics, pregnancy complications

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References


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;395:809 15.

Dashraath P, Wong JLJ, Lim MXK, Lim LM, Li S, Biswas A, et al. Coronavirus disease 2019 (COVID 19) pandemic and pregnancy. Am J Obstet Gynecol 2020;222:521 31.

Racicot K, Mor G. Risks associated with viral infections during pregnancy. J Clin Invest 2017;127:1591 9.

Di Mascio D, Khalil A, Saccone G, Rizzo G, Buca D, Liberati M, et al. Outcome of coronavirus spectrum infections (SARS, MERS, COVID 19) during pregnancy: A systematic review and meta analysis. Am J Obstet Gynecol MFM 2020;2:1 9. doi: 10.1016/j.ajogmf. 2020.100107.

Gajbhiye RK, Modi DN, Mahale SD. Pregnancy outcomes, newborn complications and maternal fetal transmission of SARS CoV 2 in women with COVID 19: A systematic review of 441 cases. medRxiv 2020:1 29. doi: 10.1101/2020.04.11.20062356.

Schwartz DA. An analysis of 38 pregnant women with COVID 19, their newborn infants, and maternal fetal transmission of SARS CoV 2: Maternal coronavirus infections and pregnancy outcomes. Arch Pathol Lab Med 2020;144:799 805.

Ko JY, DeSisto CL, Simeone RM, Ellington S, Galang RR, Oduyebo T, et al. Adverse pregnancy outcomes, maternal complications, and severe illness among US delivery hospitalizations with and without a coronavirus disease 2019 (COVID 19) diagnosis. Clin Infect Dis 2021;73:24 31.

Wei SQ, Bilodeau Bertrand M, Liu S, Auger N. The impact of COVID 19 on pregnancy outcomes: A systematic review and meta analysis. CMAJ 2021;193:540 8.

Khan S, Peng L, Siddique R, Nabi G, Xue M, Liu J, et al. Impact of COVID 19 infection on pregnancy outcomes and the risk of maternal to neonatal intrapartum transmission of COVID 19 during natural birth. Infect Control Hosp Epidemiol 2020;41:748 50.

Kleinwechter HJ, Weber KS, Mingers N, Ramsauer B, Schaefer Graf UM, Groten T, et al. Gestational diabetes mellitus and COVID 19: Results from the COVID 19 Related Obstetric and Neonatal Outcome Study (CRONOS). Am J Obstet Gynecol 2022;227:1 19. doi: 10.1016/j.ajog. 2022.05.027.

Wood R, Sinnott C, Goldfarb I, Clapp M, McElrath T, Little S. Preterm birth during the coronavirus disease 2019 (COVID 19) pandemic in a large hospital system in the United States. Obstet Gynecol 2021;137:403 8.

Ashish K, Gurung R, Kinney MV, Sunny AK, Moinuddin M, Basnet O, et al. Effect of the COVID 19 pandemic response on intrapartum care, stillbirth, and neonatal mortality outcomes in Nepal: A prospective observational study. Lancet Glob Health 2020;8:1273 81.

Molina RL, Tsai TC, Dai D, Soto M, Rosenthal N, Orav EJ, et al. Comparison of pregnancy and birth outcomes before vs during the COVID 19 pandemic. JAMA Network Open 2022;5:2226531 37.

Aghaeepour N, Ganio EA, Mcilwain D, Tsai AS, Tingle M, Van Gassen S, et al. An immune clock of human pregnancy. Sci Immunol 2017;2:2946 52.

Mattar CN, Kalimuddin S, Sadarangani SP, Tagore S, Thain S, Thoon KC, et al. Pregnancy outcomes in COVID 19: A prospective cohort study in Singapore. Ann Acad Med Singap 2020;49:857 69.

Chen S, Huang B, Luo D, Li X, Yang F, Zhao Y, et al. Pregnancy with new coronavirus infection: Clinical characteristics and placental pathological analysis of three cases. Zhonghua Bing Li Xue Za Zhi 2020;49:418 23.

Gilbert JS, Ryan MJ, LaMarca BB, Sedeek M, Murphy SR, Granger JP. Pathophysiology of hypertension during preeclampsia: Linking placental ischemia with endothelial dysfunction. Am J Physiol Heart Circ Physiol 2008;294:541 50.

Yue L, Han L, Li Q, Zhong M, Wang J, Wan Z, et al. Anesthesia and infection control in cesarean section of pregnant women with COVID 19 infection: A descriptive study. J Clin Anesth 2020;66:109908. doi: 10.1016/j.jclinane. 2020.109908.

Qi H, Luo X, Zheng Y, Zhang H, Li J, Zou L, et al. Safe delivery for COVID 19 infected pregnancies. BJOG(An International Journal of Obstetrics & Gynaecology) 2020;127:927 9.

Du M, Yang J, Han N, Liu M, Liu J. Association between the COVID 19 pandemic and the risk for adverse pregnancy outcomes: A cohort study. BMJ Open 2021;11:1 8. doi: 10.1136/ bmjopen 2020 047900

Chen Y H, Keller J, Wang I T, Lin C C, Lin H C. Pneumonia and pregnancy outcomes: A nationwide population based study. Am J Obstet Gynecol 2012;207:288.e1 7.

Tang P, Wang J, Song Y. Characteristics and pregnancy outcomes of patients with severe pneumonia complicating pregnancy: A retrospective study of 12 cases and a literature review. BMC Pregnancy Childbirth 2018;18:1 6. doi: 10.1186/ s12884 018 2070 0.

Wastnedge EA, Reynolds RM, Van Boeckel SR, Stock SJ, Denison FC, Maybin JA, et al. Pregnancy and COVID 19. Physiol Rev 2021;101:303 18.

Townsend R, Chmielewska B, Barratt I, Kalafat E, van der Meulen J, Gurol Urganci I, et al. Global changes in maternity care provision during the COVID 19 pandemic: A systematic review and meta analysis. EClinicalMedicine 2021;37:1 19. doi: 10.1016/j.eclinm. 2021.100947.

Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, et al. Pathological findings of COVID 19 associated with acute respiratory distress syndrome. Lancet Respir Med 2020;8:420 2.

Khan MMA, Khan MN, Mustagir MG, Rana J, Haque MR, Rahman MM. COVID 19 infection during pregnancy: A systematic review to summarize possible symptoms, treatments, and pregnancy outcomes. MedRxiv 2020:1 23. doi: 10.1101/2020.03.31.20049304.

Roberton T, Carter ED, Chou VB, Stegmuller AR, Jackson BD, Tam Y, et al. Early estimates of the indirect effects of the COVID 19 pandemic on maternal and child mortality in low income and middle income countries: A modelling study. Lancet Glob Health 2020;8:901 8.


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