Obstetric and perinatal risks after new coronavirus infection

BACKGROUND: Numerous studies indicate that pregnant women are at risk for severe morbidity, adverse gestational outcomes, and mortality following COVID-19. These patients have a higher frequency of miscarriage at various stages of gestation, premature birth, preeclampsia, cesarean section, and birth of children with low body weight. Other publications have suggested that the clinical characteristics of the disease detected in pregnant women with confirmed COVID-19 are similar to those in the general population.

AIM: The aim of this study was to determine obstetric and perinatal risks in women who have had COVID-19 during pregnancy.

MATERIALS AND METHODS: We conducted an open prospective continuous cross-sectional study in which 114 patients were examined after suffering from COVID-19. Depending on the severity of the new coronavirus infection, they were divided into groups: group I (n = 36) included patients with mild disease, group II (n = 56) – with moderate disease, group III (n = 22) – with heavy. The control group consisted of 93 pregnant women who were hospitalized during the specified period without COVID-19 and signs of acute respiratory viral infection.

RESULTS: Gestational diabetes mellitus is associated with a risk of the moderate and severe new coronavirus infections during pregnancy. Placental deficiency is significantly more often recorded in moderate and severe COVID-19 cases. Severe COVID-19 in pregnant women determines a high probability of fetal growth restriction. Preeclampsia complicates pregnancy in all patients with either mild, moderate, or severe COVID-19. The risk of premature birth with a high probability is determined by the moderate and severe courses of the disease. Only moderate COVID-19 during pregnancy is associated with the risk of induced labor. The risk of operative delivery by cesarean section is significantly increased in moderate and severe COVID-19. Moderate and severe courses of the underlying disease during pregnancy determine a high probability of low body weight of children at birth. The risk of hospitalization in the resuscitation unit is associated with moderate and severe COVID-19 during pregnancy.

CONCLUSIONS: Maternal mortality among women with COVID-19 who were hospitalized in an obstetric hospital was 3,636 per 100,000 live births. Perinatal mortality in patients who suffered a new coronavirus infection during pregnancy was 52.6‰.