Maternal and Neonatal Outcomes in Pregnant Women With Coronavirus Disease 2019 in Korea

Abstract

Background This study aimed to describe the maternal, obstetrical, and neonatal outcomes in pregnant women with coronavirus disease 2019 (COVID-19) and identify the predictors associated with the severity of COVID-19. Methods This multicenter observational study included consecutive pregnant women admitted because of COVID-19 confirmed using reverse transcriptase-polymerase chain reaction (RT-PCR) test at 15 hospitals in the Republic of Korea between January 2020 and December 2021. Results A total of 257 women with COVID-19 and 62 newborns were included in this study. Most of the patients developed this disease during the third trimester. Nine patients (7.4%) developed pregnancy-related complications. All pregnant women received inpatient treatment, of whom 9 (3.5%) required intensive care, but none of them died. The gestational age at COVID-19 diagnosis (odds ratio [OR], 1.096, 95% confidence interval [CI], 1.04–1.15) and parity (OR, 1.703, 95% CI, 1.13–2.57) were identified as significant risk factors of severe diseases. Among women who delivered, 78.5% underwent cesarean section. Preterm birth (38.5%), premature rupture of membranes (7.7%), and miscarriage (4.6%) occurred, but there was no stillbirth or neonatal death. The RT-PCR test of newborns’ amniotic fluid and umbilical cord blood samples was negative for severe acute respiratory syndrome coronavirus 2. Conclusion At the time of COVID-19 diagnosis, gestational age and parity of pregnant women were the risk factors of disease severity. Vertical transmission of COVID-19 was not observed, and maternal severity did not significantly affect the neonatal prognosis.

Analysis of pregnant women with critically severe COVID-19 in Republic of Korea from February 2020 and December 2021

“…According to a recent study of pregnant women infected with COVID-19 at 15 hospitals located in the Republic of Korea between January 2020 and December 2021, the ICU admission rate was 3.5% (9/257 people) [ 15 ], which was similar to the proportion of critically severe cases confirmed in the present study. In Korea, the rate of critically severe cases among all ages was 2.98% before the predominance of the Delta variant and 2.14% during the Delta-predominant period.…”

“…Regarding risk factors based on the stage of pregnancy, a study found that SARS-CoV-2 infection in the second and third trimesters may lead to abnormal circulation, placental infection, and negative perinatal outcomes [ 21 ]. The risk of critically severe disease was reported to be high in patients diagnosed after 21.5 weeks of pregnancy [ 15 ]. As pregnant women diagnosed with COVID-19 in the second or third trimester are at high risk of developing critically severe symptoms, it is necessary to implement careful prevention, promotion, and treatment interventions for pregnant women diagnosed with COVID-19 in the second trimester or beyond.…”

Clinical Characteristics and Risk of Hypoxemia Development in Women Infected with SARS-CoV-2 during Pregnancy

“… 35 36 Previous study in South Korea also revealed that the gestational age of pregnant women was the risk factor for disease severity, especially if infection after 21.5 weeks (late second trimester). 37 …”

Impact of COVID-19 on risks and deaths of non-communicable diseases in the Western Pacific region

“… 64 In the Republic of Korea, the prevalence of preterm birth was 38.5% among pregnant women infected with COVID-19. 65 The long-term inter-generational effects of the COVID-19 pandemic on NCDs are of concerns and need to be monitored in the future.…”