One Year of COVID-19 in Pregnancy: A National Wide Collaborative Study

Charepe, Nádia; Queirós, Alexandra; Alves, Maria José; Serrano, Fátima; Ferreira, Catarina; Gamito, Mariana; Smet, Carolina; Silva, Vanessa; Féria, Beatriz; Laranjo, Mafalda; Martins, Inês; Vieira-Coimbra, Márcia; Almeida, Maria do Céu; Soares, Catarina; Castro, Fabiana; Almeida, Gisela; Reis, Isabel; Barbosa, Marta; Santos, Mariana; Melo, Marta; Bárbara, A.; Gonçalves, Daniela; Oliveira, Mariline; Pinheiro, Paula; Faustino, Maria de Fátima; Oliveira, A.; Canhão, Helena; Campos, Ana Cristina Viana

doi:10.20344/amp.16574

Cited by 6 publications

(2 citation statements)

References 20 publications

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“…This demonstrates the possible increased risk of being symptomatic or morbidity for those infected with SARS-CoV-2, which shows the importance of monitoring pregnant women in the third trimester. Higher incidences of COVID-19 involvement in the third trimester of pregnancy have also been seen in previous studies (14)(15)(16). Cesarean delivery in 26.5% of the studied population was carried out before 35 weeks of gestational age.…”

Section: Discussionsupporting

confidence: 83%

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Determination of COVID-19 Mortality and Morbidity in Women Who Had Cesarean Sections and Terminated Pregnancies

Alavi,

Bahrami,

Kavousi

et al. 2023

Jundishapur J Microbiol

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Background: COVID-19 infection is a contemporary global concern with serious ramifications. This disease is caused by a virus belonging to the Coronaviridae family named SARS-CoV-2. Immunologic and physiologic changes during pregnancy make pregnant women more susceptible to viral infection, especially COVID-19. Objectives: The present study aimed to identify the clinical manifestations, radiologic findings, indications for cesarean delivery, underlying conditions, and the critical outcome of mothers and newborns regarding COVID-19 women who had cesarean sections and terminated pregnancies. Methods: This cross-sectional study was conducted on the mortality and morbidity rates of 98 women with terminated pregnancies infected with COVID-19 at the time of their cesarean delivery. The demographic, clinical, and pregnancy data were collected from Razi Teaching Hospital between March 2020 and March 2021 and analyzed using SPSS version 24. Results: The mean age was 31.31 ± 7.16, and the mean gestational age was 36.45 ± 3.334 weeks. The most prevalent cause of cesarean section was fetal distress (28%), followed by preeclampsia and meconium aspiration. The most common symptoms were sore throat, cough, fever, nausea, diarrhea, and weakness; moreover, hypothyroidism and diabetes mellitus were the most predominant underlying diseases. The mean duration for hospitalization was 5.21 ± 4.584 days, the maternal death rate was 5.1%, and the neonatal death rate was 2%. Conclusions: The majority of women infected with COVID-19 had cesarean sections and terminated pregnancies in the third trimester. This highlights the need for better care and education for mothers in this period. The body mass index (BMI) level and obesity are strongly associated with COVID-19 severity. Furthermore, healthcare workers should pay more attention to underlying diseases during pregnancy.

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Section: Discussionsupporting

confidence: 83%

“…This implies that obesity might be a risk factor for COVID-19 infection and its morbidity. Previous investigations also demonstrate that obesity is the most prevalent comorbidity among women suffering from COVID-19 (16,21). Thirty-five pregnant women (35.7%) had a history of close contact with SARS-CoV-2-positive family members.…”

Section: Discussionmentioning

confidence: 89%

Determination of COVID-19 Mortality and Morbidity in Women Who Had Cesarean Sections and Terminated Pregnancies

Alavi,

Bahrami,

Kavousi

et al. 2023

Jundishapur J Microbiol

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Systematic review and synthesis of stillbirths and late miscarriages following SARS-CoV-2 infections

Alcover¹,

Regiroli²,

Benachi³

et al. 2023

American Journal of Obstetrics and Gynecology

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COVID-19 in pregnant women: a systematic review and meta-analysis on the risk and prevalence of pregnancy loss

van Baar,

Kostova,

Allotey

et al. 2023

Human Reproduction Update

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BACKGROUND Pregnant women infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are more likely to experience preterm birth and their neonates are more likely to be stillborn or admitted to a neonatal unit. The World Health Organization declared in May 2023 an end to the coronavirus disease 2019 (COVID-19) pandemic as a global health emergency. However, pregnant women are still becoming infected with SARS-CoV-2 and there is limited information available regarding the effect of SARS-CoV-2 infection in early pregnancy on pregnancy outcomes. OBJECTIVE AND RATIONALE We conducted this systematic review to determine the prevalence of early pregnancy loss in women with SARS-Cov-2 infection and compare the risk to pregnant women without SARS-CoV-2 infection. SEARCH METHODS Our systematic review is based on a prospectively registered protocol. The search of PregCov19 consortium was supplemented with an extra electronic search specifically on pregnancy loss in pregnant women infected with SARS-CoV-2 up to 10 March 2023 in PubMed, Google Scholar, and LitCovid. We included retrospective and prospective studies of pregnant women with SARS-CoV-2 infection, provided that they contained information on pregnancy losses in the first and/or second trimester. Primary outcome was miscarriage defined as a pregnancy loss before 20 weeks of gestation, however, studies that reported loss up to 22 or 24 weeks were also included. Additionally, we report on studies that defined the pregnancy loss to occur at the first and/or second trimester of pregnancy without specifying gestational age, and for second trimester miscarriage only when the study presented stillbirths and/or foetal losses separately from miscarriages. Data were stratified into first and second trimester. Secondary outcomes were ectopic pregnancy (any extra-uterine pregnancy), and termination of pregnancy. At least three researchers independently extracted the data and assessed study quality. We calculated odds ratios (OR) and risk differences (RDs) with corresponding 95% CI and pooled the data using random effects meta-analysis. To estimate risk prevalence, we performed meta-analysis on proportions. Heterogeneity was assessed by I2. OUTCOMES We included 120 studies comprising a total of 168 444 pregnant women with SARS-CoV-2 infection; of which 18 233 women were in their first or second trimester of pregnancy. Evidence level was considered to be of low to moderate certainty, mostly owing to selection bias. We did not find evidence of an association between SARS-CoV-2 infection and miscarriage (OR 1.10, 95% CI 0.81–1.48; I2 = 0.0%; RD 0.0012, 95% CI −0.0103 to 0.0127; I2 = 0%; 9 studies, 4439 women). Miscarriage occurred in 9.9% (95% CI 6.2–14.0%; I2 = 68%; 46 studies, 1797 women) of the women with SARS CoV-2 infection in their first trimester and in 1.2% (95% CI 0.3–2.4%; I2 = 34%; 33 studies; 3159 women) in the second trimester. The proportion of ectopic pregnancies in women with SARS-CoV-2 infection was 1.4% (95% CI 0.02–4.2%; I2 = 66%; 14 studies, 950 women). Termination of pregnancy occurred in 0.6% of the women (95% CI 0.01–1.6%; I2 = 79%; 39 studies; 1166 women). WIDER IMPLICATIONS Our study found no indication that SARS-CoV-2 infection in the first or second trimester increases the risk of miscarriages. To provide better risk estimates, well-designed studies are needed that include pregnant women with and without SARS-CoV-2 infection at conception and early pregnancy and consider the association of clinical manifestation and severity of SARS-CoV-2 infection with pregnancy loss, as well as potential confounding factors such as previous pregnancy loss. For clinical practice, pregnant women should still be advised to take precautions to avoid risk of SARS-CoV-2 exposure and receive SARS-CoV-2 vaccination.

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One Year of COVID-19 in Pregnancy: A National Wide Collaborative Study

Cited by 6 publications

References 20 publications

Determination of COVID-19 Mortality and Morbidity in Women Who Had Cesarean Sections and Terminated Pregnancies

Determination of COVID-19 Mortality and Morbidity in Women Who Had Cesarean Sections and Terminated Pregnancies

Systematic review and synthesis of stillbirths and late miscarriages following SARS-CoV-2 infections

COVID-19 in pregnant women: a systematic review and meta-analysis on the risk and prevalence of pregnancy loss

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