Maternal morbidity and outcomes in pregnant women with COVID-19

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Maternal morbidity and outcomes in pregnant women with COVID-19


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In a recent study, researchers in France assessed the association between maternal morbidity and coronavirus disease 2019 (COVID-19). In this retrospective analysis, the researchers found that, compared to pregnant women without COVID-19, there was a higher frequency of pregnant women with maternal morbidity and the diagnosis of COVID-19.

That PLOS Medicine The study is the first report on obstetric outcomes and maternal morbidity associated with COVID-19 in pregnant women.

Study: Obstetric Outcomes and Maternal Morbidities Associated with COVID-19 in Pregnant Women in France: A National Retrospective Cohort Study. Image credit: mikumistock / Shutterstock.com

Introduction

In early 2020, the impact of severe acute respiratory syndrome (SARS-CoV-2) coronavirus 2, the virus responsible for COVID-19, in pregnant women was unknown. Although common symptoms of this disease included mild pneumonia, severe COVID-19 was associated with an increased likelihood of hospitalization, admission to the intensive care unit (ICU), or even death.

Previous reports have suggested that SARS-CoV-2 infection increased the risk of maternal and neonatal morbidity. These studies have also shown an increased risk of hospitalizations and adverse outcomes in pregnant women infected with SARS-CoV-2.

Despite these observations, the risk of maternal morbidity and adverse obstetric outcomes in pregnant women with COVID-19 should be fully assessed. Is there an association between the two?

To answer this question, the researchers behind the current study sought to determine whether maternal morbidity and adverse obstetric outcomes were more common in pregnant women with COVID-19 compared with pregnant women without COVID-19. The results of this study will assist in the treatment and management policies of pregnancies during the COVID-19 pandemic.

Study results

The researchers collected data from the French National Hospitalization Database (PMSI), taking a national cohort of all pregnant women hospitalized by childbirth after 22 weeks of gestation in France from January to June 2020. They analyzed 244,645 births during this period, of which 874 women. were diagnosed with COVID-19.

The researchers reported that women pregnant with COVID-19 were identified in the database if they were registered with the International Classification of Diseases (ICD-10) code for the presence of hospitalization for COVID-19. To confirm COVID-19 hospitalization in women, the researchers included having symptoms of COVID-19 associated with signs of COVID-19 in chest scans by computed tomography (CT), a reverse transcriptase polymerase chain reaction. (RT-PCR) and / or antigen test and / or positive serological test for COVID-19. Both symptomatic and asymptomatic patients were included in this study.

The researchers presented all the characteristics of women with and without a diagnosis of COVID-19, including obstetric complications depending on the presence or absence of a diagnosis of COVID-19. The model used in this study was tailored to the patient’s characteristics, such as maternal age, body mass index, active smoking, parity, history of diabetes or hypertension, multiple pregnancies, and conception. assisted reproduction technique (ART).

Study results

Compared to pregnant women without COVID-19, those with COVID-19 were older, more likely to be obese, had multiple pregnancies, and had a history of hypertension. The researchers observed that the frequency of conception of the assisted reproduction technique (ART) was not different between those with and without a diagnosis of COVID-19.

Compared to the non-COVID group, women pregnant with COVID-19 were more likely to be admitted to the intensive care unit (ICU), mortality, preeclampsia / eclampsia, gestational hypertension, postpartum hemorrhage, premature birth at less than 37 weeks. , 32 weeks and 28 weeks of gestation, induced preterm birth, spontaneous preterm birth, fetal discomfort and cesarean section.

According to previous studies, the frequency and severity of preterm birth, both spontaneous and medically induced, were more likely to occur in pregnant women with COVID-19. In particular, fetal discomfort was also higher in COVID-19 cases.

Other complications such as termination of pregnancy after 22 weeks of gestation, stillbirth, gestational diabetes, previous placenta, placental abruption, and venous thromboembolic events were similar between the COVID-19 and non-COVID groups. -19.

Conclusion

Comparing two groups of pregnant women with or without COVID-19 during the first wave of the COVID-19 pandemic, the current study aimed to address whether COVID-19 is associated with an increased risk of adverse obstetric outcomes. among pregnant women.

This study presented a retrospective observation of an increase in the frequency of pregnant women with maternal morbidity and diagnosis of COVID-19 compared with pregnant women without COVID-19. These results indicate that women who are pregnant with COVID-19 are at increased risk for obstetric morbidity.

In particular, in populations with a known risk of developing a serious infection or obstetric morbidity, it is essential to be aware of the possibilities. This can ensure that obstetric units better inform pregnant women and provide the best care in these scenarios.

Based on the results of this study, researchers reaffirmed recent vaccination recommendations for pregnant women.

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