COVID-19 among pregnant women: management outcome and risk of transmission to newborns in western India
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20215015Keywords:
COVID-19, Pregnancy, Clinical features, Pre term deliveryAbstract
Background: The WHO declared a global pandemic of coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 in March 2020. With so much female population in reproductive period in India the effect of corona virus in pregnancy warrants attention as the impact of maternal infection during pregnancy in India remains poorly understood. Objectives of current study were to know the management outcome and risk of transmission among COVI-19 positive pregnant women admitted in a tertiary care institute in western India.
Materials: The present cross sectional study was conducted among 217 admitted COVID-19 positive pregnant women in a tertiary care institute in western India from May 2020 to April 2021. Data were collected from the department of obstetrics and gynaecology after taking permission from the head of department of obstetrics and gynaecology.
Results: Most of patients were asymptomatic and managed conservatively but some also needed special interventions. Out of 217 patients 124 patients delivered in the hospital, 5 maternal deaths, one stillbirth and one congenital anomaly was reported. Only 25% of patients had normal delivery rest had caesarean and one neonate was found COVID-19 positive. Around one forth deliveries were pre term.
Conclusions: The study suggests that most women do not have severe illness and that transmission of infection to infants of infected mothers is uncommon but there are increased chances of pre-term delivery. Majority of the women and neonates were managed and discharged without any major complications. But in some cases COVID in pregnancy may complicate the situation; so it should be handled by a multidisciplinary team of experts in COVID-19.
References
WHO Corona Virus Disease (COVID 19) Dashboard. Available at: https://www.who.int/health-topics/coronavirus. Accessed on 20 August 2021.
Siston AM, Rasmussen SA. Pandemic 2009 influenza A (H1N1) virus illness among pregnant women in US. J Am Med Assoc. 2010;303(15):1517-25.
Gottfredsson M. The Spanish flu in Iceland 1918. Lessons in medicine and history. Laeknabladid. 2008;94:737-45.
Schwartz DA, Graham AL. Potential maternal and infant outcomes from (Wuhan) coronavirus 2019-nCoV infecting pregnant women: lessons from SARS, MERS, and other human coronavirus infections. Viruses. 2020;12:194.
Jamieson DJ, Honein MA, Rasmussen SA. H1N1 2009 influenza virus infection during pregnancy in the USA. Lancet. 2009;374:451-8.
Knight M, Bunch K, Vousden N, Morris E, Simpson N, Gale C, et al. Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: national population based cohort study. BMJ. 2020;8:369.
Yan J, Guo J, Fan C, Juan J, Yu X, Li J, et al. Coronavirus disease 2019 in pregnant women: a report based on 116 cases. Am J Obstet Gynecol. 2020;223(1):111-e1.
Nayak AH, Kapote DS, Fonseca M, Chavan N, Mayekar R, Sarmalkar M, et al. Impact of the coronavirus infection in pregnancy: a preliminary study of 141 patients. J Obstet Gynecol India. 2020;70(4):256-61.
Chen H, Guo J, Wang C. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet. 2020;395(10226):809-15.
Yu N, Li W, Kang Q, et al. Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre, descriptive study. Lancet Infect Dis. 2020;20(5):559-64.
WHO. Coronavirus disease 2019 (COVID-19). Situation report-72. Available at: https ://www.who.int/docs/defau lt-sourc e/coronaviru se/situation-reports/20200 401-sitre p-72-covid -19.pdf?sfvrsn=3dd89 71b_2. Accessed on 20 August 2021.
Fan C, Lei D, Fang C. Perinatal transmission of COVID-19 Associated SARSCoV- 2: should we worry? Clin Infect Dis. 2020;41:52-9.
Kennedy CE, Yeh PT, Pandey S. Elective cesarean section for women living with HIV: a systematic review of risks and benefits. AIDS. 2017;31:1579-91.
Debrabandere ML, Farabaugh DC, Giordano C. A review on mode of delivery during COVID-19 between December 2019 and April 2020. Am J Perinatol. 2020;45:52-9.
Guidance for Management of Pregnant Women in COVID-19 Pandemic. Available at: https://www. icmr.gov.in/pdf/covid/techdoc/Guidance_for_ Management_of_Pregnant_Women_in_COVID19_ Pandemic_12042020.pdf. Accessed on 20 August 2021.
Woodworth KR, Olsen EO, Neelam V, Lewis EL, Galang RR, Oduyebo T, et al. Birth and infant outcomes following laboratory-confirmed SARS-CoV-2 infection in pregnancy—SET-NET, 16 jurisdictions, March 29–October 14, 2020. Morb Mortal Weekly Rep. 2020;69(44):1635.
Allotey J, Stallings E, Bonet M, Yap M, Chatterjee S, Kew T, et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ. 2020;1;370.
Dong L, Tian J, He S, Zhu C, Wang J, Liu C, et al. Possible vertical transmission of SARS-CoV-2 from an infected mother to her newborn. JAMA. 2020;323:1846-8.
Kirtsman M, Diambomba Y, Poutanen SM, Malinowski AK, Vlachodimitropoulou E, Parks WT, et al. Probable congenital SARS-CoV-2 infection in a neonate born to a woman with active SARS-CoV-2 infection. CMAJ. 2020;192:E647-50.
Vivanti AJ, Vauloup-Fellous C, Prevot S, Zupan V, Suffee C, Do Cao J, et al. Transplacental transmission of SARS-CoV-2 infection. Nat Commun. 2020;11:3572.
Salvatore CM, Han JY, Acker KP, Tiwari P, Jin J, Brandler M, et al. Neonatal management and outcomes during the COVID- 19 pandemic: an observation cohort study. Lancet Child Adolesc Health. 2020;4:721-7.
Kotlyar AM, Grechukhina O, Chen A, Popkhadze S, Grimshaw A, Tal O, et al. Vertical transmission of coronavirus disease 2019: a systematic review and meta-analysis. Am J Obstet Gynecol. 2020. S0002-9378(20)30823-1.
Dumitriu D, Emeruwa UN, Hanft E, Liao GV, Ludwig E, Walzer L, et al. Outcomes of neonates born to mothers with severe acute respiratory syndrome coronavirus 2 infection at a Large Medical Center in New York City. JAMA Pediatr. 2020;12:e204298.
Solís-García G, Gutiérrez-Vélez A, Chamorro IP, Zamora-Flores E, Vigil-Vázquez S, Rodríguez-Corrales E, Sánchez-Luna M. Epidemiology, management and risk of SARS-CoV-2 transmission in a cohort of newborns born to mothers diagnosed with COVID-19 infection. Anales de Pediatría. 2021;94(3):173-8.