Maternal and Fetal Outcomes in Pregnant Women With COVID -19, A retrospective Study

Background: The current coronavirus disease 2019 (COVID-19) pneumonia pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is spreading globally at an accelerated rate. A serious public health emergency, it is particularly deadly in vulnerable populations and communities in which healthcare providers are insufficiently prepared to manage the infection. Pregnant women, their fetuses, and newborns are likely to represent a high-risk population during the current (COVID- 19) pandemic caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Approximately one- third of infected pregnant women died from severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV) epidemics of the past two decades.
The Aim of this Study: To assess the adverse maternal and neonatal outcomes of pregnant women with confirmed COVID-19 infection.
Patients and Methods: This is a retrospective analytical study that was conducted on the inpatient isolation wards’ medical records, Obstetrics and Gynecology hospital Kasr Al- Ainy, Cairo University during period time from April 2020 to December 2021. A total of 70 pregnant women with confirmed COVID-19 between April, 2020 and December 2021 were identified. Maternal and neonatal outcomes were described from their archived medical records in details.
Results: Regarding mode of delivery, higher rates of CS were identified (57.1%). Most common symptom of COVID-19 was cough and loss of smell while 50% 0f patients were asymptomatic. There was a significant increase in the incidence of preterm births regarding pregnancy outcomes (28.5 %). A 20% of the patients have associated comorbidities, the most common was pregestational DM. There was a higher incidence of preeclampsia, HELLP syndrome and eclamptic fits (25.7%). Regarding adverse neonatal outcomes, the most prevalent was preterm birth (31.5%) and NICU admission (27.7%). It was noted a high percentage of ICU admission as a specific adverse maternal out comes, also maternal mortality and venous thromboembolic events are reported.
Conclusion: The evidence collected showed that the symptoms, diagnosis, treatment and comorbidity factors associated with COVID-19 were the same in pregnant women as in non- pregnant women. It was, however, noticeable that morbidity especially preeclampsia, preterm and caesarean birth rates necessitating admission to the intensive care unit as well as maternal and perinatal death rates were higher in pregnant women with COVID-19 and their infants.