Impact of Clinical Severity on Maternal and Perinatal Outcome Across Trimesters in COVID 19 Pregnancies: A Prospective Cohort Study

Kubiszeski EH *

Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Mato Grosso, Cuiabá, MT, Brazil and Women's Health Care Unit, Júlio Müller University Hospital, Federal University of Mato Grosso, Cuiabá, MT, Brazil.

Carmo MAMV

Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Mato Grosso, Cuiabá, MT, Brazil and Department of Gynecology and Obstetrics, Faculty of Medicine, Federal University of Mato Grosso, Cuiabá, MT, Brazil.

Carmo AV

Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Mato Grosso, Cuiabá, MT, Brazil and Department of Gynecology and Obstetrics, Faculty of Medicine, Federal University of Mato Grosso, Cuiabá, MT, Brazil.

Rosa AANCR

Women's Health Care Unit, Júlio Müller University Hospital, Federal University of Mato Grosso, Cuiabá, MT, Brazil.

Carvalho AMB

Women's Health Care Unit, Júlio Müller University Hospital, Federal University of Mato Grosso, Cuiabá, MT, Brazil.

Souza NS

Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Mato Grosso, Cuiabá, MT, Brazil.

Fontes CJ

Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Mato Grosso, Cuiabá, MT, Brazil.

Galera MF

Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Mato Grosso, Cuiabá, MT, Brazil and Department of Pediatrics, Faculty of Medicine, Federal University of Mato Grosso, Cuiabá, MT, Brazil.

*Author to whom correspondence should be addressed.


Abstract

Aims: To analyze the impact of clinical severity on maternal and perinatal outcomes across trimesters in coronavirus disease 2019 (COVID-19) pregnancies.

Study design: This was a prospective open cohort study of pregnant women with COVID-19 during the prenatal, delivery, postpartum periods from September 2020 to March 2022.

Methodology: For data analysis, 132 pregnant women who had no pre-existing comorbidities or pregnancy-related complications at the beginning of the cohort were selected. Data related to COVID-19, demographic, clinical, obstetric, laboratory, ultrasound and birth outcomes were collected.

Results: A total of 132 pregnant women with COVID-19 were followed up for 2237 women-week. Among them, 19.7% experienced maternal complications such as premature rupture of membranes (19.7%), premature delivery (10.6%), postpartum hemorrhage (8.3%), and preeclampsia (6.8%), or fetal/neonatal complications, including small for gestational age (9.1%), need for neonatal intensive care unit (9.1%), and acute fetal distress (6.1%). Having moderate/severe COVID-19 on prenatal care admission (hazard ratio (HR):3.75) and 95% confidence interval (CI95%):1.63; 8.61 or contracting the infection during the second (HR: 6.35; CI95%: 2.35; 17.17) or third trimester (HR:14.35; CI95%:4.85; 42.41) of pregnancy were significantly associated with these maternal complications. Similarly, having moderate/severe COVID-19 on prenatal care admission (HR:3.90; CI95%:1.48; 10.24) or contracting the infection during the second (HR:6.84; CI95%:2.05; 22.84) or third trimester (HR:22.4; CI95%:6.57; 76.33) of pregnancy were also associated with fetal/neonatal complications.

Conclusion: Pregnant women with COVID-19 have a higher risk of maternal or fetal/neonatal complications if they present with a moderate/severe COVID-19 on prenatal care admission or if the infection occurs in the second or third trimester of pregnancy.

Keywords: Pregnancy, COVID-19, pregnancy complications, newborn complications, cohort study


How to Cite

Kubiszeski EH, Carmo MAMV, Carmo AV, AANCR , R., Carvalho AMB, Souza NS, Fontes CJ, & Galera MF. (2024). Impact of Clinical Severity on Maternal and Perinatal Outcome Across Trimesters in COVID 19 Pregnancies: A Prospective Cohort Study. Journal of Advances in Medicine and Medical Research, 36(2), 63–76. https://doi.org/10.9734/jammr/2024/v36i25367

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