Research Article
Volume 10 Issue 4 - 2021
Comparison of Outcomes among Pregnant Women with or without COVID-19 during Intrapartum and Postpartum Care: A Longitudinal-Study
Shaista Zubair1*, Afsheen Mahboob2, Idoracaera Ikhwan3, Mah Jabeen4, Surekha Kanchanagari5, Afshana Ali5, Maryam Younus6 and Zubair Anwar7
1sSenior Registrar in Obstetrics and Gynaecology Good Hope Hospitals, University Hospitals of Birmingham NHS Foundation Trust, UK
2Consultant Obstetrician and Gynaecologist, University Hospitals of Birmingham NHS Foundation Trust, UK, Clinical Trust Lead for Perinatal Mental Health, Obstetrics and Gynaecology Good Hope Hospitals, University Hospitals Birmingham, UK
3ST2 Trainee in Obstetrics and Gynaecology, University Hospitals of Birmingham NHS Foundation Trust, UK
4ST3 Trainee (MRCOG Part-1) in Obstetrics and Gynaecology, University Hospitals of Birmingham NHS Foundation Trust, UK
5Junior Specialty Doctor in Obstetrics and Gynaecology, University Hospitals of Birmingham NHS Foundation Trust, UK
6CPSP College of Physcician and Surgeons Pakistan/University of Karachi, Pakistan
7ENT Specialist, The Royal London Hospital, Barts Health NHS Trust, UK
*Corresponding Author: Shaista Zubair MRCOG.UK, MRCPI. Ireland, FCPS, MCPS, Senior Registrar in Obstetrics and Gynaecology Good Hope Hospitals, University Hospitals of Birmingham NHS Foundation Trust, UK.
Received: September 29, 2020; Published: March 25, 2021




Abstract

Background: COVID-19 is spreading quickly across the world. However, little is known about the relation between COVID-19 infection and the risk of unfavorable intrapartum, pregnancy-related fetal-maternal and postnatal outcomes in pregnant women.

Objectives: To determine the prevalence of COVID-19 in suspected pregnant women and compare the intrapartum care, analgesic requirements, mode of delivery, postpartum complication, feto-maternal outcomes, postnatal treatment and care amongst pregnant women with or without COVID-19.

Subjects and Method: This retrospective comparative study was carried out at University Hospitals Birmingham (UHB) during the first wave of COVID-19, between 20 th March and 1 stJune 2020. Ethical approval was received from the hospital ethical committee. Detailed data was obtained of 63 admitted suspected COVID-19 pregnant women, from the hospital records. Swabs were taken for confirmation of COVID-19. All precautions and Standard Operating Procedures (SOPs) were considered to limit the transmission of disease. After confirmation, patients were separated as positive and negative cases. Details regarding demographics, medical conditions at admission, intrapartum care and analgesic requirements, mode of delivery, indications of C-section, postpartum complication, feto-maternal outcomes, postnatal treatment and care were obtained from electronic medical records using standard proforma. All patients were followed during hospitalisation until discharge. Data was entered and analyzed using SPSS Version 24.0. Descriptive statistics for quantitative variables reported as mean and standard deviation, categorical variables measured as frequency and percentages. Statistical tests including: chi-square test, fisher exact test and t-test were applied to check the association at 5% significance level.

Results: During study duration, 63 suspected pregnant women delivered with mean age 28.6 ± 5.64 years; 27% were COVID-19 positive. Pregnancy outcomes are shown as follows for COVID-19 positive and negative patients. Presence of partner (58.8% vs. 78.3%; P: 0.112), C-section (76.5% vs. 80.8%), low APGAR at 1 minute (12.5% vs. 14.3%: P: 0.615), low birth weight (29.4% vs. 15.9%; P: 0.200), usage of antibiotic (64.7% vs. 58.7%; P: 0.665), oxygen therapy (58.8% vs. 34.8%; P: 0.085), Maternal HDU admission (17.6% vs. 0%; P: 0.017), ITU admission (11.8% vs. 0%; P: 0.070), breast feeding (23.5% vs. 39.1%; P: 0.249)and mean length of hospital stay (3.53 vs. 2.09; P: 0.004).

Conclusion: This study determined that older age, overweight/obese, multiparous and obstetric comorbid patients had higher risk of getting infected. There was no difference observed in any aspect of intrapartum care. Furthermore, there was increased usage of antibiotic in COVID-19 positive cases. Similarly maternal High Dependency Unit (HDU), Intensive Care Unit (ITU) and hospital admissions were significantly higher in COVID-19 positive patients. This study concluded that: COVID-19 may not lead to unfavorable Intrapartum and postnatal outcomes.

Keywords: COVID-19; Pregnancy; Suspected; Intrapartum Care; Analgesic Requirements; Mode of Delivery; Postpartum Complication; Feto-Maternal Outcomes; Postnatal Treatment; Pregnant Women

References

  1. Valencia DN. “Brief review on COVID-19: the 2020 pandemic caused by SARS-CoV-2”. Cureus3 (2020).
  2. Cucinotta D and Vanelli M. “WHO Declares COVID-19 a Pandemic”. Acta Bio-Medica: Atenei Parmensis1 (2020): 157-160.
  3. Jafari M., et al. “Clinical characteristics and outcomes of pregnant women with COVID‐19 and comparison with control patients: A systematic review and meta‐analysis”. Reviews in Medical Virology
  4. Rasmussen SA., et al. “Coronavirus disease 2019 (COVID-19) and pregnancy: what obstetricians need to know”. American Journal of Obstetrics and Gynecology5 (2020): 415-426.
  5. Rothan HA and Byrareddy SN. “The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak”. Journal of Autoimmunity 109 (2020): 102433.
  6. McMahon SA., et al. “Healthcare providers on the frontlines: a qualitative investigation of the social and emotional impact of delivering health services during Sierra Leone’s Ebola epidemic”. Health Policy and Planning9 (2016): 1232-1239.
  7. Menendez C., et al. “Avoiding indirect effects of COVID-19 on maternal and child health”. The Lancet Global Health7 (2020): e863.
  8. Corps D. “Provisional births in England and Wales: 2020: Office for National Statistics (2020).
  9. Madjunkov M., et al. “A comprehensive review of the impact of COVID-19 on human reproductive biology, assisted reproduction care and pregnancy: a Canadian perspective”. Journal of Ovarian Research1 (2020): 1-18.
  10. Zhu H., et al. “Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia”. Translational Pediatrics1 (2020): 51.
  11. Dashraath P., et al. “Coronavirus disease 2019 (COVID-19) pandemic and pregnancy”. American Journal of Obstetrics and Gynecology6 (2020): 521-531.
  12. Ryan GA., et al. “Clinical update on COVID‐19 in pregnancy: A review article”. Journal of Obstetrics and Gynaecology Research8 (2020): 1235-1245.
  13. Mahase E. “COVID-19: Pregnant women with virus are more likely to need intensive care, study finds”. British Medical Journal Publishing Group (2020).
  14. Allotey J., 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): 370.
  15. Burke RM., et al. “Symptom profiles of a convenience sample of patients with COVID-19-United States, January–April 2020”. Morbidity and Mortality Weekly Report28 (2020): 904.
  16. Chamseddine RS., et al. “Pregnancy and neonatal outcomes in SARS-CoV-2 Infection: a systematic review”. Journal of Pregnancy (2020).
  17. Vousden N., et al. “The incidence, characteristics and outcomes of pregnant women hospitalized with symptomatic and asymptomatic SARS-CoV-2 infection in the UK from March to September 2020: a national cohort study using the UK Obstetric Surveillance System (UKOSS)”. Med Rxiv (2021).
  18. Ayoubkhani D., et al. “Ethnic minority groups in England and Wales-factors affecting the size and timing of elevated COVID-19 mortality: a retrospective cohort study linking Census and death records”. Medrxiv (2020).
  19. Tamara A and Tahapary DL. “Obesity as a predictor for a poor prognosis of COVID-19: A systematic review”. Diabetes and Metabolic Syndrome: Clinical Research and Reviews4 (2020): 655-659.
  20. Ellington S., et al. “Characteristics of women of reproductive age with laboratory-confirmed SARS-CoV-2 infection by pregnancy status—United States, January 22–June 7, 2020”. Morbidity and Mortality Weekly Report25 (2020): 769.
  21. Adhikari EH., et al. “Pregnancy outcomes among women with and without severe acute respiratory syndrome coronavirus 2 infection”. JAMA Network Open11 (2020): e2029256.
  22. Capobianco G., et al. “COVID-19 in pregnant women: A systematic review and meta-analysis”. European Journal of Obstetrics and Gynecology and Reproductive Biology 252 (2020): 543-558.
  23. Yang R., et al. “Pregnant women with COVID-19 and risk of adverse birth outcomes and maternal-fetal vertical transmission: a population-based cohort study in Wuhan, China”. BMC Medicine1 (2020): 1-7.
  24. Melo GCd and Araújo KCGMd. “COVID-19 infection in pregnant women, preterm delivery, birth weight, and vertical transmission: a systematic review and meta-analysis”. Cadernos de Saude Publica 36 (2020): e00087320.
  25. Levy A., et al. “ACE2 expression and activity are enhanced during pregnancy”. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology6 (2008): R1953-R61.
  26. Fenizia C., et al. “Analysis of SARS-CoV-2 vertical transmission during pregnancy”. Nature Communications1 (2020): 1-10.
  27. Alzamora MC., et al. “Severe COVID-19 during pregnancy and possible vertical transmission”. American Journal of Perinatology8 (2020): 861.
  28. Yan J., et al. “Coronavirus disease 2019 in pregnant women: a report based on 116 cases”. American Journal of Obstetrics and Gynecology1 (2020): e1-e14.
  29. Di Mascio D., et al. “Outcome of coronavirus spectrum infections (SARS, MERS, COVID-19) during pregnancy: a systematic review and meta-analysis”. American Journal of Obstetrics and Gynecology MFM2 (2020): 100107.
Citation: Gaye Bulut and Umut Taşdemir. “Pregnancy Associated Glycoproteins are an Option in Early Pregnancy Diagnosis in Cattle”. EC Gynaecology 10.4 (2021): 41-51.

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