Fetal Outcome Associated with COVID-19; Correlation between Ultrasound and Birth Measures in COVID-19 Pregnant Women
DOI:
https://doi.org/10.6000/1929-4247.2024.13.04.4Keywords:
COVID-19 pregnant women, Fetal ultrasound in Covid-19 infectionAbstract
Background: Coronavirus disease 2019 (COVID-19), caused by the virus SARS-CoV-2, was declared a global pandemic in March 2020. Pregnant women might be especially vulnerable to COVID-19 because the physiological changes in their cardiorespiratory and immune systems during pregnancy could alter their response to SARS-CoV-2 infection.
Objective: to determine the association between SARS-CoV-2 infection and fetal outcomes, including SGA, FGR, preterm birth, and stillbirth.
Methods: This prospective study was conducted at the Ultrasound and Fetal Medicine Unit of Ain Shams University Maternity Hospital, a tertiary care center, from October 2021 to January 2023. The study included 45 pregnant women diagnosed with COVID-19 during the first or second trimester of their current pregnancy. Additionally, a control group of 45 pregnant women who were not infected with COVID-19 was included. Both groups were selected based on predefined inclusion and exclusion criteria.
Results: There were no statistically significant differences between the two groups regarding demographic characteristics, including age, body mass index, and parity. The timing of COVID-19 infection was nearly evenly distributed between the first and second trimesters. All cases in the infected group were non-hospitalized. No statistically significant differences were found between the groups regarding the need for induction or mode of delivery. Additionally, there were no significant differences in gestational age, estimated fetal weight, birth weight, or NICU admission rates. Stillbirth, prematurity, intrauterine growth restriction (IUGR), macrosomia, and neonatal mortality did not occur in either group.
Conclusion: As evident from the current study, there were no differences between first and second-trimester COVID-19-infected and non-infected pregnant women according to maternal and neonatal outcomes regarding fetal growth complications, APGAR score, preterm Labour, NICU admission, Placental abnormalities, and Liquor abnormalities. Consequently, clinical characteristics of first and second-trimester COVID-19 in pregnant patients and neonates seem to be similar to those in non-pregnant infected adults.
References
Narang K, Miller M, Trinidad C, Wick M, Theiler R, Weaver AL, Schenone M. Impact of asymptomatic and mild COVID-19 infection on fetal growth during pregnancy. European Journal of Obstetrics & Gynecology and Reproductive Biology 2023; 281: 63-67. https://doi.org/10.1016/j.ejogrb.2022.12.020
Dileep A, Zain AlAbdin S, AbuRuz S. Investigating the association between severity of COVID-19 infection during pregnancy and neonatal outcomes. Scientific Reports 2022; 12(1): 3024. https://doi.org/10.1038/s41598-022-07093-8
Mei JY, Mok T, Cambou MC, Fuller T, Fajardo VM, Kerin T, Rao R. Can prenatal ultrasound predict adverse neonatal outcomes in SARS-CoV-2-affected pregnancies? American Journal of Obstetrics & Gynecology MFM 2023; 5(9): 101028. https://doi.org/10.1016/j.ajogmf.2023.101028
Karaçam Z, Kizilca-Çakaloz D, Güneş-Öztürk G, Çoban A. Maternal and perinatal outcomes of pregnancy associated with COVID-19: systematic review and meta-analysis. European Journal of Midwifery 2022; 6. https://doi.org/10.18332/ejm/149485
de Medeiros KS, Sarmento AC, Costa AP, Macêdo LTDA, da Silva LA, de Freitas CL, & Gonçalves AK. Consequences and implications of the coronavirus disease (COVID‐19) on pregnancy and newborns: a comprehensive systematic review and meta‐analysis. International Journal of Gynecology & Obstetrics 2022; 156(3): 394-405. https://doi.org/10.1002/ijgo.14015
Gholami R, Borumandnia N, Kalhori E, Taheri M, Khodakarami N. The impact of the COVID-19 pandemic on pregnancy outcome. BMC Pregnancy and Childbirth 2023; 23(1): 811. https://doi.org/10.1186/s12884-023-06098-z
Crovetto F, Crispi F, Llurba E, Pascal R, Larroya M, Trilla C, et al. Impact of SARS-CoV-2 infection on pregnancy outcomes: a population-based study. Clin Infect Dis 2021; 73(10): 1768-75. https://doi.org/10.1093/cid/ciab104
Cosma S, Carosso AR, Cusato J, Borella F, Bertero L, Bovetti M, Benedetto C. Obstetric and neonatal outcomes after SARS‐CoV‐2 infection in the first trimester of pregnancy: a prospective comparative study. Journal of Obstetrics and Gynaecology Research 2022; 48(2): 393-401. https://doi.org/10.1111/jog.15105
Favre G, Pomar L, Musso D, Baud D. 2019-nCoV epidemic: what about pregnancies? Lancet 2020; 395: e40. https://doi.org/10.1016/S0140-6736(20)30311-1
Di Toro F, Gjoka M, Di Lorenzo G, De Santo D, De Seta F, Maso G, Risso FM, Romano F, Wiesenfeld U, Levi-D'Ancona R, Ronfani L, Ricci G. Impact of COVID-19 on maternal and neonatal outcomes: a systematic review and meta-analysis. Clin Microbiol Infect 2021; 27(1): 36-46. https://doi.org/10.1016/j.cmi.2020.10.007
Antoun L, Taweel NE, Ahmed I, Patni S, Honest H. Maternal COVID-19 infection, clinical characteristics, pregnancy, and neonatal outcome: A prospective cohort study. Eur J Obstet Gynecol Reprod Biol 2020; 252: 559-562. https://doi.org/10.1016/j.ejogrb.2020.07.008
Pirjani R, Hosseini R, Soori T, Rabiei M, Hosseini L, Abiri A, Moini A, Shizarpour A, Razani G, Sepidarkish M. Maternal and neonatal outcomes in COVID-19 infected pregnancies: a prospective cohort study. J Travel Med 2020; 27(7): taaa158. https://doi.org/10.1093/jtm/taaa158
la Cour FN, Egerup P, Hviid KVR, et al. SARS-CoV-2 in first-trimester pregnancy: a cohort study. Hum Reprod 2021; 36(1): 40-7.
Sharps MC, Hayes DJL, Lee S, Zou Z, Brady CA, Almoghrabi Y, et al. A structured review of placental morphology and histopathological lesions associated with SARS-CoV-2 infection. Placenta 2020; 101: 13-29. https://doi.org/10.1016/j.placenta.2020.08.018
Patberg ET, Adams T, Rekawek P, Vahanian SA, Akerman M, Hernandez A, et al. Coronavirus disease 2019 infection and placental histopathology in women delivering at term. Am J Obstet Gynecol 2020; S0002-9378 (20): 31194-7.
Kim CJ, Romero R, Chaemsaithong P, Kim J-S. Chronic inflammation of the placenta: definition, classification, pathogenesis, and clinical significance. Am J Obstet Gynecol 2015; 213(4 Suppl): S53-69. https://doi.org/10.1016/j.ajog.2015.08.041
Wong YP, Khong TY, Tan GC. The effects of COVID-19 on placenta and pregnancy: what do we know so far? Diagnostics (Basel) 2021; 11(1): 94. https://doi.org/10.3390/diagnostics11010094
Akbarian-Rad Z, Mojaveri MH, Bouzari Z, Sadeghi F, Yahyapour Y, Rad MN, et al. Neonatal Outcomes in Pregnant Women Infected with COVID-19 in Babol, North of Iran: A Retrospective Study with Short-Term Follow-Up. Infectious Diseases in Obstetrics and Gynecology 2021 ArticleID 9952701, 5 pages 2021. https://doi.org/10.1155/2021/9952701
Smith V, Seo D, Warty R, Payne O, Salih M, Chin KL, et al. Maternal and neonatal outcomes associated with COVID-19 infection: A systematic review. PLoS One 2020; 15(6): e0234187. https://doi.org/10.1371/journal.pone.0234187
Cosma S, Borella F, Carosso A, Sciarrone A, Cusato J, Corcione S, et al. The "scar" of a pandemic: cumulative incidence of COVID-19 during the first trimester of pregnancy. J Med Virol 2021; 93(1): 537-40. https://doi.org/10.1002/jmv.26267
Di Mascio D. WAPM (the World Association of Perinatal Medicine) working group on COVID-19. Maternal and perinatal outcomes of pregnant women with SARS-COV-2 infection. Ultrasound Obstet Gynecol 2021; 57(2): 232-41. https://doi.org/10.1002/uog.23107
D'Antonio F, Sen C, Mascio DD, et al. Maternal and perinatal outcomes in high vs. low risk-pregnancies affected by SARS-COV-2 infection (Phase-2): the WAPM (World Association of Perinatal Medicine) working group on COVID-19. Am J Obstet Gynecol MFM 2021; 100329: 71-8. https://doi.org/10.2399/prn.21.0291011
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