Document Type : Original Article

Authors

Department of Microbiology, SN Medical College, Agra, Uttar Pradesh, India

Abstract

BACKGROUND: Since the advent of coronavirus disease 2019 (COVID‑19) infection, there is
debate whether pregnancy outcome in COVID‑19 is more severe as compared to general population.
Pregnant population is particularly susceptible to viral infections due to altered immune response.
H1N1 infection and Zika virus infection led to unfavorable maternal and fetal outcomes.SARS during
pregnancy has been linked previously with high risk of spontaneous abortions, preterm births and
intrauterine growth restriction. The effects of this novel virus need to be studied.
MATERIALS AND METHODS: This is a single‑center descriptive prospective observational study
of 65 pregnant women with reverse transcriptase–polymerase chain reaction confirmed COVID‑19
infection, regardless of gestational age at diagnosis, admitted from April 15 to June 30, 2020, at the
COVID hospital in SN Medical college a tertiary center of Agra in North India. Maternal and perinatal
outcomes were studied. Data were analyzed using the SPSS software for windows. Continuous
variables were expressed as mean ± standard deviation. Categorical variables were expressed as
numbers and percentages.
RESULTS: Majority 88.4% of the women were asymptomatic. Rest had mild illness only. Majority
94.23% were third‑trimester pregnancies; preterm birth was not reported in any singleton pregnancy.
Majority 85% were delivered by cesarean section done for obstetric indications.Maternal outcome of
all patients was favourable, and only two women who had moderate pneumonia recovered. Maternal
mortality was reported in only 1 case. All neonates were negative for COVID‑19. Neonatal outcome
was favorable.
CONCLUSION: COVID‑19 in pregnancy led to mild symptoms only.Infection in the third trimester
did not led to adverse obstetric outcome including preterm labor and premature membrane rupture.
SARSCoV2 infection in pregnancy did not increase the risk of maternal mortality. Vertical transmission
of COVID‑19 was not found in neonates .The maternal, neonatal, and perinatal outcomes of
COVID‑19 patients infected in late pregnancy were favorable.

Keywords

1. Ksiazek TG, Erdman D, Goldsmith CS, Zaki SR, Peret T, Emery S,
et al. A novel coronavirus associated with severe acute respiratory
syndrome. N Engl J Med 2003;348:1953‑66.
2. Zaki AM, van Boheemen S, Bestebroer TM, Osterhaus AD,
Fouchier RA. Isolation of a novel coronavirus from a man with
pneumonia in Saudi Arabia. N Engl J Med 2012;367:1814‑20.
3. Wong SF, Chow KM, Leung TN, NgWF, Ng TK, Sik CC, Pak C Ng,
et al. Pregnancy and perinatal outcomes of women with severe
acute respiratory syndrome. Am J Obstet Gynecol 2004;191:292‑7.
4. Lu R, Zhao Xiang, Li Juan, Niu Peihua, Yang Bo, Wu H, onglong
et al. Genomic characterisation and epidemiology of 2019 novel
coronavirus: Implications for virus origins and receptor binding.
Lancet 2020;395:565‑74.
5. IraniM, Pakfetrat Ali, Mask Mahin Kiyani. Novel coronavirus disease
2019 and perinatal outcomes. J Educ Health Promot 2020;9:78.
6. Kazemi‑KaryaniA, Safari‑FaramaniR, AminiS, Ramezani‑DorohV,
Berenjian F, Dizaj MY et al. World one‑hundred days after
COVID‑19 outbreak: Incidence, case fatality rate, and trend. J Educ
Health Promot 2020;9:199.
7. Fornari F. Vertical transmission of COVID‑19‑A systematic
review. J Pediatr Perinatol Child Health 2020;4:7‑13.
8. Sutton D, Fuchs K, D’Alton M, Goffman D. Universal screening
for SARS‑CoV‑2 in women admitted for delivery. N Engl J Med
2020;382:2163‑4.
9. Gajbhiye R, Modi D, Mahale S. Pregnancy outcomes, Newborn
complications and Maternal‑Fetal Transmission of SARS‑CoV‑2
in women with COVID‑19: A systematic review of 441 cases.
Preprint 15April 2020 medRxiv 2020PPR: PPR15125 Doi:
10.1101/2020.04.11.200623576.
10. Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical
characteristics and intrauterine vertical transmission potential
of COVID‑19 infection in nine pregnant women: A retrospective
review of medical records. Lancet 2020;395:809‑15.
11. Chen L, Li Q, Zheng D, Jiang H, Wei Y, Zou L, et al. Clinical
Characteristics of Pregnant Women with Covid‑19 in Wuhan,
China. N Engl J Med 2020;382:e100.
12. Sentilhes L, De Marcillac F, Jouffrieau C, Kuhn P, Thuet V,
Hansmann Y, et al. Coronavirus disease 2019 in pregnancy was
associated with maternal morbidity and preterm birth. Am J
Obstet Gynecol 2020;223:914.e1‑15.
13. Schwartz DA. An analysis of 38 pregnant women with COVID‑19,
their newborn infants, and maternal‑fetal transmission of
SARS‑CoV‑2: Maternal coronavirus infections and pregnancy
outcomes. Arch Pathol Lab Med (2020) 144 (7):799‑805; Doi:
10.5858/arpa. 2020‑0901‑SA.
14. Sun B, Yeh J. Mild and asymptomatic Covid‑19 infections:
Implications for maternal, fetal, and reproductive health. Front
Reprod Health 2020, 2:1. doi: https://doi.org/10.3389/frph
0.2020.00001].
15. Qiancheng X, Jian S, Lingling P, Lei H, Xiaogan J, Weihua L,
et al. Coronavirus disease 2019 in pregnancy. Int J Infect Dis
2020;95:376‑83.
16. 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;223:111.e1‑14.
17. Liu D, Li L, Wu X, Zheng D, Wang J, Yang L. Women with
coronavirus disease (COVID‑19) pneumonia: A preliminary
analysis. Am J Roentgenol 2020;215:127‑32.