Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Virol. Dec 25, 2024; 13(4): 96573
Published online Dec 25, 2024. doi: 10.5501/wjv.v13.i4.96573
COVID-19 in pregnancy: Perinatal outcomes and complications
Karolina Akinosoglou, Georgios Schinas, Evangelia Papageorgiou, Theodoros Karampitsakos, Vasiliki Dimakopoulou, Eleni Polyzou, Argyrios Tzouvelekis, Markos Marangos, Despoina Papageorgiou, Nikolaos Spernovasilis, George Adonakis
Karolina Akinosoglou, Georgios Schinas, Vasiliki Dimakopoulou, Eleni Polyzou, Markos Marangos, Despoina Papageorgiou, Department of Medicine, University of Patras, Patras 26504, Greece
Evangelia Papageorgiou, George Adonakis, Department of Obstetrics and Gynecology, University General Hospital of Patras, Patras 26504, Greece
Theodoros Karampitsakos, Argyrios Tzouvelekis, Department of Pneumonology, University General Hospital of Patras, Patras 26504, Greece
Nikolaos Spernovasilis, Department of Infectious Diseases, German Oncology Center, Limassol 4108, Limassol, Cyprus
Author contributions: Akinosoglou K and Adonakis G conceived idea; Schinas G, Papageorgiou E, Karampitsakos T, Dimakopoulou V, and Polyzou E collected data; Schinas G analyzed data; Akinosoglou K and Papageorgiou D wrote manuscript; Akinosoglou K, Tzouvelekis A, Marangos M, and Adonakis G oversaw study; Spernovasilis N critically corrected manuscript; Schinas G and Papageorgiou E equally contributed to this work.
Institutional review board statement: The study was approved by the institute ethics committee of the University Hospital of Patras (Approval No.: 477/24.11.2022).
Informed consent statement: Due to the retrospective type of the study a signed by the participants informed consent form was not necessary.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nikolaos Spernovasilis, MD, MSc, PhD, Director, Department of Infectious Diseases, German Oncology Center, Nikis 1, Limassol 4108, Limassol, Cyprus. nikspe@hotmaiil.com
Received: May 9, 2024
Revised: August 28, 2024
Accepted: September 6, 2024
Published online: December 25, 2024
Processing time: 161 Days and 14.8 Hours
Abstract
BACKGROUND

The risk of severe coronavirus disease 2019 (COVID-19) in pregnant women is elevated.

AIM

To examine the outcomes of pregnant women with COVID-19 and report perinatal outcomes and complications, while providing a brief review of current literature.

METHODS

The study included pregnant women presenting from April 2020 to February 2022 to the emergency department (ED) of a tertiary hospital. We retrospectively recorded the maternal and perinatal files, including patient epidemiological and clinical characteristics, laboratory values, outcomes, treatment modalities and associations were explored.

RESULTS

Among the 60 pregnant women, 25% required hospitalization, all of whom were symptomatic. Preterm delivery occurred in 30% of cases. Ten percent of neonates required admission to the neonatal intensive care unit, and 5% were classified as small for their gestational age. All mothers survived COVID-19 and pregnancy, with 6.6% requiring invasive mechanical ventilation. Preterm delivery rates did not differ between hospitalized and non-hospitalized pregnant women; composite unfavorable perinatal outcomes, including stillbirth, small for gestational age, or neonatal intensive care unit (ICU) admission, did not significantly increase in the cases hospitalized for COVID-19 (P = 0.09). The odds of hospitalization increased 2.3-fold for each day of delayed ED presentation [adj. OR (95%CI: 1.46-3.624), P < 0.001]. Comorbidity status was an independent predictor of hospitalization, albeit with marginal significance [adj. OR = 16.13 (95%CI: 1.021-255.146), P = 0.048]. No independent predictors of adverse fetal outcome (composite) were identified, and eventual hospitalization failed to reach statistical significance by a slight margin (P = 0.054).

CONCLUSION

Delayed ED presentation and comorbidities increase hospitalization odds. This study highlights the importance of continuous and specific guidance for managing pregnant COVID-19 patients, including timely and appropriate interventions to minimize maternal and perinatal morbidity and mortality.

Keywords: SARS-CoV-2; COVID-19; Pregnancy; Maternal outcomes; Preterm delivery

Core Tip: Pregnant individuals' risk of contracting severe disease from severe acute respiratory syndrome coronavirus 2 infection is elevated. If hospitalization for coronavirus disease 2019 is indicated for expecting mothers, it is crucial the medical treatment to take place in a facility equipped to monitor both maternal and fetal health. Early detection and management of these cases are paramount for optimal results regarding motherhood and newborn care outcomes.