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Kurbatfinski S, Dosani A, Fajardo C, Cuncannon A, Kassam A, Lodha AK. Impacts of COVID-19 on mothers' and newborns' health outcomes in regional Canada: A cross-sectional analysis. Heliyon 2024; 10:e34165. [PMID: 39092269 PMCID: PMC11292244 DOI: 10.1016/j.heliyon.2024.e34165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 06/27/2024] [Accepted: 07/04/2024] [Indexed: 08/04/2024] Open
Abstract
Background COVID-19 infection and pandemic-related stressors (e.g., socioeconomic challenges, isolation) resulted in significant concerns for the health of mothers and their newborns during the perinatal period. Therefore, the primary objective of this study was to compare the health outcomes of pregnant mothers and their newborns one year prior to and one year into the pandemic period in Alberta, Canada. Secondary objectives included investigating: 1) predictors of admission to neonatal intensive care units (NICU) and to compare NICU-admitted newborn health outcomes between the two time periods; 2) hospital utilization between the two time periods; and 3) the health outcomes of mothers and their newborns following infection with COVID-19. Methods This analytical cross-sectional study used a large administrative dataset (n = 32,107) obtained from provincial regional hospitals and homebirths in Alberta, Canada, from April 15, 2019, to April 14, 2021. Descriptive statistics characterized the samples. Chi-squares and two-sample t-tests statistically compared samples. Multivariable logistic regression identified predictor variables. Results General characteristics, pregnancy and labor complications, and infant outcomes were similar for the two time periods. Preterm birth and low birthweight predicted NICU admission. During the pandemic, prevalence of hospital visits and rehospitalization after discharge decreased for all infants and hospital visits after discharge decreased for NICU-admitted neonates. The odds of hospital revisits and rehospitalization after discharge were higher among newborns with COVID-19 at birth. Conclusions Most of the findings are contextualized on pandemic-related stressors (rather than COVID-19 infection) and are briefly compared with other countries. Hospitals in Alberta appeared to adapt well to COVID-19 since health conditions were comparable between the two time periods and COVID-19 infection among mothers or newborns resulted in few observable impacts. Further investigation is required to determine causal reasons for changes in hospital utilization during the pandemic and greater birthweight among pandemic-born infants.
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Affiliation(s)
- Stefan Kurbatfinski
- Owerko Centre, Alberta Children’s Hospital Research Institute, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada
| | - Aliyah Dosani
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada
- Faculty of Health, Community and Education, Mount Royal University, 4825 Mount Royal Gate SW, Calgary, AB, T3E 6K6, Canada
- O'Brien Institute for Public Health, University of Calgary, 3280 Hospital Dr NW, Calgary, AB, T2N 4Z6, Canada
| | - Carlos Fajardo
- Department of Pediatrics, Cumming School of Medicine, University of Calgary Foothills Medical Centre, 1403 29 St NW, Calgary, AB, T2N 2T9, Canada
| | | | - Aliza Kassam
- Department of Medical Sciences, Western University, 1151 Richmond St, London, ON, N6A 3K7, Canada
| | - Abhay K. Lodha
- Department of Pediatrics and Community Health Sciences, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada
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van Baar JAC, Kostova EB, Allotey J, Thangaratinam S, Zamora JR, Bonet M, Kim CR, Mofenson LM, Kunst H, Khalil A, van Leeuwen E, Keijzer J, Strikwerda M, Clark B, Verschuuren M, Coomarasamy A, Goddijn M, van Wely M. COVID-19 in pregnant women: a systematic review and meta-analysis on the risk and prevalence of pregnancy loss. Hum Reprod Update 2024; 30:133-152. [PMID: 38016805 PMCID: PMC10905512 DOI: 10.1093/humupd/dmad030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/01/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Pregnant women infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are more likely to experience preterm birth and their neonates are more likely to be stillborn or admitted to a neonatal unit. The World Health Organization declared in May 2023 an end to the coronavirus disease 2019 (COVID-19) pandemic as a global health emergency. However, pregnant women are still becoming infected with SARS-CoV-2 and there is limited information available regarding the effect of SARS-CoV-2 infection in early pregnancy on pregnancy outcomes. OBJECTIVE AND RATIONALE We conducted this systematic review to determine the prevalence of early pregnancy loss in women with SARS-Cov-2 infection and compare the risk to pregnant women without SARS-CoV-2 infection. SEARCH METHODS Our systematic review is based on a prospectively registered protocol. The search of PregCov19 consortium was supplemented with an extra electronic search specifically on pregnancy loss in pregnant women infected with SARS-CoV-2 up to 10 March 2023 in PubMed, Google Scholar, and LitCovid. We included retrospective and prospective studies of pregnant women with SARS-CoV-2 infection, provided that they contained information on pregnancy losses in the first and/or second trimester. Primary outcome was miscarriage defined as a pregnancy loss before 20 weeks of gestation, however, studies that reported loss up to 22 or 24 weeks were also included. Additionally, we report on studies that defined the pregnancy loss to occur at the first and/or second trimester of pregnancy without specifying gestational age, and for second trimester miscarriage only when the study presented stillbirths and/or foetal losses separately from miscarriages. Data were stratified into first and second trimester. Secondary outcomes were ectopic pregnancy (any extra-uterine pregnancy), and termination of pregnancy. At least three researchers independently extracted the data and assessed study quality. We calculated odds ratios (OR) and risk differences (RDs) with corresponding 95% CI and pooled the data using random effects meta-analysis. To estimate risk prevalence, we performed meta-analysis on proportions. Heterogeneity was assessed by I2. OUTCOMES We included 120 studies comprising a total of 168 444 pregnant women with SARS-CoV-2 infection; of which 18 233 women were in their first or second trimester of pregnancy. Evidence level was considered to be of low to moderate certainty, mostly owing to selection bias. We did not find evidence of an association between SARS-CoV-2 infection and miscarriage (OR 1.10, 95% CI 0.81-1.48; I2 = 0.0%; RD 0.0012, 95% CI -0.0103 to 0.0127; I2 = 0%; 9 studies, 4439 women). Miscarriage occurred in 9.9% (95% CI 6.2-14.0%; I2 = 68%; 46 studies, 1797 women) of the women with SARS CoV-2 infection in their first trimester and in 1.2% (95% CI 0.3-2.4%; I2 = 34%; 33 studies; 3159 women) in the second trimester. The proportion of ectopic pregnancies in women with SARS-CoV-2 infection was 1.4% (95% CI 0.02-4.2%; I2 = 66%; 14 studies, 950 women). Termination of pregnancy occurred in 0.6% of the women (95% CI 0.01-1.6%; I2 = 79%; 39 studies; 1166 women). WIDER IMPLICATIONS Our study found no indication that SARS-CoV-2 infection in the first or second trimester increases the risk of miscarriages. To provide better risk estimates, well-designed studies are needed that include pregnant women with and without SARS-CoV-2 infection at conception and early pregnancy and consider the association of clinical manifestation and severity of SARS-CoV-2 infection with pregnancy loss, as well as potential confounding factors such as previous pregnancy loss. For clinical practice, pregnant women should still be advised to take precautions to avoid risk of SARS-CoV-2 exposure and receive SARS-CoV-2 vaccination.
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Affiliation(s)
- Janneke A C van Baar
- Department of Obstetrics and Gynaecology, Center for Reproductive Medicine, Amsterdam UMC, Amsterdam, The Netherlands
| | - Elena B Kostova
- Department of Obstetrics and Gynaecology, Center for Reproductive Medicine, Amsterdam UMC, Amsterdam, The Netherlands
- Cochrane Gynaecology and Fertility Satellite, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - John Allotey
- Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK
- NIHR Biomedical Research Center, University Hospitals Birmingham, Birmingham, UK
| | - Shakila Thangaratinam
- Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK
- NIHR Biomedical Research Center, University Hospitals Birmingham, Birmingham, UK
- WHO Collaborating Centre for Global Women’s Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - Javier R Zamora
- WHO Collaborating Centre for Global Women’s Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
- Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Mercedes Bonet
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Caron Rahn Kim
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | | | - Heinke Kunst
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Barts Health NHS Trust, London, UK
| | | | - Elisabeth van Leeuwen
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
- Women and Childrens Hospital, Amsterdam UMC, Amsterdam, The Netherlands
| | - Julia Keijzer
- Department of Obstetrics and Gynaecology, Center for Reproductive Medicine, Amsterdam UMC, Amsterdam, The Netherlands
| | - Marije Strikwerda
- Department Vrouw & Baby, Utrecht UMC, location University of Utrecht, Utrecht, The Netherlands
| | - Bethany Clark
- Department Vrouw & Baby, Utrecht UMC, location University of Utrecht, Utrecht, The Netherlands
| | - Maxime Verschuuren
- Department of Obstetrics and Gynaecology, Center for Reproductive Medicine, Amsterdam UMC, Amsterdam, The Netherlands
| | - Arri Coomarasamy
- Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK
- NIHR Biomedical Research Center, University Hospitals Birmingham, Birmingham, UK
- Tommy's Centre for Miscarriage Research, Birmingham, UK
| | - Mariëtte Goddijn
- Department of Obstetrics and Gynaecology, Center for Reproductive Medicine, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Madelon van Wely
- Department of Obstetrics and Gynaecology, Center for Reproductive Medicine, Amsterdam UMC, Amsterdam, The Netherlands
- Cochrane Gynaecology and Fertility Satellite, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
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Mahajan NN, Ansari M, Munshi H, More P, Gajbhiye RK. Different impact of COVID-19 on symptomatic pregnant and postpartum women in low-income countries and low- and middle-income countries. Int J Gynaecol Obstet 2023; 162:1110-1113. [PMID: 37337930 DOI: 10.1002/ijgo.14934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 02/03/2023] [Accepted: 05/28/2023] [Indexed: 06/21/2023]
Abstract
SynopsisThe adverse outcomes of COVID‐19 among pregnant women have been pronounced in the low‐income countries compared with low‐ and middle‐income countries.
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Affiliation(s)
- Niraj N Mahajan
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, India
| | - Munira Ansari
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, India
| | - Hrishikesh Munshi
- Department of Clinical Research Laboratory, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai, India
| | - Pradnya More
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, India
| | - Rahul K Gajbhiye
- Department of Clinical Research Laboratory, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai, India
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Ambade PN, Thavorn K, Pakhale S. COVID-19 Pandemic: Did Strict Mobility Restrictions Save Lives and Healthcare Costs in Maharashtra, India? Healthcare (Basel) 2023; 11:2112. [PMID: 37510552 PMCID: PMC10379405 DOI: 10.3390/healthcare11142112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/29/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
INTRODUCTION Maharashtra, India, remained a hotspot during the COVID-19 pandemic. After the initial complete lockdown, the state slowly relaxed restrictions. We aim to estimate the lockdown's impact on COVID-19 cases and associated healthcare costs. METHODS Using daily case data for 84 days (9 March-31 May 2020), we modeled the epidemic's trajectory and predicted new cases for different phases of lockdown. We fitted log-linear models to estimate the growth rate, basic (R0), daily reproduction number (Re), and case doubling time. Based on pre-restriction and Phase 1 R0, we predicted new cases for the rest of the restriction phases, and we compared them with the actual number of cases during each phase. Furthermore, using the published and gray literature, we estimated the costs and savings of implementing these restrictions for the projected period, and we performed a sensitivity analysis. RESULTS The estimated median R0 during the different phases was 1.14 (95% CI: 0.85, 1.45) for pre-lockdown, 1.67 (95% CI: 1.50, 1.82) for phase 1 (strict mobility restrictions), 1.24 (95% CI: 1.12, 1.35) for phase 2 (extension of phase 1 with no restrictions on agricultural and essential services), 1.12 (95% CI: 1.01, 1.23) for phase 3 (extension of phase 2 with mobility relaxations in areas with few infections), and 1.05 (95% CI: 0.99, 1.123) for phase 4 (implementation of localized lockdowns in high-case-load areas with fewer restrictions on other areas), respectively. The corresponding doubling time rate for cases (in days) was 17.78 (95% CI: 5.61, -15.19), 3.87 (95% CI: 3.15, 5.00), 10.37 (95% CI: 7.10, 19.30), 20.31 (95% CI: 10.70, 212.50), and 45.56 (95% CI: 20.50, -204.52). For the projected period, the cases could have reached 631,819 without the lockdown, as the actual reported number of cases was 64,975. From a healthcare perspective, the estimated total value of averted cases was INR 194.73 billion (USD 2.60 billion), resulting in net cost savings of 84.05%. The Incremental Cost-Effectiveness Ratio (ICER) per Quality Adjusted Life Year (QALY) for implementing the lockdown, rather than observing the natural course of the pandemic, was INR 33,812.15 (USD 450.83). CONCLUSION Maharashtra's early public health response delayed the pandemic and averted new cases and deaths during the first wave of the pandemic. However, we recommend that such restrictions be carefully used while considering the local socio-economic realities in countries like India.
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Affiliation(s)
- Preshit Nemdas Ambade
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Kednapa Thavorn
- Faculty of Medicine, School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
| | - Smita Pakhale
- Faculty of Medicine, School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
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Dandona R, Kumar GA, Akbar M, Dora SSP, Dandona L. Substantial increase in stillbirth rate during the COVID-19 pandemic: results from a population-based study in the Indian state of Bihar. BMJ Glob Health 2023; 8:e013021. [PMID: 37491108 PMCID: PMC10373740 DOI: 10.1136/bmjgh-2023-013021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 07/13/2023] [Indexed: 07/27/2023] Open
Abstract
INTRODUCTION We report on the stillbirth rate (SBR) and associated risk factors for births during the COVID-19 pandemic, and change in SBR between prepandemic (2016) and pandemic periods in the Indian state of Bihar. METHODS Births between July 2020 and June 2021 (91.5% participation) representative of Bihar were listed. Stillbirth was defined as fetal death with gestation period of ≥7 months where the fetus did not show any sign of life. Detailed interviews were conducted for all stillbirths and neonatal deaths, and for 25% random sample of surviving live births. We estimated overall SBR, and during COVID-19 peak and non-peak periods per 1000 births. Multiple logistic regression models were run to assess risk factors for stillbirth. The change in SBR for Bihar from 2016 to 2020-2021 was estimated. RESULTS We identified 582 stillbirths in 30 412 births with an estimated SBR of 19.1 per 1000 births (95% CI 17.7 to 20.7); SBR was significantly higher in private facility (38.4; 95% CI 34.3 to 43.0) than in public facility (8.6; 95% CI 7.3 to 10.1) births, and for COVID-19 peak (21.2; 95% CI 19.2 to 23.4) than non-peak period (16.3; 95% CI 14.2 to 18.6) births. Pregnancies with the last pregnancy trimester during the COVID-19 peak period had 40.4% (95% CI 10.3% to 70.4%) higher SBR than those who did not. Risk factor associations for stillbirths were similar between the COVID-19 peak and non-peak periods, with gestation age of <8 months with the highest odds of stillbirth followed by referred deliveries and deliveries in private health facilities. A statistically significant increase of 24.3% and 68.9% in overall SBR and intrapartum SBR was seen between 2016 and 2020-2021, respectively. CONCLUSIONS This study documented an increase in SBR during the COVID-19 pandemic as compared with the prepandemic period, and the varied SBR based on the intensity of the COVID-19 pandemic and by the place of delivery.
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Affiliation(s)
- Rakhi Dandona
- Public Health Foundation of India, New Delhi, India
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - G Anil Kumar
- Public Health Foundation of India, New Delhi, India
| | - Md Akbar
- Public Health Foundation of India, New Delhi, India
| | | | - Lalit Dandona
- Public Health Foundation of India, New Delhi, India
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
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Vanremmawii, Lalrinfela, Vanlalpeka H, Lalduhchhungi, Zothansangi, Ralte H. A spectrum of pathological changes induced by SARS-COV-2: An observational study in a cohort of pregnant women from Mizoram, India. GYNECOLOGY AND OBSTETRICS CLINICAL MEDICINE 2023; 3:106-111. [PMID: 38620151 PMCID: PMC10160527 DOI: 10.1016/j.gocm.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/31/2023] [Accepted: 05/03/2023] [Indexed: 04/17/2024]
Abstract
Background Maternal infection by SARS-CoV-2 may lead to adverse pregnancy outcomes and causes pathological changes in the placenta. However, consensus regarding characteristic pathological features is lacking. Researchof the placental histopathology in a cohort of women from Mizoram, India, was conducted to relate the SARS-CoV-2 infection's effectswith pregnancy and its outcome. Materials and methods The characteristics of 72 pregnant women diagnosed positive for SARS-CoV-2 who eventually delivered at Zoram Medical College Hospital, Mizoram, neonates' well-being, and histopathological features of placentas were studied. Results Of 72 women in this study, 59 (81.9%) gave birth at full term. Among these births, 5 were normal vaginal deliveries, while the remaining 67 (93.1%) were delivered via cesarean section. The reasons for cesarean delivery were either related to SARS-CoV-2 infection (n = 49), existing obstetric problems (n = 15) or fetal-distress (n = 5). All deliveries resulted in live births of COVID-negative babies, with 80.6% (n = 58) of the newborns having a birth weight of over 2.5 kg. APGAR scores ranged from 4 to 6 in 61 (84.7%) of the babies, and 10 neonates required resuscitation, of which 8 were managed in the neonatal intensive care unit (NICU). The placental histopathology showed increased fibrin thrombi in 8 cases (11.1%), while 20 cases (28%) showed focal infarction, microcalcification levels were elevated in 16 cases (22.2%), and a small percentage of cases (1.4%) exhibited small fibrotic villi and inter-villus agglutination. Placental chorioangiosis was detected in 28 (38.9%) of the cases, while avascular villi were seen in 6 cases. Meconium-stained liquor was observed in a single case. Intervillous hemorrhage was found in 42 cases, whileintervillous inflammation and increased syncytial knots were present in 14 and 5 cases, respectively. The placenta pathology of 10 neonates who required resuscitation/NICU admission was not significantly different from that of the 62 neonates who did not require it. However, a higher proportion of placenta from the asymptomatic group showed no abnormality compared to the symptomatic group (p = 0.046). Conclusion SARS-CoV-2 infection causes a range of morphological changes and lesions in the placenta, including chorangiosis, villositis, chorioamnionitis, fetal vascular malperfusion/thrombosis, fibrin-deposition, increased syncytial-knotting, increased microcalcification, increased villous agglutination, focal infarct, intervilloushemorrhage as well as inflammation. Placental histopathological findings from this study can provide additional information to the existing literature on the subject.
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Affiliation(s)
- Vanremmawii
- Department of Obstetrics and Gynaecology, Zoram Medical College, India
| | - Lalrinfela
- Department of Obstetrics and Gynaecology, Zoram Medical College, India
| | - Harvey Vanlalpeka
- Department of Obstetrics and Gynaecology, Zoram Medical College, India
| | - Lalduhchhungi
- Department of Obstetrics and Gynaecology, Zoram Medical College, India
| | - Zothansangi
- Department of Pathology, Zoram Medical College, India
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Tapasvi I, Sethi A, Tapasvi C, Grover S, Rajora P. To Compare the Maternal and Fetal Outcomes of COVID-19-Affected Expectant Mothers During the First and Second COVID-19 Waves: Data From a Tertiary Care Referral Hospital in Punjab. Cureus 2023; 15:e36319. [PMID: 37077599 PMCID: PMC10106863 DOI: 10.7759/cureus.36319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2023] [Indexed: 03/20/2023] Open
Abstract
BACKGROUND Coronavirus 2019 (COVID-19) infection, declared pandemic in March 2020 by the World Health Organization, paved the way for newer research in the field of medicine. The second wave, beginning in March 2021, appeared to be more devastating. The purpose of this study is to evaluate the clinical characteristics, effects of COVID-19 infection in pregnancy, and obstetric and perinatal outcomes in the first and second waves. MATERIALS AND METHODS This study was conducted from January 2020 to August 2021 at the Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab. The patients were enrolled immediately after each infected woman was identified as per the inclusion and exclusion criteria. Demographic details of the patients, associated comorbid conditions, intensive care unit (ICU) admission, and treatment details were noted. Neonatal outcomes were recorded. The testing of pregnant women was done as per the Indian Council of Medical Research (ICMR) guidelines. RESULTS There were 3421 obstetric admissions and 2132 deliveries during this period. Group 1 had 123 COVID-19-positive admissions, while group 2 had 101 admissions. The incidence of COVID-19 infection in pregnancy was 6.54%. In both groups, the majority of patients were between the ages of 21 and 30. About 80(66%) of the admissions in group 1 and 46(46%) in group 2 were in the gestational age of 29-36 weeks. Multiparity was more common in both groups, with 58% of cases in group 1 and 79% of cases in group 2. Obstetric comorbidities were common in both groups, seen in 46% of cases in group 1 and 78% of cases in group 2. The majority of patients were asymptomatic in group 1, with an 89% incidence, whereas only 33% of patients in group 2 were without symptoms. In biological data, D-dimers, prothrombin time, and platelet count were altered in 11%, 14%, and 17% of cases, respectively, in group 2, with almost normal data in group 1. Most cases in group 2 (52%) were critical cases in the moderate and severe categories requiring intensive care unit (ICU) treatment, whereas there was only single ICU admission in group 1. The overall case fatality rate (CFR) in group 2 was found to be 19.8(20/101). Delivery by cesarean section was done in 38.2% of cases in group 1, while in 33% of cases in group 2, with a significant p-value of 0.001. About 29% of cases in group 1 and 34% of cases in group 2 underwent vaginal delivery. The rate of abortion was almost similar in both groups. Only two cases in group 1 and nine cases in group 2 had intrauterine fetal death. Observations of neonatal outcomes suggested that five cases in group 2 and two cases in group 1 had severe birth asphyxia. Only one case in group 1 and four cases in group 2 had positive COVID-19 status. Maternal mortality was significantly higher in group 2 with 20 cases, while only one case was in group 1. Anemia and pregnancy-induced hypertension were the chief comorbidities in this group. CONCLUSION COVID-19 infection during pregnancy may be associated with maternal mortality while having a minimal effect on neonatal morbidity and mortality. The possibility of maternal-fetal transmission cannot be ruled out completely. The severity and characteristics of COVID-19 may vary in each wave, and we need to modify treatment strategies. More studies or meta-analyses reports are required to authenticate this transmission.
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Mahajan NN, Gajbhiye RK. Oxygen saturation in pregnant women with COVID-19: challenges in low-income and middle-income countries. Am J Obstet Gynecol 2023; 228:356-357. [PMID: 36306857 DOI: 10.1016/j.ajog.2022.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 10/13/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Niraj N Mahajan
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, 4th Floor, College Bldg., Mumbai 400008, India.
| | - Rahul K Gajbhiye
- Indian Council of Medical Research-National Institute for Research in Reproductive and Child Health, Mumbai, India
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Carrión-Nessi FS, Castro MP, Freitas-De Nobrega DC, Moncada-Ortega A, Omaña-Ávila ÓD, Mendoza-Millán DL, Marcano-Rojas MV, Trejo NJ, Virriel IV, Chavero M, Camejo-Ávila NA, Rodriguez-Morales AJ, Forero-Peña DA. Clinical-epidemiological characteristics and maternal-foetal outcomes in pregnant women hospitalised with COVID-19 in Venezuela: a retrospective study. BMC Pregnancy Childbirth 2022; 22:905. [PMID: 36471262 PMCID: PMC9720989 DOI: 10.1186/s12884-022-05253-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND In low- and middle-income countries, pregnant women and newborns are more vulnerable to adverse outcomes from coronavirus disease 2019 (COVID-19). However, in Venezuela, there are no integrated data in a national surveillance system to identify the clinical-epidemiological characteristics and maternal-foetal outcomes of pregnant women hospitalised with COVID-19. METHODS A retrospective study was conducted among Venezuelan pregnant women hospitalised with COVID-19 seen at the "Ruiz y Páez" University Hospital Complex and the San Cristobal Central Hospital between June 2020 and September 2021. Information was obtained from physical and digitised clinical records using a purpose-designed proforma to collect epidemiological, clinical, paraclinical, treatment, obstetric and perinatal complications, and maternal-foetal outcomes data. RESULTS A total of 80 pregnant women with confirmed severe acute respiratory syndrome coronavirus 2 infection were seen within the study period, 59 (73.8%) survived and 21 (26.2%) died. The median (interquartile range) age was 29 (23-33) years, the majority being in the third trimester of pregnancy (81.2%; n = 65). Interestingly, four (5%) pregnant women were co-infected with malaria by Plasmodium vivax and three (3.8%) with syphilis. The most frequent symptoms were fever (75%; n = 60), dry cough (68.8%; n = 55), dyspnoea (55%; n = 44), and headache (53.8%; n = 43). The most frequent maternal complications were anaemia (51.5%; n = 66) and hypertensive disorders of pregnancy (17.5%; n = 14). The most frequent perinatal complications were preterm delivery (39.2%; n = 20/51) and oligohydramnios (31.3%; n = 25). A total of 29 (36.3%) adverse foetal outcomes were documented, 21 stillbirth and eight abortions. CONCLUSION This is the first study to describe the clinical-epidemiological behaviour of COVID-19 in hospitalised Venezuelan pregnant women. Anaemia, hypertensive disorders of pregnancy, oligohydramnios, and low birth weight were the most frequent maternal-foetal complications in this population of pregnant women.
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Affiliation(s)
- Fhabián S. Carrión-Nessi
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela ,“Dr. Francisco Battistini Casalta” Health Sciences School, University of Oriente – Bolivar Nucleus, Ciudad Bolivar, Venezuela
| | - Mercedes P. Castro
- Obstetrics and Gynaecology Department, San Cristobal Central Hospital, San Cristobal, Venezuela
| | - Diana C. Freitas-De Nobrega
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela ,“Dr. Francisco Battistini Casalta” Health Sciences School, University of Oriente – Bolivar Nucleus, Ciudad Bolivar, Venezuela
| | - Augusto Moncada-Ortega
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela ,grid.8171.f0000 0001 2155 0982“José María Vargas” School of Medicine, Central University of Venezuela, Caracas, Venezuela
| | - Óscar D. Omaña-Ávila
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela ,grid.8171.f0000 0001 2155 0982“Luis Razetti” School of Medicine, Central University of Venezuela, Caracas, Venezuela
| | - Daniela L. Mendoza-Millán
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela ,grid.8171.f0000 0001 2155 0982“Luis Razetti” School of Medicine, Central University of Venezuela, Caracas, Venezuela
| | | | - Nayren J. Trejo
- “Dr. Francisco Battistini Casalta” Health Sciences School, University of Oriente – Bolivar Nucleus, Ciudad Bolivar, Venezuela
| | - Isabella V. Virriel
- “Dr. Francisco Battistini Casalta” Health Sciences School, University of Oriente – Bolivar Nucleus, Ciudad Bolivar, Venezuela
| | - Melynar Chavero
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
| | - Natasha A. Camejo-Ávila
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela ,“Dr. Francisco Battistini Casalta” Health Sciences School, University of Oriente – Bolivar Nucleus, Ciudad Bolivar, Venezuela
| | - Alfonso J. Rodriguez-Morales
- grid.441853.f0000 0004 0418 3510Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de Las Américas - Institución Universitaria Visión de Las Américas, Pereira, Risaralda Colombia ,grid.411323.60000 0001 2324 5973Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon ,grid.430666.10000 0000 9972 9272Master of Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru
| | - David A. Forero-Peña
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela ,grid.411226.2Infectious Diseases Department, University Hospital of Caracas, Caracas, Venezuela
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10
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Mahajan NN, Kesarwani S, Salunke C, Kumbhar P, Yenkure P, Shaikh J, Shikhare S, Mahale SD, Sachdeva G, Gajbhiye RK. Clinical presentation, pregnancy complications, and outcomes of pregnant women with COVID-19 during the Omicron-dominant third wave in Mumbai, India. Int J Gynaecol Obstet 2022; 159:968-973. [PMID: 35861246 PMCID: PMC9349384 DOI: 10.1002/ijgo.14348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 07/07/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To study clinical presentation, disease severity, pregnancy complications, and maternal outcomes in women affected with coronavirus disease 2019 (COVID-19) during the third wave compared with the first and second waves of COVID-19. METHODS A retrospective, observational cohort study was conducted among 2058 pregnant and postpartum women with COVID-19 admitted during three wave periods at a tertiary care COVID-19-dedicated hospital. RESULTS The number of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) -infected pregnant and postpartum women with symptoms of COVID-19 was four times higher during the third wave compared with the first (odds ratio [OR] 4.6, 95% confidence interval [CI] 3.5-6.0, P < 0.001). There was a significantly lower proportion of pregnant and postpartum women with moderate to severe COVID-19 during the third wave (0.6%, 2/318) compared with those during the first wave (2.4%, 27/1143, P < 0.001) and second wave (14.4%, 86/597, P < 0.001). The intensive care/high dependency unit admissions during the third wave were significantly lower (2.5%, 8/318) than during the second wave (14.7%, 88/597; OR 0.2, 95% CI 0.1-0.3, P < 0.001) but similar to the first wave (2.4%, 27/1143). CONCLUSIONS Decreased severity of COVID-19, reduced maternal mortality, and morbidity were reported in the third wave compared with the first wave and second wave of COVID-19 in the Mumbai Metropolitan Region, India. TRIAL REGISTRATION The study is registered with the Clinical Trial Registry of India (Registration no: CTRI/2020/05/025423).
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Affiliation(s)
- Niraj N. Mahajan
- Department of Obstetrics and GynecologyTopiwala National Medical College and BYL Nair Charitable HospitalMumbaiIndia
| | - Shweta Kesarwani
- Department of Obstetrics and GynecologyTopiwala National Medical College and BYL Nair Charitable HospitalMumbaiIndia
| | - Chetna Salunke
- Department of Obstetrics and GynecologyTopiwala National Medical College and BYL Nair Charitable HospitalMumbaiIndia
| | - Padmaja Kumbhar
- Department of Obstetrics and GynecologyTopiwala National Medical College and BYL Nair Charitable HospitalMumbaiIndia
| | - Piyusha Yenkure
- Department of Obstetrics and GynecologyTopiwala National Medical College and BYL Nair Charitable HospitalMumbaiIndia
| | - Juvairiya Shaikh
- Department of Obstetrics and GynecologyTopiwala National Medical College and BYL Nair Charitable HospitalMumbaiIndia
| | - Shrutika Shikhare
- Department of Obstetrics and GynecologyTopiwala National Medical College and BYL Nair Charitable HospitalMumbaiIndia
| | - Smita D. Mahale
- ICMR‐National Institute for Research in Reproductive and Child HealthMumbaiIndia
| | - Geetanjali Sachdeva
- ICMR‐National Institute for Research in Reproductive and Child HealthMumbaiIndia
| | - Rahul K. Gajbhiye
- ICMR‐National Institute for Research in Reproductive and Child HealthMumbaiIndia
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11
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Maza-Arnedo F, Paternina-Caicedo A, Sosa CG, de Mucio B, Rojas-Suarez J, Say L, Cresswell JA, de Francisco LA, Serruya S, Lic DCFP, Urbina L, Hilaire ES, Munayco CV, Gil F, Rousselin E, Contreras L, Stefan A, Becerra AV, Degraff E, Espada F, Conde V, Mery G, Castaño VHÁ, Umbarila ALT, Romero ILT, Alfonso YCR, Lovato Silva R, Calle J, Díaz -Viscensini CM, Frutos VNB, Laguardia EV, Padilla H, Ciganda A, Colomar M. Maternal mortality linked to COVID-19 in Latin America: Results from a multi-country collaborative database of 447 deaths. LANCET REGIONAL HEALTH. AMERICAS 2022; 12:100269. [PMID: 35539820 PMCID: PMC9073212 DOI: 10.1016/j.lana.2022.100269] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Background This study aimed to describe the clinical characteristics of maternal deaths associated with COVID-19 registered in a collaborative Latin-American multi-country database. Methods This was an observational study implemented from March 1st 2020 to November 29th 2021 in eight Latin American countries. Information was based on the Perinatal Information System from the Latin American Center for Perinatology, Women and Reproductive Health. We summarized categorical variables as frequencies and percentages and continuous variables into median with interquartile ranges. Findings We identified a total of 447 deaths. The median maternal age was 31 years. 86·4% of women were infected antepartum, with most of the cases (60·3%) detected in the third trimester of pregnancy. The most frequent symptoms at first consultation and admission were dyspnea (73·0%), fever (69·0%), and cough (59·0%). Organ dysfunction was reported in 90·4% of women during admission. A total of 64·8% women were admitted to critical care for a median length of eight days. In most cases, the death occurred during the puerperium, with a median of seven days between delivery and death. Preterm delivery was the most common perinatal complication (76·9%) and 59·9% were low birth weight. Interpretation This study describes the characteristics of maternal deaths in a comprehensive multi-country database in Latin America during the COVID-19 pandemic. Barriers faced by Latin American pregnant women to access intensive care services when required were also revealed. Decision-makers should strengthen severity awareness, and referral strategies to avoid potential delays. Funding Latin American Center for Perinatology, Women and Reproductive Health.
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Affiliation(s)
- Fabian Maza-Arnedo
- Grupo de Investigación en Cuidados Intensivos y Obstetricia (GRICIO), Universidad de Cartagena, Colombia
| | | | - Claudio G. Sosa
- Latin American Center for Perinatology, Women's Health, and Reproductive Health (CLAP/WR), Montevideo, Uruguay
| | - Bremen de Mucio
- Latin American Center for Perinatology, Women's Health, and Reproductive Health (CLAP/WR), Montevideo, Uruguay
| | - José Rojas-Suarez
- Grupo de Investigación en Cuidados Intensivos y Obstetricia (GRICIO), Universidad de Cartagena, Colombia,Corporación Universitaria Rafael Núñez, Cartagena, Colombia
| | - Lale Say
- Department of Sexual and Reproductive Health and Research, UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - Jenny A. Cresswell
- Department of Sexual and Reproductive Health and Research, UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - Luis Andrés de Francisco
- Family, Health Promotion and Life Course (FPL), Pan American Health Organization-World Health Organization, United States
| | - Suzanne Serruya
- Latin American Center for Perinatology, Women's Health, and Reproductive Health (CLAP/WR), Montevideo, Uruguay
| | | | | | - Erika Saint Hilaire
- San Lorenzo de Los Mina Children Maternity Hospital, Santo Domingo, Dominican Republic
| | - César V. Munayco
- National Epidemiology, Prevention, and Disease Control Center, Ministry of Health, Perú
| | - Fabiola Gil
- National Epidemiology, Prevention, and Disease Control Center, Ministry of Health, Perú
| | | | | | - Allan Stefan
- Dr Leonardo Martínez Valenzuela Hospital, San Pedro Sula, Honduras
| | | | | | | | | | - Gustavo Mery
- Family, Promotion and Life Course, PAHO Representation, Costa Rica
| | | | | | | | | | | | - Jakeline Calle
- Ministry of Public Health and Welfare, Asunción, Paraguay
| | | | | | | | | | - Alvaro Ciganda
- Clinical and Research Unit (UNICEM), Montevideo, Uruguay
| | - Mercedes Colomar
- Latin American Center for Perinatology, Women's Health, and Reproductive Health (CLAP/WR), Montevideo, Uruguay,Clinical and Research Unit (UNICEM), Montevideo, Uruguay,Corresponding author at: Latin American Center for Perinatology, Women's Health, and Reproductive Health (CLAP/WR), Montevideo, Uruguay.
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12
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Vera von Bargen H, Espinosa Serrano M, Martin Navarrete D, Ahumada Droguett P, Méndez Benavente C, Flores Castillo M, Ramírez González N, Ulloa Contador G, López Aceiton M. Analysis of prevalence and sociodemographic conditions among women in labor with and without COVID-19 in public hospitals in Chile. J Perinat Med 2022; 50:132-138. [PMID: 34881550 DOI: 10.1515/jpm-2021-0286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 11/11/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVES The SARS-CoV-2 virus continues wreaking worldwide havoc on health and between March and August 2020, the first outbreak of COVID-19 hit Chile. The pregnant population is especially vulnerable to infection. Studies have been published that associate socioeconomic status, overcrowding, and poverty with a higher prevalence of SARS-CoV-2 infection. There are few studies about the development of this pandemic in Latin American countries so far. This study seeks to show the prevalence and sociodemographic and perinatal characteristics in pregnant women at the time of delivery, comparing both groups with positive and negative COVID-19 PCR results. METHODS A prospective, cross-sectional study of pregnant women who delivered at the San Juan de Dios Hospital in Santiago between April 15, 2020 and June 15, 2020. Analysis of epidemiological, sociodemographic, obstetric, perinatal and sociodemographic data of patients with positive and negative COVID-19 PCR results. RESULTS There were 701 patients included in the study. The prevalence of those with a positive COVID-19 PCR was 9.7% and 67.7% being asymptomatic. Pre-term delivery was significantly higher in the group of positive patients (23.5%) vs. negative patients (8.7%), which was not the same rate as with cesarean sections (C-sections). A 13.2% of patients required management of the pathology in the Critical Care Unit (CCU) and there were no cases of maternal or fetal deaths. We found no significant difference between both groups when analyzing socioeconomic variables, though we noted a trend of greater overcrowding among the group of patients with infection. CONCLUSIONS The majority of pregnant patients with SARS-CoV-2 infection are asymptomatic. COVID-19 increases the rate of premature births, but this rate is not same with C-sections. Sociodemographic conditions and overcrowding do not show a higher infection rate in a homogeneous population in relation to the economic, social and demographic level.
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Affiliation(s)
| | - María Espinosa Serrano
- Gynecolgy and Obstetrics Physician, San Juan de Dios Hospital, Santiago, Chile.,Obstetrics and Gynecology Program Scholarship, San Juan de Dios Hospital, Universidad de Chile, Santiago, Chile
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13
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Gandhi AP, Thakur JS, Gupta M, Kathirvel S, Goel K, Singh T. COVID-19 vaccination uptake and adverse events following COVID-19 immunization in pregnant women in Northern India: a prospective, comparative, cohort study. J Rural Med 2022; 17:228-235. [DOI: 10.2185/jrm.2022-025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 06/24/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Aravind P. Gandhi
- Department of Community Medicine & School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - JS Thakur
- Department of Community Medicine & School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Madhu Gupta
- Department of Community Medicine & School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Soundappan Kathirvel
- Department of Community Medicine & School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Kapil Goel
- Department of Community Medicine & School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Tarundeep Singh
- Department of Community Medicine & School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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14
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Malik S, Jain D, Bokade CM, Savaskar S, Deshmukh LS, Wade P, Madhura AD, Suryawanshi M, Bandichhode ST, Bodhgire SB, Zala S, Mahale SD, Modi DN, Waghmare R, Surve SV, Gajbhiye RK. Outcomes in neonates born to mothers with COVID-19 during the second wave in India. Eur J Pediatr 2022; 181:3537-3543. [PMID: 35802208 PMCID: PMC9263042 DOI: 10.1007/s00431-022-04546-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 06/20/2022] [Accepted: 06/23/2022] [Indexed: 11/30/2022]
Abstract
UNLABELLED COVID-19 pandemic has affected all age groups globally including pregnant women and their neonates. The aim of the study was to understand outcomes in neonates of mothers with COVID-19 during the first and second waves of COVID-19 pandemic. A retrospective analysis of 2524 neonates born to SARS-CoV-2-infected mothers was conducted during the first wave (n = 1782) and second wave (n = 742) of the COVID-19 pandemic at five study sites of the PregCovid registry in Maharashtra, India. A significant difference was noted in preterm birth, which was higher in the second wave (15.0%, 111/742) compared to the first wave (7.8%, 139/1782) (P < 0.001). The proportion of neonates requiring NICU admission was significantly higher in the second wave (19.0%, 141/742) as compared to that in the first wave (14.8%, 264/1782) (P < 0.05). On comparing regional differences, significantly higher neonatal complications were reported from Mumbai metropolitan region (P < 0.05). During the second wave of COVID-19, birth asphyxia and prematurity were 3.8- and 2.1-fold higher respectively (P < 0.001). Neonatal resuscitation at birth was significantly higher in second wave (3.4%, 25/742 vs 1.8%, 32/1782) (P < 0.05). The prevalence of SARS-CoV-2 infection in neonates was comparable (4.2% vs 4.6%) with no significant difference between the two waves. CONCLUSION Higher incidence of adverse outcomes in neonates born to SARS-CoV-2-infected mothers in the second wave of COVID-19 as compared to the first wave. TRIAL REGISTRATION PregCovid study is registered with the Clinical Trial Registry of India (CTRI/2020/05/025423, Registered on 28/05/2020). WHAT IS KNOWN • The second wave of COVID-19 was more lethal to pregnant women than the first wave. Newborns are at risk of developing complications. WHAT IS NEW • Birth asphyxia, prematurity, and neonatal resuscitation at birth were significantly higher in the second wave as compared to those in the first wave of the COVID-19 pandemic in India.
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Affiliation(s)
- Sushma Malik
- Department of Paediartrics, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, Maharashtra India
| | - Dipty Jain
- Department of Paediartrics, Government Medical College, Nagpur, Maharashtra India
| | - Chandrakant M. Bokade
- Department of Paediartrics, Indira Gandhi Government Medical College, Nagpur, Maharashtra India
| | - Shakira Savaskar
- Department of Paediartrics, Dr Vaishampayan Memorial Government Medical College, Solapur, Maharashtra India
| | - Laxmikant S. Deshmukh
- Department of Paediatrics, Government Medical College, Aurangabad, Maharashtra India
| | - Poonam Wade
- Department of Paediartrics, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, Maharashtra India
| | - Abhishek D. Madhura
- Department of Paediartrics, Government Medical College, Nagpur, Maharashtra India
| | - Milind Suryawanshi
- Department of Paediartrics, Indira Gandhi Government Medical College, Nagpur, Maharashtra India
| | - Sachin T. Bandichhode
- Department of Paediartrics, Dr Vaishampayan Memorial Government Medical College, Solapur, Maharashtra India
| | - Sachin B. Bodhgire
- Department of Paediatrics, Government Medical College, Aurangabad, Maharashtra India
| | - Sarika Zala
- Clinical Research Lab, ICMR-National Institute for Research in Reproductive and Child Health, Parel, Mumbai, India
| | - Smita D. Mahale
- Emeritus Scientist, ICMR-National Institute for Research in Reproductive and Child Health, Parel, Mumbai India
| | - Deepak N. Modi
- Molecular and Cellular Biology Laboratory, ICMR-National Institute for Research in Reproductive and Child Health, Parel, Mumbai India
| | - Rakesh Waghmare
- Medical Education and Drugs Department, Government of Maharashtra, Mumbai, India.
| | - Suchitra V. Surve
- Child Health Research Department, ICMR-National Institute for Research in Reproductive and Child Health, Maharashtra Parel, Mumbai, India
| | - Rahul K. Gajbhiye
- Clinical Research Lab, ICMR-National Institute for Research in Reproductive and Child Health, Parel, Mumbai, India
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