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Aim. To identify confounding factors, features of the clinical course and outcomes of COVID-19 in pregnant and non-pregnant patients of early reproductive age who have no known risk factors and premorbid background. Materials and methods. The study included 163 pregnant women in the third trimester of gestation, 100 non-pregnant women with laboratory-confirmed SARS-CoV-2 infection and 100 pregnant women who did not get sick. Patients of all groups were comparable in age (1835 years), social status, parity, body mass index, had no known risk factors for COVID-19; those who got sick were treated simultaneously. Results. Statistically significant associations were revealed between COVID-19 infection in the pregnant and iron deficiency anemia, vegetovascular dystonia, belonging to the Buryat ethnicity, and smoking. Pregnant women with COVID-19 were more likely to have no symptoms (23.3% vs 5%; p0.001) or had a mild course of the disease (58.9% vs 24%; p0.001). In non-pregnant patients, the course of infection was more often moderate (61% vs 14.7%; p0.001) or severe (10% vs 3.1%; p=0.038). Clinical manifestations of new coronavirus infection (NCV) in pregnant women were dominated by anosmia (87.7% vs 40%; p0.001), drowsiness (68.7% vs 17%; p0.001), dyspnea, even with a mild lung lesion (68.1% vs 19%; p0.001), headache (41.7% vs 24%; p=0.006), arthralgia (29.4% vs 16%; p=0.021), while fever above 38 C (7.4% vs 28%; p0.001) and cough (38.7% vs 61%; p0.001) were much less common. With computed tomography, pneumonia in pregnant women was diagnosed several times less often (21.4% vs 87.4%; p0.001). In the non-pregnant group, there was one death (1% vs 0%; p=0.201) associated with late hospitalization for severe NCI with grade 4 pulmonary involvement as shown on computed tomography. Conclusion. Confounders of COVID-19 in pregnant women who have no known risk factors in the third trimester of gestation are iron deficiency anemia, vegetovascular dystonia, belonging to the Buryat subpopulation, and smoking. In pregnant women, the main clinical symptoms of SARS-CoV-2 infection, with the exception of loss of smell, were nonspecific and characteristic of the physiological course of late gestation: drowsiness, dyspnea, joint pain. The predominance of mild or asymptomatic forms of infection, the lower incidence of pneumonia, and the absence of deaths in pregnant women suggests a more favorable course of COVID-19 NCI.

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Aim. To assess the incidence, clinical course, outcomes of a novel coronavirus infection (NKI) COVID-19 for mother and child in the population of pregnant women in the Far Eastern (FEFD) and Siberian Federal Districts (SFD). Materials and methods. The study design: a population-based epidemiological prospective study. We analyzed operative information on NKI COVID-19 incidence and features of clinical course in pregnant women, women in labor and parturient women as well as maternal and perinatal outcomes for March 11 to December 25, 2020 which were provided by the FEFD and SFD chief obstetricians-gynecologists. Mathematical analysis included methods of descriptive statistics, analysis of contingency table, where the value of 2, the achieved level of significance (p) was estimated. Results. In the FEFD and SFD, over the COVID-19 2020 epidemic, the SARS-CoV-2 virus was revealed in 8485 pregnant women, women in labor and postpartum women (5.9% of pregnant women subjected to regular medical check-up; 1.71% of the sick entire population). The incidence rate in pregnant women was 3.0 times higher than in the entire population: 5933,2 vs 1960,8 per 100 thousand (p0.001). Among SARS-CoV-2 infected patients, 27.4% (2324) were asymptomatic, 52.7% (4471) have mild, 16.6% (1388) moderate, 2.5% (210) severe 0,5% (39) extremely severe clinical course. In the intensive care and anesthesiology departments, 3.57% of pregnant women and 2.24% of the entire population (p0.001) have been treated. Rate of using invasive artificial lung ventilation in pregnant women was lower than in the population: 0.48% vs 1.05% (p0.001). 27.97% (2373) of women with confirmed NKI COVID-19 completed pregnancy. 81,7% of mothers delivered on time, 18.3% prematurely. Cesarean delivery was performed in 42,0% of women, operative vaginal delivery (vacuum extraction, obstetric forceps) was registered in 0.2% of cases. 12 (0.14%) mothers died. The maternal mortality rate was 505.69 per 100 thousand live births (0.51% of patients with COVID-19 who gave birth). Mortality rates and the proportion of deaths in the entire population were statistically significantly higher: 1948.93 per 100 thousand sick population and 1.95% (p0.001), respectively. 37 (1.56%) cases of perinatal losses were registered, of which 31 (1.30%) stillbirths, 6 (0.26%) early neonatal mortality. The SARS-CoV-2 virus was revealed in 148 (6.2%) newborns with the observance of anti-epidemic measures and separation of the mother and child immediately after delivery. Conclusion. The rate of revealing SARS-CoV-2 virus in pregnant women, women in labor and parturient women in Siberia and the Far East was 3.0 times higher than in the entire population, while clinical course of infectious process was less severe (less need for invasive mechanical ventilation, lower mortality rate). In mothers with COVID-19, preterm birth rate was 3.0 times higher, caesarean delivery rate 1.4 times higher compared with the average population indicators. Reveling SARS-CoV-2 virus RNA in 6.2% of newborns suggests the possibility of vertical transmission of the infection.