Birthing Experience and Perinatal Outcomes with COVID-19: A Prospective Study

Abstract

Aim: To study childbirth experience of women with coronavirus disease-2019 (COVID-19) at our institute and to assess clinical characteristics, maternal, and perinatal outcomes of SARS-CoV-2-positive pregnancies. Materials and methods:We conducted a prospective cohort study of all SARS-CoV-2-positive women who delivered at our institute from 1 September 2020 to 31 March 2021. The data was collected from labor room birth register, electronic medical record (EMR), and feedback questionnaire, Kerala Institute of Medical Sciences-Childbirth Experience Questionnaire (KIMS-CEQ), filled by women to express their childbirth experience.Results: Of the 50 women we studied, 84% were asymptomatic. In contrast to the majority of the studies published till now, preterm labor in our study was noted only in 12% cases. In our study, 62% delivered vaginally and cesarean section (CS) rate was 38%. All cesarean deliveries were done only for obstetric or fetal indications. A total of 6% women had minor peripartum complications. Majority of the neonates had normal appearance, pulse, grimace, activity, and respiration (APGAR) scores, and all were COVID-19 screen negative; 12% required neonatal intensive care unit (NICU) admission; 84% women opted to breastfeed their babies (direct breastfeeding or expressed breast milk) maintaining all precautions and hygiene they were taught; 88% women experienced positive childbirth experience based on KIMS-CEQ score. Conclusion:In our study, the pregnancy complications including the pre-term labor and severity of COVID-19 are not found to be above those in screen negative pregnant women nor any case of vertical transmission of SARS-CoV-19 reported. Our study is unique as it also assesses the birthing experience in women with COVID-19 which shows that most of them had a positive birth experience at our institute. The COVID-19 status should not deprive any women of her childbirth rights, although more precautions are warranted. Clinical significance: A positive or negative childbirth experience can have far-reaching consequences in life of a woman and the newborn. It is the need of the hour to address the important issue of positive birth experience, especially during the era of ongoing COVID-19 pandemic. The KIMS-CEQ provides an efficient tool to assess birthing experience of women with COVID-19.