Increased risk of early-onset preeclampsia in pregnant women with COVID-19

Mahajan, Niraj N.; Kesarwani, Shweta; Kumbhar, Padmaja; Kuppusamy, Periyasamy; Pophalkar, Madhura; Thamke, Pratiksha; Asawa, Ruchi; Sharan, Saumya; Mahale, Smita D.; Gajbhiye, Rahul

doi:10.1080/10641955.2023.2187630

Cited by 8 publications

(4 citation statements)

References 15 publications

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“…An observational study (sample size = 68, number of cases = 15) suggested that approximately half of pre-eclampsia-like syndrome cases may be misdiagnosed as preeclampsia (76). However, constrained by the laboratory and ultrasonographic examinations required to differentiate these two pathologies, most observational studies, including the FinnGenn project, did not distinguish between PE-like syndrome and PE syndrome (22,77,78). Hence, the results regarding the association between critical COVID-19 illness and pre-eclampsia in this study may be impacted.…”

Section: Discussionmentioning

confidence: 79%

Mendelian randomization supports genetic liability to hospitalization for COVID-19 as a risk factor of pre-eclampsia

Wu,

Zhang,

Qiao

et al. 2024

Front. Cardiovasc. Med.

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BackgroundPre-eclampsia and eclampsia are among the major threats to pregnant women and fetuses, but they can be mitigated by prevention and early screening. Existing observational research presents conflicting evidence regarding the causal effects of coronavirus disease 2019 (COVID-19) on pre-eclampsia risk. Through Mendelian randomization (MR), this study aims to investigate the causal effect of three COVID-19 severity phenotypes on the risk of pre-eclampsia and eclampsia to provide more rigorous evidence.MethodsTwo-sample MR was utilized to examine causal effects. Summary-level data from genome-wide association studies (GWAS) of individuals of European ancestry were acquired from the GWAS catalog and FinnGen databases. Single-nucleotide polymorphisms associated with COVID-19 traits at p < 5 × −8 were obtained and pruned for linkage disequilibrium to generate instrumental variables for COVID-19. Inverse variance weighted estimates were used as the primary MR results, with weighted median and MR-Egger as auxiliary analyses. The robustness of the MR findings was also evaluated through sensitivity analyses. Bonferroni correction was applied to primary results, with a p < 0.0083 considered significant evidence and a p within 0.083–0.05 considered suggestive evidence.ResultsCritical ill COVID-19 [defined as hospitalization for COVID-19 with either a death outcome or respiratory support, OR (95% CI): 1.17 (1.03–1.33), p = 0.020] and hospitalized COVID-19 [defined as hospitalization for COVID-19, OR (95% CI): 1.10 (1.01–1.19), p = 0.026] demonstrated suggestive causal effects on pre-eclampsia, while general severe acute respiratory syndrome coronavirus 2 infection did not exhibit a significant causal effect on pre-eclampsia. None of the three COVID-19 severity phenotypes exhibited a significant causal effect on eclampsia.ConclusionsOur investigation demonstrates a suggestive causal effect of genetic susceptibility to critical ill COVID-19 and hospitalized COVID-19 on pre-eclampsia. The COVID-19 severity exhibited a suggestive positive dose–response relationship with the risk of pre-eclampsia. Augmented attention should be paid to pregnant women hospitalized for COVID-19, especially those needing respiratory support.

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Section: Discussionmentioning

confidence: 79%

Mendelian randomization supports genetic liability to hospitalization for COVID-19 as a risk factor of pre-eclampsia

Wu,

Zhang,

Qiao

et al. 2024

Front. Cardiovasc. Med.

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“…Specifically, early-onset preeclampsia (before 34 weeks of gestation) has been associated with symptomatic COV-ID-19. 8 The association between nirmatrelvirritonavir use and antepartum diagnosis of preeclampsia may have been due to a difference in symptoms between the two groups and merits further study.…”

Section: Discussionmentioning

confidence: 99%

“…Specifically, early-onset preeclampsia (before 34 weeks of gestation) has been associated with symptomatic COVID-19. 8 The association between nirmatrelvir–ritonavir use and antepartum diagnosis of preeclampsia may have been due to a difference in symptoms between the two groups and merits further study. Given no clear safety signals, this preliminary report can be used to reassure both clinicians and pregnant individuals who would like to use nirmatrelvir–ritonavir for treatment of COVID-19 until larger studies become available.…”

Section: Discussionmentioning

confidence: 99%

Oral Nirmatrelvir–Ritonavir Use and Clinical Outcomes in Pregnant Patients With Coronavirus Disease 2019 (COVID-19)

Toure,

Panakam,

Johns

et al. 2023

Obstetrics &Amp; Gynecology

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We conducted a retrospective cohort study of pregnant patients who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection by RNA polymerase chain reaction test or home test who were counseled about taking nirmatrelvir–ritonavir if they were within 5 days of symptom onset. Obstetric and coronavirus disease 2019 (COVID-19) outcomes were compared between patients who did and did not take the medication. Overall, 114 individuals took nirmatrelvir–ritonavir and 323 did not. The cohorts were comparable, including high rates of vaccination in both groups. Nirmatrelvir–ritonavir was well-tolerated, with no patients discontinuing medication due to side effects. There were no intensive care unit admissions in either group. Most obstetric and medical outcomes were similar between those taking and not taking nirmatrelvir–ritonavir. Patients taking nirmatrelvir–ritonavir had significantly higher rates of surgical site infection (3 [2.7%] vs 0 [0%], P=.02) and preeclampsia (11 [9.6%] vs 12 [3.7%], P=.02). Outcome event numbers were too small for multivariable modeling. These preliminary data may be reassuring to clinicians and patients who would like to use nirmatrelvir–ritonavir in pregnancy.

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“…In addition to focusing on the psychological wellbeing of pregnant women, it is also important to consider the broader spectrum of challenges they face, including physical health concerns and the need for social support during epidemics. Studies have demonstrated that epidemics like COVID-19 pose significant risks to the physical health of pregnant women, increasing the likelihood of complications such as preterm birth, preeclampsia, and gestational diabetes ( 10 , 11 ). Moreover, the impact of social distancing and healthcare system strain on the availability and quality of prenatal care further complicates these physical health challenges.…”

Section: Introductionmentioning

confidence: 99%

Understanding health education needs of pregnant women in China during public health emergencies: a qualitative study amidst the COVID-19 pandemic

Su,

Zhang,

Chen

et al. 2024

Front. Public Health

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BackgroundPublic health emergencies impose unique challenges on pregnant women, affecting their physiological, psychological, and social wellbeing. This study, focusing on the context of the corona virus disease in 2019 (COVID-19) pandemic in China, aims to comprehensively explore the experiences of pregnant women amidst diverse public health crises. Herein, we investigate the health education needs of pregnant Chinese women in regard to public health emergencies to provide a scientific foundation for the development of targeted health education strategies.ObjectiveThe study described in this article aims to explore the health education needs of pregnant Chinese women in the context of public health emergencies specifying the types of emergencies of pandemics and to provide a scientific basis for targeted health education interventions.MethodsThirteen pregnant women were purposively selected, and the rationale for this sample size lies in the qualitative nature of the study, seeking in-depth insights rather than generalizability. Data collection involved semi-structured interviews, and the Colaizzi, which is a structured qualitative technique used to extract, interpret, and organize significant statements from participant descriptions into themes, providing a comprehensive understanding of their lived experiences.ResultsThe analysis yielded six prominent themes encompassing the following areas: I. Personal protection and vaccine safety; II. Knowledge of maternal health; III. Knowledge of fetal health; IV. Knowledge of childbirth; V. Knowledge of postpartum recovery; and VI. Knowledge sources of health education for pregnant women and their expectations of healthcare providers. Theme I was analyzed with two sub-themes (needs for personal protection knowledge, vaccine safety knowledge needs); Theme II was analyzed with three sub-themes (nutrition and diet, exercise and rest, sexual life); Theme III was analyzed with three sub-themes (medications and hazardous substances, pregnancy check-ups, and fetal movement monitoring); Theme IV was analyzed with three sub-themes (family accompaniment, analgesia in childbirth, and choice of mode of delivery); Theme V was analyzed with one sub-theme (knowledge of postnatal recovery); Theme VI was analyzed with one sub-theme (expectations of Healthcare providers). Sub-themes within each main theme were identified, offering a nuanced understanding of the multifaceted challenges faced by pregnant women during public health emergencies. The interrelation between sub-themes and main themes contributes to a holistic portrayal of their experiences.ConclusionThe study emphasizes the need for healthcare professionals to tailor health education for pregnant women during emergencies, highlighting the role of the Internet in improving information dissemination. It recommends actionable strategies for effective health communication, ensuring these women receive comprehensive support through digital platforms for better health outcomes during public health crises.

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Increased risk of early-onset preeclampsia in pregnant women with COVID-19

Cited by 8 publications

References 15 publications

Mendelian randomization supports genetic liability to hospitalization for COVID-19 as a risk factor of pre-eclampsia

Mendelian randomization supports genetic liability to hospitalization for COVID-19 as a risk factor of pre-eclampsia

Oral Nirmatrelvir–Ritonavir Use and Clinical Outcomes in Pregnant Patients With Coronavirus Disease 2019 (COVID-19)

Understanding health education needs of pregnant women in China during public health emergencies: a qualitative study amidst the COVID-19 pandemic

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