Influence of SARS-CoV-2 acute respiratory viral disease on pregnancy and childbirth

Abstract

Acute Respiratory Viral Disease SARS - CoV2 - 19 is a new poorly understood disease with an unpredictable course. This article is devoted to the analysis of coronavirus disease and its impact on the condition of newborns.The objective: to identify and investigate the relationship between the detected and revealed SARS-CoV-2 disease and the course of pregnancy and childbirth, dependence on the term in which the diagnosis was established and the consequences of the disease on the course of pregnancy, childbirth and the condition of newborns; to investigate the frequency of detected complications during pregnancy and the peculiarities of the course of pregnancy with combined pathology.Materials and methods. We analyzed 57 stories of pregnancy and childbirth of women who were admitted to the Uzhgorod City Maternity Hospital in the period from May 2020 to January 2021 with a positive result of the SARS-CoV-2 PLR study.Results. Of 57 patients, pregnancy is ongoing in 18 women, and in 39 it has already ended. Of these, 17 (29.8%) women had vaginal physiological childbirth, 21 (36.8%) women had pathological course of labor, of which 16 (28%) patients underwent cesarean section. In general, 34 pregnant women (59.6%) were asymptomatic. A mild course of the disease was in 20 pregnant women (35%), and a severe course was in three patients (5.2%). As a result of 39 births, 41 children were born (two biochorial twins). Of these, 38 children were born alive (92.7%), stillborn - 4 (5.3%). 31 children were born on time (81.6%). The physiological course of the early neonatal period was observed in all full-term newborns. Perinatal loss was observed in three women at 23, 25 and 28 weeks.Conclusions. In children born of mothers with COVID-19, there was no increase in the frequency of the pathological course of the early neonatal period or detected signs of acute respiratory viral infection. It was also found that there is no clear correlation between the severity of the course of coronavirus infection and complications in pregnant women. So, with a relatively easy mile, even an asymptomatic course, threatening complications were observed, since premature detachment of a normally located placenta was evident, but there was no clear correlation between coronavirus, while with a moderate course of pregnancy, we observed a fairly good result of delivery. The sample of patients is very small and does not allow us to draw definitive conclusions about the effect of coronavirus on pregnancy and fetal health. But these data give us the basis for the next studies on the influence of the new SARS-CoV-2 virus on the course of the gestational process, childbirth and the condition of newborns.

Clinical and laboratory characteristics of COVID-19 in pregnant women

“…It was only after 5-7 days that signs of a severe course of the disease appeared. In the group with a severe COVID-19 coronavirus disease, the percentage of pregnant women with concomitant somatic and prenatal pathology was higher than in the group with a mild course of the disease [20][21][22][23][24].…”

“…The progression of COVID-19 and the occurrence of various complications and consequences are attributed to a complex interplay of immunopathological and inflammatory reactions, cytokine cascades, endothelial dysfunction, and coagulation disorders, all of which are associated with the underlying coronavirus infection [10,[23][24][25][26]. Consequently, there is considerable interest among researchers to identify early predictors of disease severity, particularly in pregnant women.…”

Determinants of perinatal medical care at the ambulatory level in the conditions of the COVID-19 pandemic

“…Pregnant women and their newborns need special attention due to the increased risk of adverse consequences [5][6][7]. According to various reports, the prevalence of SARS-CoV-2 infection among pregnant women is 3-20%, with a wide spectrum of severity ranging from asymptomatic to extremely severe cases [8,9].…”