Maternal and Neonatal Outcomes of COVID-19 in Pregnancy: A Single-Centre Observational Study

Singh, Vinita; Choudhary, Anisha; Datta, Mamta R; Ray, Alokananda

doi:10.7759/cureus.13184

Cited by 30 publications

(55 citation statements)

References 24 publications

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“…Delivery via cesarean section but not breast feeding was associated with an increased risk of neonatal transmission [ 62 ]. Similar results are also provided from other smaller cohort studies performed in different populations worldwide, including cohorts in Spain, Turkey, India, and Iran [ 63 , 64 , 65 , 66 ]. These recently published data demonstrate that in comparison to the general pregnant population, COVID-19 infected pregnant women present with increased risk of adverse maternal, neonatal, and perinatal outcomes, highlighting the need for careful monitoring of pregnancies implicating COVID-19.…”

Section: Complications Of Covid-19 Reported In Pregnancysupporting

confidence: 86%

The Current Evidence Regarding COVID-19 and Pregnancy: Where Are We Now and Where Should We Head to Next?

Kalampokas

Rapani

Παπαγεωργίου

et al. 2021

Viruses

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Despite the volume of publications dedicated to unraveling the biological characteristics and clinical manifestations of SARS-CoV-2, available data on pregnant patients are limited. In the current review of literature, we present an overview on the developmental course, complications, and adverse effects of COVID-19 on pregnancy. A comprehensive review of the literature was performed in PubMed/Medline, Embase, and Cochrane Central databases up to June 2021. This article collectively presents what has been so far reported on the identified critical aspects, namely complications during pregnancy, delivery challenges, neonatal health care, potential routes of viral transmission, including vertical transmission or breastfeeding, along with the risks involved in the vaccination strategy during pregnancy. Despite the fact that we are still largely navigating uncharted territory, the observed publication explosion in the field is unprecedented. The overwhelming need for data is undoubtable, and this serves as the driver for the plethora of publications witnessed. Nonetheless, the quality of data sourced is variable. In the midst of the frenzy for reporting on SARS-CoV-2 data, monitoring this informational overload is where we should head to next, considering that poor quality research may in fact hamper our attempts to prevail against this unparalleled pandemic outbreak.

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Section: Complications Of Covid-19 Reported In Pregnancysupporting

confidence: 86%

The Current Evidence Regarding COVID-19 and Pregnancy: Where Are We Now and Where Should We Head to Next?

Kalampokas

Rapani

Παπαγεωργίου

et al. 2021

Viruses

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“…Similarly, high rates of cesarean delivery, around 50% and above, have been described in both high-income countries and LMICs in many large studies of women admitted with SAR-CoV-2 infection. 9,[12][13][14] Of concern is the high mortality rate in the present cohort, in particular among those admitted primarily due to clinical SARS-CoV-2 illness. Mortality rates in the present cohort are higher than those identified in the UKOSS study, 12 which was based on the same protocol and focused on hospitalized women but predominantly in a high-income setting.…”

Section: Discussionmentioning

confidence: 91%

Maternal characteristics and pregnancy outcomes of hospitalized pregnant women with SARS‐CoV‐2 infection in South Africa: An International Network of Obstetric Survey Systems‐based cohort study

Budhram

Vannevel

Botha

et al. 2021

Intl J Gynecology & Obste

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Objective: To describe risk factors and outcomes of pregnant women infected with SARS-CoV-2 admitted to South African healthcare facilities. Methods:A population-based cohort study was conducted utilizing an amended International Obstetric Surveillance System protocol. Data on pregnant women with SARS-CoV-2 infection, hospitalized between April 14, 2020, and November 24, 2020, were analyzed.Results: A total of 36 hospitals submitted data on 673 infected hospitalized pregnant women; 217 (32.2%) were admitted for COVID-19 illness and 456 for other indications. There were 39 deaths with a case fatality rate of 6.3%: 32 (14.7%) deaths occurred in women admitted for COVID-19 illness compared to 7 (1.8%) in women admitted for other indications. Of the women, 106 (15.9%) required critical care.Maternal tuberculosis, but not HIV co-infection or other co-morbidities, was associated with admission for COVID-19 illness. Rates of cesarean delivery did not differ significantly between women admitted for COVID-19 and those admitted for other indications. There were 179 (35.4%) preterm births, 25 (4.7%) stillbirths, 12 (2.3%) neonatal deaths, and 162 (30.8%) neonatal admissions. Neonatal outcomes did not differ significantly from those of infected women admitted for other indications. Conclusion:The maternal mortality rate was high among women admitted with SARS-CoV-2 infection and higher in women admitted primarily for COVID-19 illness with tuberculosis being the only co-morbidity associated with admission.

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“…Recent studies analyzing various biological samples did not detect SARS-CoV-2 in either amniotic fluid or umbilical cord [ 26 , 32 , 33 ]. Among 179 newborns, SARS-CoV-2 was identified in the nasopharyngeal swabs of six neonates in the literature [ 29 , 32 , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] ]. It was assumed that transmission may have occurred after birth after inhalation of droplets by contaminated mothers or healthcare workers.…”

Section: Discussionmentioning

confidence: 99%

Placental deficiency during maternal SARS-CoV-2 infection

et al. 2022

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Introduction Maternal anti-SARS-CoV-2 Spike antibodies can cross the placenta during pregnancy, and neonates born to infected mothers have acquired antibodies at birth. Few studies reported data on the histopathological changes of the placenta during infection and placental infection. SARS-CoV-2 infection may cause impaired development of the placenta, thus predisposing maternal and fetal unfavorable outcomes. The prospective study aims to evaluate the risk of vertical transmission of SARS-CoV-2 and placental passage of anti-Spike antibodies as well as the impact of clinical severity on placental structures. Methods This is a prospective cohort study on 30 pregnant women infected by SARS-CoV-2 with their neonates. The demographic features and pregnancy outcomes were collected. Gross and microscopic examinations of the placentas were done. Maternal and umbilical cord sera were obtained at the time of delivery. Nasopharyngeal swabs were collected from neonates immediately after birth. Results The concentrations of total anti-SARS-CoV-2 Spike antibodies were higher in pregnant women with moderate to severe/critical disease. The maternal total anti-SARS-CoV-2 Spike levels were correlated with those of neonatal levels. The rate of placental abnormalities is high in the mothers with severe disease, and those with positive anti-SARS-CoV-2 IgM. All neonates had negative nasopharyngeal swabs for SARS- CoV-2 infections and all placentas were negative in immunohistochemical staining for Spike protein. Discussion The maternally derived anti-SARS-CoV-2 Spike antibody can transmit to neonates born to infected mothers regardless of gestational age. Our results indicated that the disease severity is associated with ischemic placental pathology which may result in adverse pregnancy outcomes.

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Maternal and Neonatal Outcomes of COVID-19 in Pregnancy: A Single-Centre Observational Study

Cited by 30 publications

References 24 publications

The Current Evidence Regarding COVID-19 and Pregnancy: Where Are We Now and Where Should We Head to Next?

The Current Evidence Regarding COVID-19 and Pregnancy: Where Are We Now and Where Should We Head to Next?

Maternal characteristics and pregnancy outcomes of hospitalized pregnant women with SARS‐CoV‐2 infection in South Africa: An International Network of Obstetric Survey Systems‐based cohort study

Placental deficiency during maternal SARS-CoV-2 infection

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