Maternal risk factors of COVID-19-affected pregnancies: A comparative analysis of symptomatic and asymptomatic COVID-19 from the Q-PRECIOUS registry

Abstract

Background: The novel coronavirus disease 2019 (COVID-19) pandemic has had consequences on the pregnant population, as disease severity is associated with the quality of maternal health and pregnancy complications, increasing maternal and neonatal morbidity. Worldwide descriptive data help describe risk factors that could predict symptomatic and severe COVID-19 in pregnancy. Objectives: To describe demographic features and risk factors of pregnant women with COVID-19 in Qatar and compare symptomatic versus asymptomatic disease. Study design and methodology: Clinical characteristics and risk factors of pregnant women with COVID-19 in Qatar from March 2020 to March 2021 was retrospectively reviewed, comparing the cohort with the general pregnant population. Crude and adjusted odds ratios (aORs) were computed, comparing symptomatic versus asymptomatic infection. Results: Of the 500 women, 347 reported at least one symptom at diagnosis (347/500; 69.4%). The majority fell in the 30–39 years age group (241/500; 48%), with more than half in the obese body mass index (BMI) category. The cohort was 66% (332/500) Qatari women, compared with the 26% expected in the population (26.4% vs 66.4% p < 0.001). Compared with the 2019 national statistics, the number of women was higher in the >40 years age group (5% vs 7.6%, p = 0.027) and grand multiparous group (5.4% vs 13.6%, p < 0.001). The symptom most commonly reported by the symptomatic group was cough (276/500; 55%), followed by fever, fatigue, and myalgia. In the adjusted analysis, the symptomatic group had 2.7 times higher odds of being asthmatic (OR = 2.67, 95% CI 1.1–6.7, p = 0.037). Women aged >40 years had 6.6 times higher odds of symptomatic disease (aOR = 6.6, 95% CI 1.08–39.73, p = 0.041). A history of contact with a patient with symptomatic COVID and earlier gestational age at diagnosis increased the odds (aOR = 2.06, 95% CI 1.2–3.54, p = 0.009; aOR = 0.73 95% CI 0.57–0.96; p = 0.017). Conclusions: This study cohort included significantly more Qatari women, older women, grand multiparous women, a higher proportion with pre-existing and gestational diabetes, and higher BMI than national data. In addition, contact to a patient with symptomatic disease, history of asthma, older age, and earlier gestational age at diagnosis were significantly associated with symptomatic disease.

Low Interferon-γ Levels in Cord and Peripheral Blood of Pregnant Women Infected with SARS-CoV-2

“…Regarding neonatal outcomes, regarding neonatal length, birthweight, head circumference and Apgar score, we observed no significant differences between cases and controls. These findings are consistent with the literature, particularly in reference to the alpha variant of SARS-CoV-2 [ 42 , 43 , 44 ]. There are differences in the response of the immune system (in the mother and fetus) and symptoms among SARS-CoV-2 variants [ 45 , 46 ].…”

A Literature Review of Advanced Maternal Age in Pregnant Women with COVID-19

“…On the contrary, out of 12 articles in this study, two stated the higher portion of COVID-19 cases in pregnancy was in the AMA group (Babic et al, 2022;Minisha et al, 2022). This might be explained by social factors, such as the likelihood that older women will encounter sick older relatives and children who are left in their care at home (Minisha et al, 2022). Despite the fact that COVID-19 had a lower percentage of AMA cases, the mortality and morbidity risks were higher compared with the younger aged pregnant women.…”

“…Another study in Cameroon reported 64% of pregnant women with COVID-19 were 25-35 years old (Dingom et al, 2020). On the contrary, out of 12 articles in this study, two stated the higher portion of COVID-19 cases in pregnancy was in the AMA group (Babic et al, 2022;Minisha et al, 2022). This might be explained by social factors, such as the likelihood that older women will encounter sick older relatives and children who are left in their care at home (Minisha et al, 2022).…”

COVID-19, Pregnancy, and Diabetes Mellitus

“…The evaluation of the registries, in turn, is the basis for developing guidelines, which must be dynamically adapted to new findings over the course of time. Some important registries are listed in ▶Table 3 [92][93][94][95][96][97][98][99][100][101][102][103].…”