Impact of COVID-19 infection during pregnancy

Section: Originals

How to quote

Maroto Alonso V, Fuentes García P, Morillo Pareja M, Sanz Escribano B. Impacto de la infección por COVID-19 durante la gestación. Metas Enferm dic 2021/ene 2022; 24(10):7-14. Doi: https://doi.org/10.35667/MetasEnf.2021.24.1003081842

Authors

Virginia Maroto Alonso1, Paula Fuentes García2, Melodía Morillo Pareja3, Beatriz Sanz Escribano4

Position

1Matrona. Doctora en Cuidados de la Salud (Universidad Complutense de Madrid). Servicio de Obstetricia y Ginecología. Hospital Infanta Cristina. Parla (Madrid). Facultad de Enfermería. Universidad Antonio de Nebrija. Madrid2Matrona. Doctoranda (Universidad de Salamanca). Servicio de Obstetricia y Ginecología del Hospital Infanta Cristina (Parla). Servicio de Obstetricia y Ginecología del Hospital General Universitario Gregorio Marañón (Madrid). Universidad Alfonso X El Sabio. Madrid3Matrona. Servicio de Obstetricia y Ginecología. Hospital Infanta Cristina. Parla (Madrid)4Matrona. Consultora Internacional en Lactancia Materna. Servicio de Obstetricia y Ginecología. Hospital General Universitario Gregorio Marañón. Madrid

Contact address

Virginia Maroto Alonso. Servicio de Obstetricia y Ginecología. Hospital Infanta Cristina. Avenida 9 de Junio, 2. 28981 Parla (Madrid).

Contact email: vickyalo@hotmail.com

Abstract

Objective: to analyse the impact of the infection by SARS-CoV-2 in pregnant women, in terms of obstetric and perinatal consequences.
Method: a descriptive, longitudinal, observational and retrospective study conducted in the Hospital Infanta Cristina (Parla, Madrid) with pregnant women infected with COVID-19 during the second half of their pregnancy and/or labour, since the start of the pandemic in Spain in March until December 2020. The association between the need for hospital admission and sociodemographic, anthropometric and pregnancy variables was analysed with the Student’s T test, Mann Whitney U test, Pearson’s Chi Squared and Fisher’s Exact Test, with a p< 0.05 significance.
Results: the study included 46 women; 37% of them were Spanish, and their mean age was 31.3 years. The mean Body Mass Index (BMI) of the pregnant women was of 25.9 kg/m2, the majority were multiparous, and there was a predominance of asymptomatic pregnancies (54.23%) followed by symptoms such as cough and dyspnea (13%) and fever (13%). Four women required hospital admission, and one of them required Intensive Care. No significant differences were found according to hospital admission, although the gestational age at the time of delivery was lower among hospitalized women (38 vs. 39.5 weeks; p= 0.095) and their BMI was higher (29.7 vs. 25 kg/m2; p= 0.559). There were no perinatal deaths.
Conclusions: infection by COVID19 does not seem to have any impact on pregnancy evolution or perinatal survival, although further research is required.

Keywords:

coronavirus infections; coronavirus; infectious complications of pregnancy; second trimester of pregnancy; pregnancy; Obstetric delivery; perinatal mortality

Versión en Español

Título:

Impacto de la infección por COVID-19 durante la gestación

Artículo completo no disponible en este idioma / Full article is not available in this language

Bibliography

  1. Ministerio de Sanidad, Servicios Sociales e Igualdad de España I de SCI. Estrategia de detección precoz, vigilancia y control de COVID-19 [internet]. Madrid: MSSSI; 2020 [citado 3 nov 2021]. Disponible en: https://www.mscbs.gob.es/profesionales/saludPublica/ccayes/alertasActual/nCov/documentos/COVID19_Estrategia_vigilancia_y_control_e_indicadores.pdf
  2. Clínic Barcelona Hospital Universitari. Protocolo: Coronavirus (COVID-19) y gestación (V10- 5/8/2020) [internet]. 2020. [citado 3 nov 2020]. Disponible en: https://medicinafetalbarcelona.org/protocolos/es/patologia-materna-obstetrica/covid19-embarazo.pdf
  3. Qiao J. What are the risks of COVID-19 infection in pregnant women? Lancet. 2020 Mar 7; 395 (10226):760-2. Doi: http://doi.org/10.1016/S0140-6736(20)30365-2
  4. Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet. 2020 Mar 7; 395(10226):809-15. Doi: http://doi.org/10.1016/S0140-6736(20)30360-3. Epub 2020 Feb 12. Erratum in: Lancet. 2020 Mar 28; 395(10229):1038.
  5. Ellington S, Strid P, Tong VT, Woodworth K, Galang RR, Zambrano LD, et al. Characteristics of Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status- United States, January 22–June 7, 2020. MMWR Morb Mortal Wkly Rep 2020; 69:769-75. Doi: http://dx.doi.org/10.15585/mmwr.mm6925a1
  6. Badr DA, Mattern J, Carlin A, Cordier AG, Maillart E, El Hachem L, et al. Are clinical outcomes worse for pregnant women at ≥ 20 weeks’ gestation infected with coronavirus disease 2019? A multicenter case-control study with propensity score matching. Am J Obstet Gynecol. 2020 Nov; 223(5):764-8. Doi: http://doi.org/10.1016/j.ajog.2020.07.045
  7. Wang S, Guo L, Chen L, Liu W, Cao Y, Zhang J, et al. A Case Report of Neonatal 2019 Coronavirus Disease in China. Clin Infect Dis. 2020 Jul 28; 71(15):853-7. Doi: http://doi.org/10.1093/cid/ciaa225
  8. Dong L, Tian J, He S, Zhu C, Wang J, Liu C, et al. Possible Vertical Transmission of SARS-CoV-2 From an Infected Mother to Her Newborn. JAMA. 2020 May 12; 323(18):1846-8. Doi: http://doi.org/10.1001/jama.2020.4621
  9. Caparrós-González RA. Consecuencias maternas y neonatales de la infección por coronavirus COVID-19 durante el embarazo: una scoping review. Rev Esp Salud Publica. 2020 Abr 17; 94:e202004033.
  10. Diriba K, Awulachew E, Getu E. The effect of coronavirus infection (SARS-CoV-2, MERS-CoV, and SARS-CoV) during pregnancy and the possibility of vertical maternal-fetal transmission: a systematic review and meta-analysis. Eur J Med Res. 2020 Sep 4; 25(1):39. Doi: http://doi.org/10.1186/s40001-020-00439-w
  11. Ministerio de Sanidad. Manejo de la mujer embarazada y el recién nacido con COVID-19. Documento técnico [internet]. Madrid: Ministerio de Sanidad; 2020 [citado 3 nov 2020]. Disponible en: https://www.mscbs.gob.es/profesionales/saludPublica/ccayes/alertasActual/nCov/documentos/Documento_manejo_embarazo_recien_nacido.pdf
  12. Di Mascio D, Khalil A, Saccone G, Rizzo G, Buca D, Liberati M, et al. Outcome of coronavirus spectrum infections (SARS, MERS, COVID-19) during pregnancy: a systematic review and meta-analysis. Am J Obstet Gynecol MFM. 2020 May; 2(2):100107. Doi: http://doi.org/10.1016/j.ajogmf.2020.100107
  13. Mendoza M, García-Ruiz I, Maíz N, Rodo C, García-Manau P, Serrano B, et al. Pre-eclampsia-like syndrome induced by severe COVID-19: a prospective observational study. BJOG. 2020 Oct; 127(11):1374-80. Doi: http://doi.org/10.1111/1471-0528.16339
  14. Berghella V, Hughes B. Coronavirus disease 2019 (COVID-19): Pregnancy issues and antenatal care- UpToDate [internet] [citado 3 nov 2021]. Disponible en: https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19-pregnancy-issues-and-antenatal-care?search=Coronavirus%20disease%202019%20(COVID-19):%20Pregnancy%20issues%20and%20antenatal%20care&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
  15. Ministerio de Sanidad, Consumo y Bienestar Social. Profesionales - Situación actual Coronavirus [internet] [citado 3 nov 2021]. Disponible en: https://www.mscbs.gob.es/profesionales/saludPublica/ccayes/alertasActual/nCov/situacionActual.htm
  16. Ayuntamiento de Parla. Anuario demográfico 2018 [internet]. 2018 [citado 3 nov 2021]. Disponible en: https://www.ayuntamientoparla.es/ficheros/anuario-demografico-2018.pdf
  17. Afshar Y, Gaw SL, Flaherman VJ, Chambers BD, Krakow D, Berghella V, et al. Clinical Presentation of Coronavirus Disease 2019 (COVID-19) in Pregnant and Recently Pregnant People. Obstet Gynecol. 2020 Dic; 136(6):1117-25. Doi: http://doi.org/10.1097/AOG.0000000000004178
  18. Pineles BL, Alamo IC, Farooq N, Green J, Blackwell SC, Sibai BM, et al. Racial-ethnic disparities and pregnancy outcomes in SARS-CoV-2 infection in a universally-tested cohort in Houston, Texas. Eur J Obstet Gynecol Reprod Biol. 2020 Nov; 254:329-30. Doi: http://doi.org/10.1016/j.ejogrb.2020.09.012
  19. Allotey J, Stallings E, Bonet M, Yap M, Chatterjee S, Kew T, et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ. 2020; 370:m3320. Doi: http://doi.org/10.1136/bmj.m3320
  20. Sentilhes L, De Marcillac F, Jouffrieau C, Kuhn P, Thuet V, Hansmann Y, et al. Coronavirus disease 2019 in pregnancy was associated with maternal morbidity and preterm birth. Am J Obstet Gynecol. diciembre de 2020; 223(6):914.e1-914.e15.
  21. Hollier L. Coronavirus (COVID-19), Pregnancy, and Breastfeeding: A Message for Patients [internet]. ACOG [citado 3 nov 2021]. Disponible en: https://www.acog.org/en/womens-health/faqs/coronavirus-covid-19-pregnancy-and-breastfeeding
  22. World Health Organization (WHO). Coronavirus disease (COVID-19): Pregnancy and childbirth [internet]. Geneva: WHO; 2020 [citado 22 de marzo de 2021]. Disponible en: https://www.who.int/news-room/q-a-detail/coronavirus-disease-covid-19-pregnancy-and-childbirth
  23. Sociedad Española para el Estudio de la Obesidad SE de E y N, Sociedad Española de Ginecología y Obstetricia. Día de Lucha contra la Obesidad 2016. 2016. [citado 3 nov 2021]. Disponible en: https://www.seedo.es/images/site/ConsensoSEEDO2016.pdf
  24. Pettirosso E, Giles M, Cole S, Rees M. COVID-19 and pregnancy: A review of clinical characteristics, obstetric outcomes and vertical transmission. Aust N Z J Obstet Gynaecol. octubre de 2020; 60(5):640-59.
  25. Juan J, Gil MM, Rong Z, Zhang Y, Yang H, Poon LC. Effect of coronavirus disease 2019 (COVID-19) on maternal, perinatal and neonatal outcome: systematic review. Ultrasound Obstet Gynecol Off J Int Soc Ultrasound Obstet Gynecol. jul 2020; 56(1):15-27.
  26. Della Gatta AN, Rizzo R, Pilu G, Simonazzi G. Coronavirus disease 2019 during pregnancy: a systematic review of reported cases. Am J Obstet Gynecol. 2020; 223(1):36-41.
  27. Khalil A, Kalafat E, Benlioglu C, O’Brien P, Morris E, Draycott T, et al. SARS-CoV-2 infection in pregnancy: A systematic review and meta-analysis of clinical features and pregnancy outcomes. EClinicalMedicine. 2020; 25:100446.
  28. Elshafeey F, Magdi R, Hindi N, Elshebiny M, Farrag N, Mahdy S, et al. A systematic scoping review of COVID-19 during pregnancy and childbirth. Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet. 2020; 150(1):47-52.
  29. Bellos I, Pandita A, Panza R. Maternal and perinatal outcomes in pregnant women infected by SARS-CoV-2: A meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2021; 256:194-204.
  30. Fuentes García P, Maroto Alonso V, Patiño Maraver VM. Características de los partos de inicio espontáneo en fase de luna llena y fase de luna nueva. Metas Enferm. 2020; 23(9):49-54.
  31. Huntley BJF, Huntley ES, Di Mascio D, Chen T, Berghella V, Chauhan SP. Rates of Maternal and Perinatal Mortality and Vertical Transmission in Pregnancies Complicated by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-Co-V-2) Infection: A Systematic Review. Obstet Gynecol. 2020; 136(2):303-12.
  32. Instituto Nacional de Estadística (INE). Nacimientos por tipo de parto, tiempo de gestación y grupo de edad de la madre. INE [internet]. 2015. [citado 3 nov 2021]. Disponible en: https://www.ine.es/jaxi/Datos.htm?path=/t20/e301/nacim/a2015/l0/&file=01011.px#!tabs-tabla
  33. Sociedad Española de Ginecología y Obstetricia. Parto pretérmino. Prog Obstet Ginecol [internet] 2020 [citado 3 nov 2021]; 63:283-321. Disponible en: https://sego.es/documentos/progresos/v63-2020/n5/GAP-Parto_pretermino_2020.pdf
  34. Sociedad Española de Ginecología y Obstetricia. Rotura prematura de membranas. Protocolos SEGO. 2012.
  35. Zambrano LD, Ellington S, Strid P, Galang RR, Oduyebo T, Tong VT, et al. Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status - United States, January 22-October 3, 2020. MMWR Morb Mortal Wkly Rep. 6 de noviembre de 2020; 69(44):1641-7.
  36. Vila-Candel R, Mena-Tudela D, Gómez-Seguí A, Asensio-Tomás N, Cervera-Gasch A, Herraiz-Soler Y. Manejo del parto, el puerperio y la lactancia en mujeres positivas para SARS-CoV-2. Estudio multicéntrico en la Comunidad Valenciana. Enferm Clin [internet]. 28 enero 2021 [citado 3 nov 2021]. Disponible en: https://www.sciencedirect.com/science/article/pii/S1130862121000334
  37. Petrova D, Salamanca-Fernández E, Rodríguez Barranco M, Navarro Pérez P, Jiménez Moleón JJ, Sánchez M-J. La obesidad como factor de riesgo en personas con COVID-19: posibles mecanismos e implicaciones. Aten Primaria. 1 de agosto de 2020; 52(7): 496-500.
  38. Chua MWJ, Zheng S. Obesity and COVID-19: The clash of two pandemics. Obes Res Clin Pract. 2020; 14(4):380-2.
  39. Sociedad Española de Ginecología y Obstetricia. Hemorragia postparto precoz. Protocolos SEGO. Prog Obstet Ginecol. 2008; 51(8):497-505.