tetano
Editor, Senior Moderator
Arch Gynecol Obstet
. 2024 May 6.
doi: 10.1007/s00404-024-07536-9. Online ahead of print. Perinatal outcomes among pregnant patients with peripartum coronavirus disease 2019 infection
Alla Saban[SUP] #[/SUP][SUP] 1 2 [/SUP], Noa Leybovitz Haleluya[SUP] #[/SUP][SUP] 3 4 [/SUP], Yael Geva[SUP] 3 4 [/SUP], Neta Geva[SUP] 4 5 [/SUP], Reli Hershkovitz[SUP] 3 4 [/SUP]
Affiliations
Purpose: Evaluate maternal and neonatal outcomes in peripartum coronavirus disease 2019 (COVID-19) positive women.
Methods: A retrospective cohort study was conducted, comparing outcomes between women with and without peripartum COVID-19. All singleton deliveries from June 2020 to January 2022 were included. Univariate analysis was followed by multivariate analysis.
Results: Of 26,827 singleton deliveries, 563 women had peripartum COVID-19, associated with preterm deliveries both near-term and remote from term [adjusted odds ratio (aOR) 1.6 and 2.0, respectively, p = 0.007 and 0.003]. Women with peripartum COVID-19 had a significantly higher rate of disseminated intravascular coagulation (DIC) (aOR 23.0, p < 0.001). Conversely, peripartum COVID-19 peripartum COVID-19 was negatively associated with premature rupture of membranes and prolonged maternal length of stay (aOR 0.7 and 0.5, respectively, p = 0.006 and <0.001). In cesarean delivery (CDs), patients with COVID-19 had higher rate of urgent CDs (75.5 vs. 56.1%, p < 0.001), higher rate of regional anesthesia (74.5 vs. 64.9%, p = 0.049), and longer anesthesia duration (86.1 vs. 53.4 min, p < 0.001). CD rate due to non-reassuring fetal heart rate (NRFHR) was significantly higher in women with COVID-19 (29.6 vs. 17.4%, p = 0.002). Conversely, CDs rate due to history of previous single CD was significantly higher in patients without COVID-19 diagnosis (13.6 vs. 4.1%, p = 0.006). Concerning neonatal outcomes, an association has been observed between COVID-19 and low one-minute APGAR score <5, as well as neonatal COVID-19 infection (aOR 61.8 and 1.7 respectively, p < 0.001 and p = 0.037).
Conclusions: Peripartum COVID-19 is associated with preterm deliveries, urgent CDs and DIC, potentially aligning with the infection's pathophysiology and coagulation alterations.
Keywords: COVID-19; Perinatal outcomes; Peripartum; Preterm delivery.
. 2024 May 6.
doi: 10.1007/s00404-024-07536-9. Online ahead of print. Perinatal outcomes among pregnant patients with peripartum coronavirus disease 2019 infection
Alla Saban[SUP] #[/SUP][SUP] 1 2 [/SUP], Noa Leybovitz Haleluya[SUP] #[/SUP][SUP] 3 4 [/SUP], Yael Geva[SUP] 3 4 [/SUP], Neta Geva[SUP] 4 5 [/SUP], Reli Hershkovitz[SUP] 3 4 [/SUP]
Affiliations
- PMID: 38709269
- DOI: 10.1007/s00404-024-07536-9
Purpose: Evaluate maternal and neonatal outcomes in peripartum coronavirus disease 2019 (COVID-19) positive women.
Methods: A retrospective cohort study was conducted, comparing outcomes between women with and without peripartum COVID-19. All singleton deliveries from June 2020 to January 2022 were included. Univariate analysis was followed by multivariate analysis.
Results: Of 26,827 singleton deliveries, 563 women had peripartum COVID-19, associated with preterm deliveries both near-term and remote from term [adjusted odds ratio (aOR) 1.6 and 2.0, respectively, p = 0.007 and 0.003]. Women with peripartum COVID-19 had a significantly higher rate of disseminated intravascular coagulation (DIC) (aOR 23.0, p < 0.001). Conversely, peripartum COVID-19 peripartum COVID-19 was negatively associated with premature rupture of membranes and prolonged maternal length of stay (aOR 0.7 and 0.5, respectively, p = 0.006 and <0.001). In cesarean delivery (CDs), patients with COVID-19 had higher rate of urgent CDs (75.5 vs. 56.1%, p < 0.001), higher rate of regional anesthesia (74.5 vs. 64.9%, p = 0.049), and longer anesthesia duration (86.1 vs. 53.4 min, p < 0.001). CD rate due to non-reassuring fetal heart rate (NRFHR) was significantly higher in women with COVID-19 (29.6 vs. 17.4%, p = 0.002). Conversely, CDs rate due to history of previous single CD was significantly higher in patients without COVID-19 diagnosis (13.6 vs. 4.1%, p = 0.006). Concerning neonatal outcomes, an association has been observed between COVID-19 and low one-minute APGAR score <5, as well as neonatal COVID-19 infection (aOR 61.8 and 1.7 respectively, p < 0.001 and p = 0.037).
Conclusions: Peripartum COVID-19 is associated with preterm deliveries, urgent CDs and DIC, potentially aligning with the infection's pathophysiology and coagulation alterations.
Keywords: COVID-19; Perinatal outcomes; Peripartum; Preterm delivery.