COVID-19 in pregnancy: Maternal and perinatal outcomes at Dr. Mohammad Hoesin Hospital, Palembang, Indonesia
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HIGHLIGHTS
- COVID-19 increases the likelihood of adverse maternal outcomes throughout pregnancy, including pneumonia, cesarean section, and ICU admission. Prompt diagnosis and treatment of COVID-19 may improve maternal outcomes.
- COVID-19 does not increase the likelihood of adverse perinatal outcomes. Reassurance can be provided to expectant mothers.
ABSTRACT
Objective: The objective of this study was to analyze the maternal and perinatal outcomes of COVID-19 in pregnancy at Dr. Mohammad Hoesin Hospital, Palembang, Indonesia.
Materials and Methods: This retrospective cohort study was carried using medical records of pregnant mothers who delivered at Dr. Mohammad Hoesin Hospital Palembang from March 2020 to August 2021. The subjects were into two groups: pregnant women with and without COVID-19. Pearson Chi-Square test was used for bivariate analysis to determine the associations between COVID-19 and maternal as well as neonatal outcomes. The data were analysed using the Stata 15 statistical software. Multivariate analysis was done using the cox regression test to determine whether maternal characteristics affected those associations. P-value of < 0.05 were considered statistically significant.
Results: The study analyzed 220 subjects, including 62 COVID-19-positive (28.18%) and 158 COVID-19-negative (71.82%) patients. Among expectant mothers with COVID-19, caesarean sections were the most common maternal outcome (82.26%), while fetal distress was the most frequent perinatal outcome (12.13%). Significant associations were found between COVID-19 and maternal outcomes, including pneumonia (RR = 12.76), caesarean section (RR = 2.74), and ICU hospitalization (RR = 6.90). These associations remained significant after adjusting for maternal characteristics. However, no significant association was found between COVID-19 and perinatal outcomes.
Conclusion: COVID-19 increases the likelihood of adverse maternal outcomes throughout pregnancy.
World Health Organization. WHO-convened global study of origins of SARS-CoV-2: China Part [internet]. 2021. Available from:
World Health Organization. Weekly epidemio-logical update on COVID-19 - 24 August 2021 [internet]. 2021. Available from: https://www. who.int/publications/i/item/who-convened-global-study-of-origins-of-sars-cov-2-china-part
Indonesian Ministry of Health. COVID-19 Situation Report [internet]. 2021. Available from: https://reliefweb.int/report/indonesia/situation-update-response-covid-19-indonesia-5-april-2021
World Health Organization. Coronavirus disease (COVID-19): Pregnancy and childbirth [internet]. 2020. Available from: https://www.who.int/news-room/q-a-detail/coronavirus-disease-covid-19-pregnancy-and-childbirth
Saroyo YB. Covid-19 and Pregnancy. Indones J Obstet Gynecol. 2021;9(1):3-4. doi: 10.32771/ inajog.v9i1.1495.
Samudrala PK, Kumar P, Choudhary K, et al. Virology, pathogenesis, diagnosis and in-line treatment of COVID-19. Eur J Pharmacol. 2020;883:173375. doi: 10.1016/j.ejphar.2020.173 375. Epub 2020 Jul 17. PMID: 32682788; PMCID: PMC7366121.
Yan J, Guo J, Fan C, et al. Coronavirus disease 2019 in pregnant women: a report based on 116 cases. Am J Obstet Gynecol. 2020;223(1):111.e1-111.e14. doi: 10.1016/j.ajog.2020.04.014. Epub 2020 Apr 23. PMID: 32335053; PMCID: PMC7 177142.
Allotey J, Stallings E, Bonet M, 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: 10.1136/bmj. m3320. Update in: BMJ. 2022 May 30;377:o1205. doi: 10.1136/bmj.o1205. PMID: 32873575; PMC ID: PMC7459193.
Villar J, Ariff S, Gunier RB, et al Maternal and Neonatal Morbidity and Mortality Among Pregnant Women With and Without COVID-19 Infection: The INTERCOVID Multinational Cohort Study. JAMA Pediatr. 2021;175(8):817-26. doi: 10.1001/ jamapediatrics.2021.1050. Erratum in: JAMA Pediatr. 2022;176(1):104. doi: 10.1001/jama pediatrics.2021.4953. PMID: 33885740; PMCID: PMC8063132.
Wiyati PS, Adawiyah R, Dewantiningrum J, et al. Maternal and perinatal outcomes with covid-19: Lesson learned from the tertiary hospital. Bali Medical Journal. 2021;10(1):422–47. doi: 10.15562/bmj.v10i1.2229.
Monod M, Blenkinsop A, Xi X, et al. Age groups that sustain resurging COVID-19 epidemics in the United States. Science. 2021;371(6536):eabe8372. doi: 10.1126/science.abe8372. Epub 2021 Feb 2. PMID: 33531384; PMCID: PMC8101272.
Aghababaei S, Bashirian S, Soltanian A, et al. Perceived risk and protective behaviors regarding COVID-19 among Iranian pregnant women. Middle East Fertil Soc J. 2020;25(1):29. doi: 10.1186/s43043-020-00038-z. Epub 2020 Sep 18. PMID: 32963467; PMCID: PMC7498999.
Figueiro-Filho EA, Yudin M, Farine D. COVID-19 during pregnancy: an overview of maternal characteristics, clinical symptoms, maternal and neonatal outcomes of 10,996 cases described in 15 countries. J Perinat Med. 2020;48(9):900-11. doi: 10.1515/jpm-2020-0364. PMID: 33001856.
Wu YT, Liu J, Xu JJ, Chen YF, Yang W, Chen Y, et al. Neonatal outcome in 29 pregnant women with COVID-19: A retrospective study in Wuhan, China. PLoS Med. 2020;17(7):1–19.
Nurhasanah, Maulida DA, Erawati. Hubungan pengetahuan ibu hamil tentang covid-19 dengan perilaku pencegahan penularan covit-19. Jurnal Kebidanan Malahayati. 2021;7(3):432–40.
Antoun L, Taweel NE, Ahmed I, Patni S, Honest H. Maternal COVID-19 infection, clinical characteristics, pregnancy, and neonatal outcome: A prospective cohort study. Eur J Obstet Gynecol Reprod Biol. 2020 Sep;252:559-562.
Li N, Han L, Peng M, Lv Y, Ouyang Y, Liu K, et al. Maternal and neonatal outcomes of pregnant women with COVID-19 pneumonia: A case-control study. Clin Infect Dis. 2020;71(16):2035–41.
Martinez-Perez O, Prats Rodriguez P, Muner Hernandez M, Encinas Pardilla MB, Perez Perez N, Vila Hernandez MR, et al. The association between SARS-CoV-2 infection and preterm delivery: A prospective study with a multivariable analysis. BMC Pregnancy Childbirth. 2021;21(1):1–11.
Diaz J V, Appiah J, Askie L, Baller A, Banerjee A, Barkley S, et al. Clinical management Clinical management Living guidance COVID-19. World Health Organization; 2021.
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. Inter J Gynecol Obstet. 2020;150(1):47–52.
Singer M, Deutschman CS, Seymour C, Shankar-Hari M, Annane D, Bauer M, et al. The third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA. 2016;315(8):801–10.
Ashraf MA, Keshavarz P, Hosseinpour P, Erfani A, Roshanshad A, Pourdast A, et al. Coronavirus disease 2019 (COVID-19): A systematic review of pregnancy and the possibility of vertical transmission. J Reprod Infertil. 2020;21(3):157–68.
Gennaro F Di, Pizzol D, Marotta C, Antunes M, Racalbuto V, Veronese N, et al. Coronavirus Diseases (COVID-19) current status and future perspectives: A narrative review. Int J Environ Res Public Health. 2020;17(8):p2690.
Yang H, Sun G, Tang F, Peng M, Gao Y, Peng J, Xie H, Zhao Y, Jin Z. Clinical features and outcomes of pregnant women suspected of coronavirus disease 2019. J Infect. 2020 Jul;81(1):e40-e44.
Narang K, Enninga EAL, Gunaratne MDSK, Ibirogba ER, Trad ATA, Elrefaei A, et al. SARS-CoV-2 infection and COVID-19 during pregnancy: A multidisciplinary review. Mayo Clin Proc. 2020;95(8):1750–65.
Wang CL, Liu YY, Wu CH, Wang CY, Wang CH, Long CY. Impact of covid-19 on pregnancy. Int J Med Sci. 2021;18(3):763–7.
Sentilhes L, Marcillac F De, 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. 2020;223:914.e1-e15.
Dashraath P, Wong JLJ, Lim MXK, Lim LM, Li S, Biswas A, Choolani M, Mattar C SLL. Coronavirus disease 2019 (COVID-19) pandemic and pregnancy. Am J Obstet Gynecol. 2020;222(6):521–31.
Zaigham M, Andersson O. Maternal and perinatal outcomes with COVID-19: A systematic review of 108 pregnancies. Acta Obstet Gynecol Scand. 2020;99(7):823–9.

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