Perinatal outcomes in women with COVID-19

COVID-19 pathogenesis has not been fully understood yet. However, the virus is known to enter the epithelial cells of the upper respiratory and gastrointestinal tracts, activating S-protein by angiotensin-converting enzyme 2. This process can significantly affect the pregnancy, childbirth and postpartum period. The aim of the study is to analyze the impact of COVID-19 on pregnancy course and outcomes. Materials and Methods. The authors retrospectively analyzed case histories and surgical protocols of 67 pregnant women with confirmed and suspected COVID-19, and neonatal records of 59 newborns who were in contact with COVID-19 patients. Results. Childbirth due to antenatal fetal death occurred in 13.4 % of cases, preterm births were observed in 15.5 %. Besides, 15.2 % of children were born prematurely by gestational age (the average rate for the Russian Federation is 8-11 %); invasive artificial lung ventilation was required in 3.4 % of newborns; primary neonatal resuscitation was performed in 18.6 % of cases. PCR examination of oropharyngeal swabs for SARS-CoV-2 detection did not confirm the presence of COVID-19 causative agents. Neonatal jaundice was diagnosed in 83.1 % of cases (the average rate for the Russian Federation is 60 %). Phototherapy (serum bilirubin >220 jmol/l, transcutaneous bilirubin index >200, Kramer scale score 3-4) was required in 77.5 % of such children (the average rate for Russia is 40-50 %). Conclusion. The conducted study indicates a significant impact of COVID-19 on pregnancy course and outcomes: the risks of preterm birth, antenatal fetus death, and the need for primary neonatal resuscitation also increase.