COVID-19 in pregnant women of Siberia and the Russian Far East: 2-year results of the pandemic

Objective: To assess the morbidity, clinical course, maternal and perinatal outcomes of the new coronavirus infection COVID-19 in pregnant women in the Far Eastern and Siberian Federal Districts based on the results of2020-2021. Materials and methods: The latest information on COVID-19 in pregnant women, women in labor and women who recently gave birth was analyzed. The findings were presented by the chief obstetricians-gynecologists of the regions in the period from March 11, 2020 to December 25, 2021. Results: A total of 27,210 cases of COVID-19 in pregnant, parturient and puerperal women were registered during the 2-year pandemic. The morbidity rate in these women was 2.4 times higher compared to the general population: 18988.0vs 8019.5 per 100,000people. SARS-CoV-2 infection was asymptomatic in 24.2% of mothers; it was mild in 50.0%, moderate in 21.3%, severe in 3.7%, and extremely severe in 0.8%. Pregnant women were more often hospitalized and stayed in intensive care and anesthesiology units compared to patients in the general population (5.5% vs 1.9%, p<0.001), and invasive mechanical ventilation (IMV) was used less often (0.7% vs 1.4%, p<0.05). There were 6,416 (23.6%) patients who gave birth to 6,512 children. Preterm delivery was in 18.5% (6.1% in Russia); cesarean sections - 38.8% (30.1% in Russia); operative vaginal delivery - 0.3% (0.13% in Russia). There were 81 (0.3%) deaths among mothers with COVID-19 (2.5% of cases among the population, p<0.001). Perinatal losses were registered in 156 cases (2.4%): stillbirths - 141 (2.17%), early neonatal mortality - 15 (0.23%). COVID-19(+) was revealed in 165 (2.5%) newborns. Conclusion: The incidence of COVID-19 in pregnant women was significantly higher than in general population during the 2-year pandemic, but the disease is characterized by more frequent hospitalization to intensive care and anesthesiology units, by lower demand for IMV and lower mortality rate. The second year of the pandemic was characterized by a more unfavorable course of COVID-19 in mothers and by an increase in the severe forms of the disease and indicators of maternal and perinatal mortality. The rates of preterm delivery and cesarean section in patients with COVID-19 were higher than in the general population. The incidence of SARS- CoV-2 virus isolation in newborns decreased significantly (from 6.2 to 2.5%). Further studies in this area are necessary. The morbidity rate of COVID-19 in pregnant women in Siberia and the Far East is higher than in the general population, but the disease is characterized by a lower need for IMV and a lower mortality rate. The rates of preterm birth and cesarean section are higher in patients with COVID-19 than in the general population. Finding of the SARS-CoV-2 RNA in newborns suggests vertical transmission of the infection.

COVID-19, SARS-CoV-2, COVID-19, SARS-CoV-2, pregnancy, morbidity, childbirth, maternal mortality, perinatal mortality, vertical transmission