COVID-10 in obstetrics and neonatology: regional experience

Objective: Analysis of COVID-19 clinical course based on mild and moderate symptoms of coronavirus infection in infants born to SARS- CoV-2 positive women, and evaluation of their adaptation in postnatal period. Materials and methods: A retrospective analysis of medical records of 280 pregnant women, who had confirmed clinical diagnosis of coronavirus infection with mild and moderate symptoms of COVID-19 and medical records of 267 infants born to women with SARS-CoV-2 infection, who are residents of the North Caucasian Federal District (the Republic of Ingushetia, Dagestan and North Ossetia-Alania). Results: The analysis of the course of the disease and major laboratory test results did not show significant differences between pregnant women with mild and moderate COVID-19 depending on the gestational age at the time of infection. High temperature, continuous cough, a loss or change to the sense of smell and taste, chest pain with breathing were the most common symptoms during three trimesters of pregnancy. Assessment of clinical laboratory results in pregnant women with COVID-10 and in infants born to patients with COVID-19 showed that biochemical blood test and a complete blood count play an important role in assessment of severity and prognosis of the disease. The data on the clinical manifestations of COVID-19 in pregnant women showed that immune responses induced by COVID-19 do not correlate with the severity of the disease. The analysis of infants’ health records showed that 12/267 (4.5%) newborns required admission to NICU due to low oxygen saturation levels, shortness of breath and tachypnea; 7/267 (2.6%) newborns required mechanical ventilation. Conclusion: Most likely, the severity of COVID-19 in pregnant women depends not only and not so much on gestational age, but also on the presence of concomitant extragenital pathology and aggravated obstetric and gynecological anamnesis. Apparently, it is important that approach to management of pregnant women based on obstetric indications and maternal and fetal condition should individualized. Perinatal complications in newborns are likely due to impaired placental perfusion and/or thrombotic changes in mother, decreased barrier function and placental inflammatory changes. The issues discussed in this article confirm the high relevance of the problem of infants’ health status who were born to mother, who underwent COVID-19 at different terms of pregnancy, and this poses new challenges for identification of important features in monitoring, diagnosis, therapy and prevention of pathological conditions in newborns.

COVID-19, SARS-CoV-2, COVID-19, SARS-CoV-2, coronavirus, coronavirus infection, pregnancy, newborns, neonatal period