Novel coronavirus infection in the third trimester of pregnancy: perinatal and maternal outcomes
- Authors: Malgina G.B.1, Dyakova M.M.1, Bychkova S.V.1, Grishkina A.A.1, Melkozerova O.A.1, Bashmakova N.V.1, Pepelyaeva N.A.1, Olkov S.S.1
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Affiliations:
- Ural Research Institute of Maternity and Child Care, Ministry of Health of the Russian Federation
- Issue: No 4 (2023)
- Pages: 58-66
- Section: Original Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/462778
- DOI: https://doi.org/10.18565/aig.2023.58
- ID: 462778
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Abstract
Objective: To investigate the characteristic features of the course of pregnancy, labor, and perinatal outcomes in women who had novel coronavirus disease 2019 (COVID-19) in the third trimester of pregnancy and gave birth after COVID-19.
Materials and methods: The study group included 313 patients divided into subgroups 1 (n=90), 2 (n=154), and 3 (n=69) who had COVID-19 at 28–32, 32.1–36.6 and ≥37 weeks of gestation, respectively. The comparison group included 216 women who gave birth before the COVID-19 pandemic (2019). Histological examination of the placenta was performed in the study (n=87) and comparison (n=20) groups.
Results: COVID-19 at 28–32 weeks increases the risk of fetal growth restriction (relative risk (RR)=5.6; 95% CI 2.4; 13.0; p<0.001), preterm birth (RR=2.7; 95% CI 1.2; 5.8; p=0.01), placental abruption (RR=5.2; 95% CI 1.6; 16.4; p=0.002), fetal distress (RR=4.9; 95% CI 1.7; 13.6; p=0.001), and emergency caesarean section (RR=4.0; 95% CI 1.8; 9.1; p=0.001). The newborns had significantly smaller chest circumferences and lower Apgar scores. The placentas showed marked signs of maternal and fetal vascular malperfusion. COVID-19 at 32.1–36.6 weeks gestation increased the risk of uteroplacental circulation disorders (UPCD) (RR=4.3; 95% CI 1.1; 16.1; p=0.02), preterm birth (RR=2.8; 95% CI 1.4; 5.6; p<0.001), fetal distress (RR=3.9; 95% CI 1.5; 10.3; p=0.003), and emergency caesarean section (RR=3.4; 95% CI 1.6; 7.3, p=0.001). Newborns had a significantly smaller chest circumference and lower Apgar scores. COVID-19 after 37 weeks increased the risk of UPCD (RR=8.0; 95% CI 2.0; 31.9, p=0.001). Vascular abnormalities were most pronounced in the placentas of patients in group 1.
Conclusion: COVID-19 in the early and middle third trimesters is associated with the most adverse perinatal outcomes.
Keywords
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About the authors
Galina B. Malgina
Ural Research Institute of Maternity and Child Care, Ministry of Health of the Russian Federation
Email: galinamalgina@mail.ru
ORCID iD: 0000-0002-5500-6296
Dr. Med. Sci., Director
Russian Federation, YekaterinburgMaria M. Dyakova
Ural Research Institute of Maternity and Child Care, Ministry of Health of the Russian Federation
Author for correspondence.
Email: mariadakova40@mail.ru
ORCID iD: 0000-0001-7911-6783
Junior Researcher
Russian Federation, YekaterinburgSvetlana V. Bychkova
Ural Research Institute of Maternity and Child Care, Ministry of Health of the Russian Federation
Email: simomm@mail.ru
ORCID iD: 0000-0002-8892-7585
PhD, Leading Researcher
Russian Federation, YekaterinburgAnastasia A. Grishkina
Ural Research Institute of Maternity and Child Care, Ministry of Health of the Russian Federation
Email: xumukyc.ru@mail.ru
ORCID iD: 0000-0001-7433-2217
PhD, Pathologist, Department of Immunology, Clinical Microbiology, Pathomorphology and Cytodiagnosis
Russian Federation, YekaterinburgOksana A. Melkozerova
Ural Research Institute of Maternity and Child Care, Ministry of Health of the Russian Federation
Email: abolmed@mail.ru
ORCID iD: 0000-0002-4090-0578
Dr. Med. Sci., Deputy Director for Science
Russian Federation, YekaterinburgNadezhda V. Bashmakova
Ural Research Institute of Maternity and Child Care, Ministry of Health of the Russian Federation
Email: bashmakovanv@niiomm.ru
ORCID iD: 0000-0001-5746-316X
Dr. Med. Sci., Professor, Chief Researcher
Russian Federation, YekaterinburgNatalia A. Pepelyaeva
Ural Research Institute of Maternity and Child Care, Ministry of Health of the Russian Federation
Email: pepelyaevana@niiomm.ru
ORCID iD: 0000-0003-3278-2249
PhD, Chief Physician
Russian Federation, YekaterinburgSergey S. Olkov
Ural Research Institute of Maternity and Child Care, Ministry of Health of the Russian Federation
Email: olkovss@niiomm.ru
ORCID iD: 0000-0002-6142-3707
PhD, Deputy Head of the Pediatrics Clinic
Russian Federation, YekaterinburgReferences
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