Novel coronavirus infection in the first trimester of pregnancy: perinatal and maternal outcomes


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Objective: To investigate the characteristic features of the course of pregnancy, labor, and perinatal outcomes in women who had a new coronavirus disease 2019 (COVID-19) in the first trimester of pregnancy. Materials and methods: The first stage of the study consisted of a retrospective analysis of the COVID-19 registry of pregnant and postpartum women from the Ural Federal District (UFD) for 2020-2021. A total of2347patients had COVID-19 in the first trimester of pregnancy in the UFD in 2020-2021. The second stage of the study was a single center cross-sectional comparative study in two independent groups. The study group included 131 patients who had COVID-19 in the first trimester of pregnancy; the comparison group comprised 216 patients who gave birth before COVID-19 pandemic (2019). The analysis included the course of pregnancy, labor and delivery, neonatal health status, and histological examination of 10 placentas of women in the study group. Results: Pregnancy was terminated in 19.4% of patients who developed severe COVID-19 in the first trimester. Spontaneous miscarriages were registered in 9.2% of the women with mild and moderate COVID-19. In two cases in patients who had COVID-19 before 6 weeks, fetal malformations were detected that were incompatible with life, which are extremely rare in the population. COVID-19 in the first trimester of pregnancy increased the risk of gestational hypertension (OR=3.3; 95% CI 1.6-6.6; p<0.001) and threatened preterm birth (OR=3.4; 95% CI 1.4-8.0; p=0.004). The mean gestational age at delivery was significantly lower [38.4 (2.0), p<0.001] than in patients who gave birth before the COVID-19 pandemic. The newborns showed a significant decrease in anthropometric parameters and Apgar scores at 1 [7 (6:8), p=0.035] and 5 [8 (7:8), p<0.001] minutes compared to the newborns of the comparison group. At the same time, there were signs of both maternal and fetal blood flow abnormalities in the placenta. Conclusion: Women who had COVID-19 in the first trimester of pregnancy may be at increased risk of adverse perinatal and maternal outcomes.

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作者简介

Galina Malgina

Ural Research Institute of Maternity and Child Care, Ministry of Health of the Russian Federation

Email: galinamalgina@mail.ru
Dr. Med. Sci., Director

Maria Dyakova

Ural Research Institute of Maternity and Child Care, Ministry of Health of the Russian Federation

Email: mariadakova40@mail.ru
doctor, Junior Researcher

Svetlana Bychkova

Ural Research Institute of Maternity and Child Care, Ministry of Health of the Russian Federation

Email: simomm@mail.ru
PhD, Leading Researcher

Anastasia Grishkina

Ural Research Institute of Maternity and Child Care, Ministry of Health of the Russian Federation

Email: xumukyc.ru@mail.ru
PhD, Pathologist, Department of Immunology, Clinical Microbiology, Pathomorphology and Cytodiagnosis

Natalia Pepelyaeva

Ural Research Institute of Maternity and Child Care, Ministry of Health of the Russian Federation

Email: pepelyaevana@niiomm.ru
PhD, Head of the Department

Sergey Olkov

Ural Research Institute of Maternity and Child Care, Ministry of Health of the Russian Federation

Email: olkovss@niiomm.ru
PhD, Deputy Head of the Pediatrics Clinic

Oksana Melkozerova

Ural Research Institute of Maternity and Child Care, Ministry of Health of the Russian Federation

Email: abolmed@mail.ru
Dr. Med. Sci., Deputy Director for Science

Nadezhda Bashmakova

Ural Research Institute of Maternity and Child Care, Ministry of Health of the Russian Federation

Email: bashmakovanv@niiomm.ru
Dr. Med. Sci., Professor, Chief Researcher

Natalia Davydenko

Ural Research Institute of Maternity and Child Care, Ministry of Health of the Russian Federation

Email: orgomm@mail.ru
PhD, Head of the Department

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