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Comparison of hematological parameters and perinatal outcomes between COVID-19 pregnancies and healthy pregnancy
Esin Merve Erol Koç1, Rahime Bedir Fındık1, Hatice Akkaya1
1Department of Obstetrics and Gynecology, Ankara City Hospital, Ankara, Turkey.
Insights
Pregnancies with Coronavirus Disease 2019 (COVID-19) did not show adverse perinatal outcomes. Hematologic parameters, like monocyte/lymphocyte ratio (MLR), may aid in diagnosing COVID-19 in pregnant individuals.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Hematology
Background:
- Pregnancy involves significant physiological changes that can alter immune responses and hematologic parameters.
- Coronavirus Disease 2019 (COVID-19) poses unique challenges during pregnancy, necessitating understanding of its impact on maternal and fetal well-being.
Purpose of the Study:
- To investigate the association between COVID-19 infection in pregnancy and adverse perinatal outcomes.
- To assess the diagnostic utility of specific hematologic indices in pregnancies complicated by COVID-19.
Main Methods:
- A cohort study comparing 39 pregnant individuals with COVID-19 to 69 unaffected pregnant individuals.
- Analysis of perinatal outcomes and complete blood count indices at admission.
Main Results:
- No significant differences in obstetric or neonatal outcomes, except for an increased Cesarean section rate in the COVID-19 group (p=0.026).
- Elevated monocyte count, red cell distribution width (RDW), neutrophil/lymphocyte ratio (NLR), and monocyte/lymphocyte ratio (MLR) were observed in COVID-19 pregnancies.
- Decreased mean platelet volume (MPV) and plateletcrit were noted; MLR showed high specificity (96.7%) for COVID-19 diagnosis in pregnant individuals.
Conclusions:
- COVID-19 in pregnancy is not linked to adverse perinatal outcomes.
- The monocyte/lymphocyte ratio (MLR) can serve as a supportive diagnostic marker for COVID-19 in pregnant populations, complementing RT-PCR testing.
Objectives:
To evaluate the relationship between Coronavirus Disease 2019 (COVID-19) in pregnancy and adverse perinatal outcomes. The secondary aim is to analyze the diagnostic value of hematologic parameters in COVID-19 complicated pregnancies.
Methods:
The current study is conducted in a high volume tertiary obstetrics center burdened by COVID-19 pandemics, in Turkey. In this cohort study, perinatal outcomes and complete blood count indices performed at the time of admission of 39 pregnancies (Study group) complicated by COVID-19 were compared with 69 uncomplicated pregnancies (Control group).
Results:
There was no significant difference between the obstetric and neonatal outcomes of pregnancies with COVID-19 compared to data of healthy pregnancies, except the increased C-section rate (p=0.026). Monocyte count, red cell distribution width (RDW), neutrophil/lymphocyte ratio (NLR), and monocyte/lymphocyte ratio (MLR) were significantly increased (p<0.0001, p=0.009, p=0.043, p<0.0001, respectively) whereas the MPV and plateletcrit were significantly decreased (p=0.001, p=0.008) in pregnants with COVID-19. ROC analysis revealed that the optimal cut-off value for MLR was 0.354 which indicated 96.7% specificity and 59.5% sensitivity in diagnosis of pregnant women with COVID-19. A strong positive correlation was found between the MLR and the presence of cough symptom (r=41.4, p=<0.0001).
Conclusions:
The study revealed that, pregnancies complicated by COVID-19 is not related with adverse perinatal outcomes. MLR may serve as a supportive diagnostic parameter together with the Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) in assessment of COVID-19 in pregnant cohort.
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