COVID-19 in pregnancy: A cross-sectional study on clinical features, disease severity, and health outcome
Rozhin Amin1, Mohammad-Reza Sohrabi1, Ali-Reza Zali2
1Community Medicine Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Social Determinants of Health Research Centre, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Insights
Pregnant women with COVID-19 showed different symptoms and a more severe clinical course, yet experienced better health outcomes than non-pregnant individuals. This study highlights unique impacts of coronavirus disease 2019 on pregnancy.
Area of Science:
- * Obstetrics and Gynecology
- * Infectious Diseases
- * Public Health
Background:
- * Coronavirus disease 2019 (COVID-19) presents unique challenges for pregnant women.
- * Clinical manifestations and health outcomes differ between pregnant and non-pregnant individuals with COVID-19.
- * Understanding these differences is crucial for maternal and child health during pandemics.
Purpose of the Study:
- * To evaluate clinical features, disease severity, and health outcomes of COVID-19 in pregnant women.
- * To compare these outcomes with those of non-pregnant women diagnosed with COVID-19.
- * To identify specific risk factors and presentations associated with COVID-19 in pregnancy.
Main Methods:
- * Population-based study including women diagnosed with COVID-19 in Tehran over two years.
- * Data analysis involved descriptive statistics, chi-squared tests, and logistic regression.
- * Comparison between a cohort of 3249 pregnant women and 79,338 non-pregnant women.
Main Results:
- * Pregnancy associated with increased intensive care needs (OR 1.38) but lower mortality risk (OR 0.55).
- * Pregnant women reported more diarrhea and skin lesions; non-pregnant women more cough and muscle ache.
- * Higher prevalence of comorbidities like diabetes, hypertension, and cancers observed in pregnant patients.
Conclusions:
- * COVID-19 in pregnant women presents distinct clinical features and a more severe course.
- * Despite increased severity, pregnant women demonstrated better health outcomes post-infection compared to non-pregnant counterparts.
- * Findings underscore the need for tailored COVID-19 management strategies for pregnant populations.
Abstract:
Assessing the impact of coronavirus disease 2019 (COVID-19) reveals unique challenges for pregnant women, who experience distinct clinical manifestations and health outcomes compared to their non-pregnant counterparts. We aimed to evaluate the clinical features, disease severity, and health outcomes of COVID-19 in pregnant women and compare them to those of non pregnant women. In this population-based study, we included all women diagnosed with COVID-19 across the province of Tehran during the first two years of the epidemic. Descriptive statistics, the chi-squared test, and the logistic regression model were applied. Overall, 79,338 non-pregnant women and 3249 pregnant women diagnosed with COVID-19 were included. Pregnant women were most commonly in the age group of 25 - 34 years (54%, n = 1758), while the age group of 34-44 had the highest representation among non-pregnant women (56%, n = 44,492). After accounting for age and comorbidities, pregnancy was associated with an increased risk of requiring intensive care (odds ratio [OR] 1.38, confidence interval [CI] 1.223 - 1.564). However, the probability of dying due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was lower in pregnant women compared to non-pregnant women (OR 0.55, CI 0.394-0.793). Cough (41%) and fever (30%) were the most frequent clinical presentations in pregnant women, whereas cough (57%) and muscle ache (38%) were the most common symptoms in non-pregnant women. Furthermore, diarrhea (P < 0.001) and skin lesions (P < 0.001) were reported more frequently by pregnant patients than non-pregnant patients. A significant prevalence of diabetes (P < 0.001), hypertension (P < 0.001), cancers (P < 0.001), and chronic hematological diseases (P < 0.001) was observed in pregnant patients. In conclusion, COVID-19-infected pregnant women exhibit different clinical manifestations and a more severe clinical course but have better health outcomes compared to their non-pregnant counterparts.
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