Coronavirus disease 2019 in pregnancy: clinical manifestations, maternal, and perinatal outcomes

Asan Khaleel, N. Alhur
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Abstract

Background and objective: The current COVID-19 pandemic has become a main health threat worldwide and concerns have been raised regarding the effect of the Covid-19 infection on the wellbeing of pregnant women and their unborn baby. This study aimed to determine the clinical manifestations in addition to maternal and perinatal outcomes in pregnant women with confirmed COVID-19. Methods: A cross sectional study conducted in the Maternity Teaching Hospital and some private obstetric clinics in Erbil city/Kurdistan region, Iraq. The study started from the 1st April 2020 until the end of April of 2021. Seventy-one women who represent all infectedwithCOVID-19 during that period during pregnancy who were 16 years old or more were included in the study. Swabs were taken from nasopharynx by citoswab were diagnosed by quantitative real-time polymerase chain (qRT-PCR) at central laboratory of Erbil city/Iraq. The data were collected through direct interview with the patients using a special questionnaire, prepared for this purpose. Results: More than half (53.5%) of participants were 25-34 years old, 80.3% of women were housewives and 29.6% of them were illiterate. The majority (87.3%) of women did not have chronic illnesses and 43.7% of them were in second trimester during COVID-19 infection. The following symptoms were reported: fever (91.5%), cough (80.3%), headache (77.5%), weakness (73.2%), loss of smell (69%), aguesia (67.6%), sore throat (66.2%), arthralgia and myalgia (64.8%), flu like illness (62%), dyspnea (39.4 %), and diarrhea and/or vomiting (26.8%). The majority (84.51%) of women did notreport any fetal complications or none has happened and 1.4% of the fetuses suffered from fetal distress and FGR. Caesarean section was the commonest mode of delivery. A significant statistical association was found between age group and fetal complications suggesting that fetal complications increased with becoming older. Conclusion: Manifestations such as fever, sore throat, cough, headache, fatigue, loss of smell and taste, arthralgia and myalgia were commonly observed in Covid-19 pregnant patients. Cough was still the highest reported symptom followed by weakness and dyspnea even six months post Covid-19 infection. Adverse maternal and neonatal outcomes were observed in pregnant patients infected with Covid-19.
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2019年妊娠期冠状病毒疾病:临床表现、孕产妇和围产期结局
背景和目的:目前,COVID-19 大流行已成为全球主要的健康威胁,Covid-19 感染对孕妇及其胎儿健康的影响已引起人们的关注。本研究旨在确定确诊感染 COVID-19 的孕妇的临床表现以及孕产和围产期结果。研究方法在伊拉克埃尔比勒市/库尔德斯坦地区的妇产教学医院和一些私人产科诊所开展的横断面研究。研究从 2020 年 4 月 1 日开始,至 2021 年 4 月底结束。研究对象包括 71 名 16 岁或以上的妇女,她们都是在怀孕期间感染过 COVID-19 的患者。研究人员在伊拉克埃尔比勒市的中心实验室通过实时定量聚合酶链式反应(qRT-PCR)从鼻咽部采集拭子进行诊断。数据是通过使用为此准备的特殊问卷对患者进行直接访谈收集的。结果显示半数以上(53.5%)的参与者年龄在 25-34 岁之间,80.3% 的女性是家庭主妇,29.6% 是文盲。大多数妇女(87.3%)没有慢性疾病,43.7%的妇女在感染 COVID-19 期间处于怀孕后期。报告的症状包括:发热(91.5%)、咳嗽(80.3%)、头痛(77.5%)、虚弱(73.2%)、嗅觉减退(69%)、口吐白沫(67.6%)、咽喉痛(66.2%)、关节痛和肌痛(64.8%)、类似流感的疾病(62%)、呼吸困难(39.4%)以及腹泻和/或呕吐(26.8%)。大多数妇女(84.51%)未报告任何胎儿并发症或未发生任何并发症,1.4%的胎儿患有胎儿窘迫和胎儿畸形。剖腹产是最常见的分娩方式。年龄组与胎儿并发症之间存在明显的统计学关联,这表明胎儿并发症会随着年龄的增长而增加。结论在 Covid-19 孕妇中,发热、咽喉痛、咳嗽、头痛、乏力、嗅觉和味觉丧失、关节痛和肌痛等症状很常见。即使在感染 Covid-19 病毒六个月后,咳嗽仍是报告的最常见症状,其次是乏力和呼吸困难。在感染 Covid-19 的孕妇中观察到了不良的孕产妇和新生儿结局。
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