Assessing disease outcome in COVID-19 pregnancies in a tertiary referral center in south India: A single-center retrospective cohort study

Abstract

Aim: To study the outcome in COVID-19-positive pregnancies. Materials and methods: Data collected and analyzed retrospectively from COVID-19-positive pregnant women admitted to our hospital between April and September 2020. Results: 78.85% of women below 30 years of age, 60.57% multigravidae, 53.71% above 37 weeks of gestation. 76.85% no comorbidities, 73.42% no history of travel/contact with COVID-19 cases. 84.57% asymptomatic, two had a severe acute respiratory infection (SARI), requiring intensive care. 74.57% diagnosed using reverse transcriptase-polymerase chain reaction (RT-PCR). 91.42% turned negative within 6-10 days. The SARI patients required intensive care unit (ICU) care, one expired. 81.42% discharged between 8 days and 14 days of admission, returned for delivery at term. 83.42% required no medication. 96.28% had normal investigation reports. 83.14% of patients discharged, 16.57% required emergency obstetric intervention. Cesarean section rate 52.28%, the previous cesarean section most common indication (43.16%). Two babies were stillborn. 99.20%, Apgar > 7 at 5 minutes. Two required resuscitations. Nine required neonatal intensive care unit (NICU) admission. Two hundred and seven babies isolated from their mother, four turned positive. Forty-four were roomed in with mothers, 30 turned positive. One hundred and sixty-seven were breastfed, included 34 positive babies. Affected babies were asymptomatic. Conclusion: COVID-19 runs a milder course in pregnancy, possibly due to altered immune status. However, severe cases can deteriorate rapidly. There is evidence of community spread. COVID-19 seemed to increase cesarean rates. Neonatal transmission appeared higher following vaginal deliveries, rooming-in, and breastfeeding. Clinical significance: There is a dearth of adequate data to formulate guidelines about COVID-19-positive pregnancies despite numerous studies. We hope that our findings make a humble addition to ongoing research and provide further impetus to the global fight against this pandemic.