FEATURES OF PREGNANCY, OBSTETRIC AND PERINATAL OUTCOMES DURING THE MANIFESTATION OF COVID-19 OF VARYING SEVERITY IN THE 1ST TRIMESTER OF GESTATION
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Abstract
The new coronavirus infection COVID-19, according to a number of studies, is associated with an increased risk of gestational complications and poor obstetric and perinatal outcomes. The question of the influence of gestational age at the time of manifestation of COVID-19 on the course of pregnancy and childbirth, their outcomes for the mother and fetus remains controversial.
The aim of the research – to determine the characteristics of the course of pregnancy, obstetric and perinatal outcomes during the manifestation of COVID-19 of varying severity in the first trimester of gestation.
Materials and methods. The study included 251 pregnant women. The main group consisted of 161 pregnant women with manifestations of COVID-19 of varying severity in the first trimester of gestation. Patients of the main group were divided into 3 groups based on the severity of COVID-19: group 1 – mild (n = 84), group 2 – moderate (n = 74), group 3 – severe infection (n = 3). The comparison group included 90 pregnant women in the third trimester of gestation without a history of COVID-19.
Results. COVID-19 in the first trimester of gestation has a predominantly mild and moderate course. Against the background of manifestation, regardless of the severity of the infection, a high frequency of missed miscarriage is recorded. In moderate cases of COVID-19, both during the period of manifestation and in convalescents, the incidence of diabetes mellitus that first developed during pregnancy increases statistically significantly. Features of the course of labor during the period of convalescence have not been established. Newborns have a statistically significantly lower body weight at birth.
Conclusion. The period of manifestation of COVID-19 in the first trimester of pregnancy, even with a mild infection, is associated with a high frequency of spontaneous miscarriage (statistically significantly more often in the form of a missed miscarriage). During the period of convalescence, pregnancy is characterized by favorable obstetric and perinatal outcomes.
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Belokrinitskaya TE, Artymuk NV, Filippov OS, Frolova NI. Clinical course, maternal and perinatal outcomes of 2019 novel coronavirus infectious disease (COVID-19) in pregnant women in Siberia and Far East. Obstetrics and gynecology. 2021; (2): 48-54. Russian (Белокриницкая Т.Е., Артымук Н.В., Филиппов О.С., Фролова Н.И. Клиническое течение, материнские и перинатальные исходы новой коронавирусной инфекции COVID-19 у беременных Сибири и Дальнего Востока //Акушерство и гинекология. 2021. № 2. С. 48-54.) doi: 10.18565/aig.2021.2.48-54
Allotey J, Stallings E, Bonet M, Yap M, Chatterjee S, Kew T, et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ. 2020; 370: m3320. doi: 10.1136/bmj.m3320
Knight M, Bunch K, Vousden N, Morris E, Simpson N, Gale C, et al. Characteristics and outcomes of pregnant women admitted to hospital with confirmed infection in UK: National population based cohort study. BMJ. 2020; 369: m2107. doi: 10.1136/bmj.m2107
Juan J, Gil MM, Rong Z, Zhang Y, Yang H, Poon LC. Effect of coronavirus disease 2019 (COVID-19) on maternal, perinatal and neonatal outcome: systematic review. Ultrasound Obstet Gynecol. 2020; 56(1): 15-27. doi: 10.1002/uog.22088
Figueiro-Filho EA, Yudin M, Farine D. COVID-19 during pregnancy: an overview of maternal characteristics, clinical symptoms, maternal and neonatal outcomes of 10,996 cases described in 15 countries. J Perinat Med. 2020; 48(9): 900-911. doi: 10.1515/jpm-2020-0364
Obstetrics: a national guide /pod red. G.M. Savel'yevoy, G.T. Sukhikh, V.N. Serova, V.E. Radzinskogo. M.: GEOTAR-Media, 2015. 1080 p. Russian (Акушерство : национальное руководство /под ред. Г.М. Савельевой, Г.Т. Сухих, В.Н. Серова, В.Е. Радзинского. М.: ГЭОТАР-Медиа, 2015. 1080 c.)
Cosma S, Carosso AR, Cusato J, Borella F, Carosso M, Bovetti M, et al. Coronavirus disease 2019 and first-trimester spontaneous abortion: a case-control study of 225 pregnant patients. Am J Obstet Gynecol. 2021; 224(4): 391.e1-391.e7. doi: 10.1016/j.ajog.2020.10.005
La Cour Freiesleben N, Egerup P, Hviid KVR, Severinsen ER, Kolte AM, Westergaard D, et al. SARS-CoV-2 in first trimester pregnancy: a cohort study. Hum Reprod. 2021; 36(1): 40-47. doi: 10.1093/humrep/deaa311
Khaidukova YV, Voropaeva EE, Ishchenko LS, Kazachkova EA, Kazachkov EL, Kholopova AY, et al. Pregnancy and childbirth in women with the manifestation of a new coronavirus infection COVID-19 in the first trimester of gestation. Yuzhno-Ural'skiy meditsinskiy zhurnal. 2021; (3): 47-59. Russian (Хайдукова Ю.В., Воропаева Е.Е., Ищенко Л.С., Казачкова Э.А., Казачков Е.Л., Холопова А.Ю., и др. Беременность и роды у женщин при манифестации новой коронавирусной инфекции COVID-19 в первом триместре гестации //Южно-Уральский медицинский журнал. 2021. № 3. С. 47-59)
Hughes BL, Sandoval GJ, Metz TD, Clifton RG, Grobman WA, Saade GR, et al. First- or second-trimester SARS-CoV-2 infection and subsequent pregnancy outcomes. Am J Obstet Gynecol. 2023; 228(2): 226.e1-226.e9. doi: 10.1016/j.ajog.2022.08.009
Fallach N, Segal Y, Agassy J, Perez G, Peretz A, Chodick G, et al. Pregnancy outcomes after SARS-CoV-2 infection by trimester: A large, population-based cohort study. PLoS One. 2022; 17(7): e0270893. doi: 10.1371/journal.pone.0270893
Metodicheskiye rekomendatsii Ministerstva zdravookhraneniya Rossiyskoy Federatsii. Organizatsiya okazaniya meditsinskoy pomoshchi beremennym, rozhenitsam, rodil'nitsam i novorozhdennym pri novoy koronavirusnoy infektsii COVID-19. Versiya 5 (28.12.2021). Russian (Методические рекомендации Министерства здравоохранения Российской Федерации. Организация оказания медицинской помощи беременным, роженицам, родильницам и новорожденным при новой коронавирусной инфекции COVID-19. Версия 5 (28.12.2021)). URL: https://static-0.minzdrav.gov.ru/system/attachments/attaches/000/059/052/original/BMP_preg_5.pdf (Дата обращения: 20.08.2024)
Belokrinitskaya TE, Artymuk NV, Filippov OS, Frolova NI, Parfenova Ya A. Maternal mortality and critical conditions (near miss) in COVID-19 in pregnant women of Siberia and the Far East. Russian Journal of Human Reproduction. 2021; (5): 114-120. Russian (Белокриницкая Т.Е., Артымук Н.В., Филиппов О.С., Фролова Н.И., Парфенова Я.А. Материнская смертность и near miss при новой коронавирусной инфекции (COVID-19) у беременных Сибири и Дальнего Востока //Проблемы репродукции. 2021. Т. 27, № 5. С. 114-120.) doi: 10.17116/repro202127051114
Jafari M, Pormohammad A, Sheikh Neshin SA, Ghorbani S, Bose D, Alimohammadi S, et al. Clinical characteristics andoutcomes of pregnant women with COVID-19 and comparison with control patients: A systematic review and meta-analysis. Rev Med Virol. 2021; 31(5): 1-16. doi: 10.1002/rmv.2208
Malgina GB, Dyakova MM, Bychkova SV, Grishkina AA, Pepelyaeva NA, Olkov SS, et al. Novel coronavirus infection in the first trimester of pregnancy: perinatal and maternal outcomes. Obstetrics and gynecology. 2022; (12): 90-99. Russian (Мальгина Г.Б., Дьякова М.М., Бычкова С.В., Гришкина А.А., Пепеляева Н.А., Ольков С.С., и др. Новая коронавирусная инфекция в I триместре беременности: перинатальные и материнские последствия //Акушерство и гинекология. 2022. № 12. С. 90-99.) doi: 10.18565/aig.2022.212
Khvorostukhina NF, Sheveleva DI, Novichkov DA, Stepanova NN, Suvorova GS, Odnokozova OS, Akhmedova YuK. Obstetric and perinatal outcomes after a new coronavirus infection in the first and second trimesters of pregnancy. Medical council. 2023; 17(23): 259-267. Russian (Хворостухина Н.Ф., Шевелева Д.И., Новичков Д.А., Степанова Н.Н., Суворова Г.С., Однокозова О.С., Ахмедова Ю.К. Акушерские и перинатальные исходы после перенесенной новой коронавирусной инфекции в I и II триместрах беременности //Медицинский совет. 2023. Т. 17, № 23. С. 259-267.) doi: 10.21518/ms2023-472
Kiremitli S, Kiremitli T, Ulug P, Kirkinci A, Kurnuc FZ, Yilmaz N, et al. Does being infected with SARS-CoV-2 in the first-trimester increase the risk of miscarriage? An Acad Bras Ciênc. 2022; 94(2): e20211283. doi: 10.1590/0001-3765202220211283
Volkov AE, Rymashevsky AN, Badyan AS, Tyo SA, Esetov MA, Borshchenko IN. Gestational and perinatal outcomes after undergoing SARS-COV-2 (COVID-19) new coronavirus infection. Part I. Infection of the mother in the first trimester (4-13+6 weeks) A. Prenatal'naya diagnostika. 2023; 22(1): 11-22. Russian (Волков А.Е., Рымашевский А.Н., Бадьян А.С., Тё С.А., Эсетов М.А., Борщенко И.Н. Гестационные и перинатальные исходы после перенесенной новой коронавирусной инфекции SARS-CoV-2 (COVID-19). Часть I. Инфицирование матери во II триместре (4-13+6 недель) //Пренатальная диагностика. 2023. Т. 22, № 1. С. 11-22). doi: 10.21516/2413-1458-2023-22-1-11-21
Serrano B, Mendoza M, Garcia-Aguilar P, Bonacina E, Garcia-Ruiz I, Garcia-Manau P, et al. Shared risk factors for COVID‐19 and preeclampsia in the first trimester: An observational study. Acta Obstet Gynecol Scand. 2022; 101(7): 803-808. doi: 10.1111/aogs.14371