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Observational Study
. 2023 Feb;130(3):292-302.
doi: 10.1111/1471-0528.17313. Epub 2022 Oct 21.

Influence of COVID-19 pandemic on molar pregnancy and postmolar gestational trophoblastic neoplasia: An observational study

Vanessa Campos  1   2 , Gabriela Paiva  2 , Lilian Padron  2 , Fernanda Freitas  2 , Luana Giongo Pedrotti  3 , Sue Yazaki Sun  4 , Maurício Viggiano  5 , Larissa Oliveira  6 , Lucia Rohr  6 , José Mauro Madi  7 , Tiago Pedromônico Arrym  8 , Priscila Oliveira  2 , Ana Paula Vieira Dos Santos Esteves  2 , Joffre Amim Junior  2 , Jorge Rezende Filho  2 , Kevin M Elias  9 , Neil S Horowitz  9 , Antônio Braga  1   2   10 , Ross S Berkowitz  9
Affiliations
Observational Study

Influence of COVID-19 pandemic on molar pregnancy and postmolar gestational trophoblastic neoplasia: An observational study

Vanessa Campos et al. BJOG. 2023 Feb.

Abstract

Objective: To assess whether the incidence and aggressiveness of molar pregnancy (MP) and postmolar gestational trophoblastic neoplasia (GTN) changed during the COVID-19 pandemic.

Design: Observational study with two separate designs: retrospective multicentre cohort of patients with MP/postmolar GTN and a cross-sectional analysis, with application of a questionnaire.

Setting: Six Brazilian Reference Centres on gestational trophoblastic disease.

Population: 2662 patients with MP/postmolar GTN treated from March-December/2015-2020 were retrospectively evaluated and 528 of these patients answered a questionnaire.

Methods: Longitudinal retrospective multicentre study of patients diagnosed with MP/ postmolar GTN at presentation and a cross-sectional analysis, with application of a questionnaire, exclusive to patients treated during the period of study, to assess living and health conditions during the COVID-19 pandemic compared with previous years.

Main outcome measures: The incidence of MP/postmolar GTN.

Results: Compared with the last 5 pre-pandemic years, MP/postmolar GTN incidence remained stable during 2020 (COVID-19 pandemic). Multivariable logistic regression, adjusted for the patient age, showed that during 2020, presentation with MP was more likely to be >10 weeks of gestation (adjusted odds ratio [aOR] 2.50, 95% confidence interval [CI] 1.90-3.29, P < 0.001), have a pre-evacuation hCG level ≥100 000 iu/l (aOR 1.77, 95% CI 1.38-2.28, P < 0.001) and time to the initiation of chemotherapy ≥7 months (aOR 1.86, 95% CI 1.01-3.43, P = 0.047) when compared with 2015-2019.

Conclusions: Although the incidence of MP/postmolar GTN remained stable during the COVID-19 pandemic in Brazil, the pandemic was associated with greater gestational age at MP diagnosis and more protracted delays in initiation of chemotherapy for postmolar GTN.

Keywords: COVID-19; gestational trophoblastic disease; gestational trophoblastic neoplasia; hydatidiform mole.

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References

REFERENCES

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