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. 2022 Nov 8;12(11):1871.
doi: 10.3390/jpm12111871.

Exploring Clinical and Biological Features of Premature Births among Pregnant Women with SARS-CoV-2 Infection during the Pregnancy Period

Ingrid Hrubaru  1   2 , Andrei Motoc  3 , Felix Bratosin  4 , Ovidiu Rosca  4 , Roxana Folescu  5 , Marius Liviu Moise  6 , Octavian Neagoe  7 , Ioana Mihaela Citu  8 , Bogdan Feciche  9 , Florin Gorun  1 , Dragos Erdelean  1 , Adrian Ratiu  1 , Cosmin Citu  1
Affiliations

Exploring Clinical and Biological Features of Premature Births among Pregnant Women with SARS-CoV-2 Infection during the Pregnancy Period

Ingrid Hrubaru et al. J Pers Med. .

Abstract

Studies observed that women infected with SARS-CoV-2 during pregnancy had a higher risk of preterm birth. Although it is likely that COVID-19 during the late trimester of pregnancy can trigger premature birth, prematurity remains a concern, and it is vital to study additional clinical and biological patient factors that are highly associated with this negative pregnancy outcome and allow for better management based on the existing predictors. In order to achieve this goal, the current study retrospectively recruited 428 pregnant patients that were separated into three study groups using a 1:2:4 matching ratio and a nearest-neighbor matching method. Sixty-one pregnant patients had a history of COVID-19 during pregnancy and gave birth prematurely; 124 pregnant patient controls had COVID-19 and gave birth full-term, while the second control group of 243 pregnant patients had a premature birth but no history of COVID-19. It was observed that a symptomatic SARS-CoV-2 infection during the third trimester was significantly more likely to be associated with premature birth. Even though the rate of ICU admission was higher in these cases, the mortality rate did not change significantly in the COVID-19 groups. However, SARS-CoV-2 infection alone did not show statistical significance in determining a premature birth (β = 1.09, CI = 0.94−1.15, p-value = 0.067). Maternal anemia was the strongest predictor for prematurity in association with SARS-CoV-2 infection (β = 3.65, CI = 1.46−5.39, p-value < 0.001), followed by elevated CRP (β = 2.11, CI = 1.20−3.06, p-value < 0.001), and respectively IL-6 (β = 1.92, CI = 1.20−2.47, p-value = 0.001. SARS-CoV-2 infection is associated with an increased risk of preterm birth, as shown by our data. If SARS-CoV-2 infection arises during the third trimester, it is recommended that these patients be hospitalized for surveillance of clinical evolution and biological parameters, such as anemia and high inflammatory markers, which have a multiplicative influence on the pregnancy result.

Keywords: COVID-19; SARS-CoV-2; pregnancy infections; premature birth; prematurity.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Proportions of patients with a history of induced abortion and smoking.
Figure 2
Figure 2
Proportions of patients with gestational hypertension, premature rupture of membranes, and urinary tract infections during previous pregnancies.
Figure 3
Figure 3
Kaplan-Meier probability analysis of premature birth by study group.
Figure 4
Figure 4
Kaplan-Meier probability analysis of premature birth by clinical predictors.
Figure 5
Figure 5
Kaplan-Meier probability analysis of premature birth by biological predictors.
See this image and copyright information in PMC

References

    1. Wei S.Q., Bilodeau-Bertrand M., Liu S., Auger N. The impact of COVID-19 on pregnancy outcomes: A systematic review and meta-analysis. Can. Med Assoc. J. 2021;193:E540–E548. doi: 10.1503/cmaj.202604. - DOI - PMC - PubMed
    1. Wang C.-L., Liu Y.-Y., Wu C.-H., Wang C.-Y., Wang C.-H., Long C.-Y. Impact of COVID-19 on Pregnancy. Int. J. Med Sci. 2021;18:763–767. doi: 10.7150/ijms.49923. - DOI - PMC - PubMed
    1. Timircan M., Bratosin F., Vidican I., Suciu O., Turaiche M., Bota A.V., Mitrescu S., Marincu I. Coping Strategies and Health-Related Quality of Life in Pregnant Women with SARS-CoV-2 Infection. Medicina. 2021;57:1113. doi: 10.3390/medicina57101113. - DOI - PMC - PubMed
    1. Ryean G.A., Purandare N.C., McAuliffe F.M., Hod M., Purandare C.N. Clinical update on COVID -19 in pregnancy: A review article. J. Obstet. Gynaecol. Res. 2020;46:1235–1245. doi: 10.1111/jog.14321. - DOI - PMC - PubMed
    1. Uta M., Neamtu R., Bernad E., Mocanu A.G., Gluhovschi A., Popescu A., Dahma G., Dumitru C., Stelea L., Citu C., et al. The Influence of Nutritional Supplementation for Iron Deficiency Anemia on Pregnancies Associated with SARS-CoV-2 Infection. Nutrients. 2022;14:836. doi: 10.3390/nu14040836. - DOI - PMC - PubMed