Characteristics, comparisons and outcomes of COVID-19 hospitalization and mortality in the obstetric and non-obstetric population: Cohort study
DOI:
https://doi.org/10.33448/rsd-v13i12.47807Keywords:
COVID-19; Prenancy; Postpartum period; Hospitalization; Maternal mortality.Abstract
Objective: To explore the impact of COVID-19 on morbidity and mortality among pregnant, postpartum and non-pregnant women hospitalized in Brazil. Method: This is a retrospective cohort study using data from the Brazilian Epidemiological Surveillance Information System (SIVEP-Gripe), covering epidemiological weeks from December 29, 2019 to January 2, 2021.Data were collected through the Brazilian SIVEP-Gripe; these data include sociodemographic aspects, comorbidities and other outcomes derived from hospitalization. Results: 40,640 hospitalized women aged between 10 and 49 years were categorized as pregnant (n=3,372), puerperal (n=794) and non-pregnant (n=36,474). The 19.3% of non-pregnant and non-postpartum women had no associated comorbidities, compared to 57.7% of pregnant women and 73.3% of postpartum women. There was an increased risk of oxygen saturation below 95% in postpartum women compared to pregnant women. Conclusion: Similarly, a higher risk of mortality was observed in postpartum women compared to pregnant women. There were no differences in the risk of morbidity and mortality associated with COVID-19 between non-pregnant and pregnant women.
References
Alves, R. P., Souza, V. R de., Costa, A. J da., Cardoso, T. C dos S. F., Freitas, V. L et al. (2022). Maternal mortality in times of the COVID-19 pandemic: An integrative review. RSD, 11(4), e28711426942. https://doi.org/10.33448/rsd-v11i4.26942
Amorim, M. M. R., Soligo Takemoto, M. L. & Fonseca, E. B. D. (2020). Maternal deaths with coronavirus disease 2019: a different outcome from low- to middle-resource countries? Am J Obstet Gynecol. 223(2), 298-99. https://doi.org/10.1016/j.ajog.2020.04.023
Badr, D. A., Mattern, J., Carlin, A., Cordier, A. G., Maillart, E., El Hachem, L et al. (2020). Are clinical outcomes worse for pregnant women at ≥20 weeks' gestation infected with coronavirus disease 2019? A multicenter case-control study with propensity score matching. American journal of obstetrics and gynecology, 223(5), 764–768. https://doi.org/10.1016/j.ajog.2020.07.045
Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. (2022). Boletim epidemiológico. Doença pelo coronavírus COVID-19. Semana Epidemiológica 48 - 27/11/2022 a 3/12/2022. Brasília: Ministério da Saúde. Secretaria de Vigilância em Saúde. https://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/boletins/epidemiologicos/covid-19/2022/boletim-epidemiologico-no-142-boletim-coe-coronavirus/view
Breslin, N., Baptiste, C., Miller, R., Fuchs, K., Goffman, D., Gyamfi-Bannerman, C., D'Alton, M et al. (2020). Coronavirus disease 2019 in pregnancy: early lessons. Am J Obstet Gynecol MFM, 2(2), 100111. https://doi.org/10.1016/j.ajogmf.2020.10011
Chen, H., Guo, J., Wang, C., et al. (2020). Clinical Characteristics and Intrauterine Vertical Transmission Potential of COVID-19 Infection in Nine Pregnant Women: a Retrospective Review of Medical Records. Lancet, 395(10226), 809-815. https://doi.org/10.1016/S0140-6736(20)30360-3
Collin, J., Byström, E., Carnahan, A. & Ahrne, M. (2020). Public Health Agency of Sweden's Brief Report: Pregnant and postpartum women with severe acute respiratory syndrome coronavirus 2 infection in intensive care in Sweden. Acta Obstet Gynecol Scand. 99 (7): 819-22. 10.1111/aogs.13901
Costa, R., Barata, C., Dias, H. et al. (2022). Regional differences in the quality of maternal and neonatal care during the COVID-19 pandemic in Portugal: Results from the IMAgiNE EURO study. Int J Gynecol Obstet. 159 (Suppl. 1): 137-53. 10.1002/ijgo.14507
Di Toro, F., Gjoka, M., Di Lorenzo, G., De Santo, D., De Seta, F., Maso, G., Risso, F. M., Romano, F., Wiesenfeld, U., Levi-D'Ancona, R., Ronfani, L., & Ricci, G. (2021). Impact of COVID-19 on maternal and neonatal outcomes: a systematic review and meta-analysis. Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 27(1), 36–46. https://doi.org/10.1016/j.cmi.2020.10.007
Dos Santos, G. G., de Andrade, L. H., de Sordi, M. A. P., Nunes, H. R. C., & Parada, C. M. G. L. (2022). Progression of COVID-19 Among Black Pregnant Women: Population-Based Study. Clinical nursing research, 31(4), 733–746. https://doi.org/10.1177/10547738221078899
Elshafeey, F., Magdi, R., Hindi, N., Elshebiny, M., Farrag, N., Mahdy, S., Sabbour, M., Gebril, S., Nasser, M., Kamel, M., Amir, A., Maher Emara, M., & Nabhan, A. (2020). A systematic scoping review of COVID-19 during pregnancy and childbirth. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 150(1), 47–52. https://doi.org/10.1002/ijgo.13182
Góes, E. F., Ferreira, A. J. F., & Ramos, D. (2023). Anti-Black racism and maternal death from COVID-19: what have we seen in the Pandemic?. Racismo antinegro e morte materna por COVID-19: o que vimos na Pandemia?. Ciencia & saude coletiva, 28(9), 2501–2510. https://doi.org/10.1590/1413-81232023289.08412022
Gonzalez, I., Lea, M. L. M., Magalhães, P. A. P. de, Paes, L. B. de O., Santana, M. L. C., & Pagliuco, T. (1970, January 1). Mortalidade Materna Por Covid-19: Uma Revisão Sistemática da Literatura. CuidArte, Enferm. https://pesquisa.bvsalud.org/portal/resource/pt/biblio-1367501
Guimarães, R. M., Reis, L. G. C., de Souza Mendes Gomes, M. A., Magluta, C., de Freitas, C. M., & Portela, M. C. (2023). Tracking excess of maternal deaths associated with COVID-19 in Brazil: a nationwide analysis. BMC pregnancy and childbirth, 23(1), 22. https://doi.org/10.1186/s12884-022-05338-y
Hantoushzadeh, S., Shamshirsaz, A. A., Aleyasin, A., Seferovic, M. D., Aski, S. K., Arian, S. E., Pooransari, P., Ghotbizadeh, F., Aalipour, S., Soleimani, Z., Naemi, M., Molaei, B., Ahangari, R., Salehi, M., Oskoei, A. D., Pirozan, P., Darkhaneh, R. F., Laki, M. G., Farani, A. K., Atrak, S., Aagaard, K. (2020). Maternal death due to COVID-19. American journal of obstetrics and gynecology, 223(1), 109.e1–109.e16. https://doi.org/10.1016/j.ajog.2020.04.030
Helms, J., Tacquard, C., Severac, F., Leonard-Lorant, I., Ohana, M., Delabranche, X et al. (2020). High risk of thrombosis in patients with severe SARS-CoV-2 infection: a multicenter prospective cohort study. Intensive care medicine, 46(6), 1089–1098. https://doi.org/10.1007/s00134-020-06062-x
Jani, S., Jacques, S. M., Qureshi, F., Natarajan, G., Bajaj, S., Velumula, P., Agu, C., & Bajaj, M. (2021). Clinical Characteristics of Mother-Infant Dyad and Placental Pathology in COVID-19 Cases in Predominantly African American Population. AJP reports, 11(1), e15–e20. https://doi.org/10.1055/s-0040-1721673
Kamel, H., Navi, B. B., Sriram, N., Hovsepian, D. A., Devereux, R. B., & Elkind, M. S. (2014). Risk of a thrombotic event after the 6-week postpartum period. The New England journal of medicine, 370(14), 1307–1315. https://doi.org/10.1056/NEJMoa1311485
Kasraeian, M., Zare, M., Vafaei, H., Asadi, N., Faraji, A., Bazrafshan, K., & Roozmeh, S. (2022). COVID-19 pneumonia and pregnancy; a systematic review and meta-analysis. The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 35(9), 1652–1659. https://doi.org/10.1080/14767058.2020.1763952
Knight, M., Bunch, K., Vousden, N., Morris, E., Simpson, N., Gale, C., O'Brien, P., Quigley, M., Brocklehurst, P., Kurinczuk, J. J., & UK Obstetric Surveillance System SARS-CoV-2 Infection in Pregnancy Collaborative Group (2020). Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: national population based cohort study. BMJ (Clinical research ed.), 369, m2107. https://doi.org/10.1136/bmj.m2107
Liu, D., Li, L., Wu, X., Zheng, D., Wang, J., Yang, L., Zheng, C et al. (2020a). Pregnancy and Perinatal Outcomes of Women With Coronavirus Disease (COVID-19) Pneumonia: A Preliminary Analysis. AJR Am J Roentgenol, 215(1), 127-132. https://doi.org/10.2214/AJR.20.23072
Liu, Y., et al. (2020b). Withdrawn: Clinical manifestations and outcome of SARS-CoV-2 infection during pregnancy. J Infect. https://doi.org/10.1016/j.jinf.2020.02.028
Martínez-Perez, O., Vouga, M., Cruz Melguizo, S., Forcen Acebal, L., Panchaud, A., Muñoz-Chápuli, M., & Baud, D. (2020). Association Between Mode of Delivery Among Pregnant Women With COVID-19 and Maternal and Neonatal Outcomes in Spain. JAMA, 324(3), 296–299. https://doi.org/10.1001/jama.2020.10125
Martinez-Portilla, R. J., Sotiriadis, A., Chatzakis, C., Torres-Torres, J., Espino Y Sosa, S., Sandoval-Mandujano, K., Castro-Bernabe, D. A., Medina-Jimenez, V., Monarrez-Martin, J. C., Figueras, F., & Poon, L. C. (2021). Pregnant women with SARS-CoV-2 infection are at higher risk of death and pneumonia: propensity score matched analysis of a nationwide prospective cohort (COV19Mx). Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 57(2), 224–231. https://doi.org/10.1002/uog.23575
Menezes, M. O., Takemoto, M. L. S., Nakamura-Pereira, M., Katz, L., Amorim, M. M. R., Salgado, H. O., Melo, A., Diniz, C. S. G., de Sousa, L. A. R., Magalhaes, C. G., Knobel, R., Andreucci, C. B., & Brazilian Group of Studies for COVID-19, Pregnancy (2020). Risk factors for adverse outcomes among pregnant and postpartum women with acute respiratory distress syndrome due to COVID-19 in Brazil. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 151(3), 415–423. https://doi.org/10.1002/ijgo.13407
Mullins, E., Evans, D., Viner, R. M., O'Brien, P., & Morris, E. (2020). Coronavirus in pregnancy and delivery: rapid review. Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 55(5), 586–592. https://doi.org/10.1002/uog.22014
Santos, G. G. dos, Andrade, L. H. de, Maria Garcia de Lima Parada, C., & Frassom da Silva Magaton, A. P. (2021). Efeitos da Covid-19 Entre Gestantes pretas e Pardas: Revisão Integrativa da Literatura. https://doi.org/10.33448/rsd-v10i6.15531
Santos, M. P. A. D., Nery, J. S., Goes, E. F., Silva, A. D., Santos, A. B. S. D., Batista, L. E., & Araújo, E. M. D. (2020, July 10). População Negra E covid-19: Reflexões sobre racismo e Saúde. Estudos Avançados. https://www.scielo.br/j/ea/a/LnkzjXxJSJFbY9LFH3WMQHv/
Sentilhes, L., De Marcillac, F., Jouffrieau, C., Kuhn, P., Thuet, V., Hansmann, Y., Ruch, Y., Fafi-Kremer, S., & Deruelle, P. (2020). Coronavirus disease 2019 in pregnancy was associated with maternal morbidity and preterm birth. American journal of obstetrics and gynecology, 223(6), 914.e1–914.e15. https://doi.org/10.1016/j.ajog.2020.06.022
Silva, I. de L. da, Barreto, R. A. R., Soares, B. K. P., Matias, A. D., Souza, F. M. de L. C et al. (2021). Predictors of maternal mortality by COVID-19: an integrative review. RSD, 10(10), e435101018888. https://doi.org/10.33448/rsd-v10i10.18888
Takemoto, M. L. S., Menezes, M. O., Andreucci, C. B., Nakamura-Pereira, M., Amorim, M. M. R., Katz, L., & Knobel, R. (2020). The tragedy of COVID-19 in Brazil: 124 maternal deaths and counting. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 151(1), 154–156. https://doi.org/10.1002/ijgo.13300
Testa, C. B. et al. (2023). Cardiovascular diseases worsen the maternal prognosis of COVID-19. PLoS One, 18(2), e0266792. https://doi.org/10.1371/journal.pone.0266792
Vandenbroucke, J. P. et al. (2007). Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and Elaboration. https://www.equator-network.org/reporting-guidelines/strobe/
Wang, L., Wang, Y., Ye, D., & Liu, Q. (2020a). Review of the 2019 novel coronavirus (SARS-CoV-2) based on current evidence. Int J Antimicrob Agents, 55(6), 105948. https://doi.org/10.1016/j.ijantimicag.2020
Wang, X., Zhou, Z., Zhang, J., Zhu, F., Tang, Y., Shen, X et al. (2020b). A Case of 2019 Novel Coronavirus in a Pregnant Woman With Preterm Delivery. Clin Infect Dis, 71(15), 844-846. https://doi.org/10.1093/cid/ciaa200
World Health Organization. (2020a). Coronavirus disease 2019 (Covid-19). Situation Report (SR) – 81. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200410-sitrep-81-covid 19.pdf?sfvrsn=ca96eb84_2
World Health Organization. (2020b). Coronavirus disease 2019 (Covid-19). Situation Report (SR) – 51. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200410-sitrep-81-covid 19.pdf?sfvrsn=ca96eb84_2
Yu, N., Li, W., Kang, Q., Xiong, Z., Wang, S., Lin, X et al. (2020). Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre, descriptive study. Lancet Infect Dis, 20(5), 559-564. https://doi.org/10.1016/S1473-3099(20)30176-6
Zaigham, M., & Andersson, O. (2020). Maternal and perinatal outcomes with COVID-19: A systematic review of 108 pregnancies. Acta Obstet Gynecol Scand, 99(7), 823-829. https://doi.org/10.1111/aogs.13867
Zambrano, L. D. et al. (2020). Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status - United States, January 22-October 3, 2020. MMWR Morb Mortal Wkly Rep, 69(44), 1641-1647. https://doi.org/10.15585/mmwr.mm6944e3
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Gustavo Gonçalves dos Santos; Fátima León Larios; Cristian Martín-Vázquez; Lara Beatriz de Sousa Coelho; Marcelo Victor Freitas Nascimento; Edson Silva do Nascimento; Anderson Lima Cordeiro da Silva; Leticia de Almeida Dionizio; Luis Henrique de Andrade; Beatriz María Bermejo Gil; Leticia López Pedraza; Giovana Aparecida Gonçalves Vidotti
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.