Comparison of the pregnant and non-pregnant women of reproductive age
hospitalised due to COVID 19 infection.
Abstract
Background: COVID 19 affects pregnant women more severe than the
nonpregnant women of reproductive age. However, the rate of critical
illness and fatality reported from the other studies varied in a wide
range in both group. The study aims to investigate the clinical outcomes
of pregnant and nonpregnant patients hospitalised with COVID 19
infection. Method: Clinical, radiologoic and laboratory data of pregnant
and nonpregnant patients of reproductive age (18-45 years) infected with
COVID 19 were analysed retrospectively. Results: Of 153 patients, 123
were nonpregnant and 30 were pregnant. 15 of the 30 pregnant patients
delivered during the hopital stay and 6 of them received an urgent
cesarean section. Of the six urgent delivery, five were due to
respiratory insufficiency related to COVID 19 and one was unrelated to
COVID 19. Four preterm birth, one perinatal death but no stillbirth or
miscarriage was recorded. The most common symptom and comorbidity were
cough and asthma in both group respectively. Semiquantative CT severity
score was significantly higher in pregnants than in nonpregnants (9
points vs 2 points, p=0.022). Prognostic laboratory markers including
lymphocytopenia, C-reactive protein and D-dimer were markedly worse in
the pregnant group. Severe or critical patients were proportionally
higher in the pregnants than in the nonpregnants (26% vs 15%,
p=0.004). Hospital length of stay (HLOS) was median 4 vs 5 day; p=0.68,
mortality rate was 1/123(0.8%) vs 0/30(0%), p=0.62; intensive care
unit (ICU) admission rate was 3/123 (2.4%) vs 7/30 (23.3),
p<0.001; need for invasive mechanical ventilation (IMV) was
2/123 (1.6%) vs 5/30 (17%), p=0.003 in nonpregnant and pregnant
patients respectively. Conclusion: COVID 19 has a more severe course in
pregnant women versus nonpregnant control group, but no difference was
noted in terms of hospital length of stay and mortality.