Download PDF
CC BY-NC-ND 4.0 · Ann Natl Acad Med Sci 2023; 59(03): 158-163
DOI: 10.1055/s-0043-57224
Original Article

Second Wave of SARS-CoV-2: Impact on Pregnant Women and Newborns—A Tertiary Care Experience in North India

Sumitra Bachani
1   Department of Obstetrics & Gynecology, Vardhman Mahavir Medical College & Safdarjung Hospital, Delhi, India
,
Jyotsna Suri
1   Department of Obstetrics & Gynecology, Vardhman Mahavir Medical College & Safdarjung Hospital, Delhi, India
,
Anita Kumar
1   Department of Obstetrics & Gynecology, Vardhman Mahavir Medical College & Safdarjung Hospital, Delhi, India
,
Suchandana Dasgupta 
1   Department of Obstetrics & Gynecology, Vardhman Mahavir Medical College & Safdarjung Hospital, Delhi, India
,
Anjali Dabral
1   Department of Obstetrics & Gynecology, Vardhman Mahavir Medical College & Safdarjung Hospital, Delhi, India
› Author Affiliations Funding None.
› Further Information
   Permissions and Reprints

Abstract

Objectives The aim of this study was to evaluate the clinical presentation, course of disease, and management of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in pregnant women. We also aimed to evaluate the fetomaternal outcomes in these women.

Material and Methodology This was a single-center, retrospective study performed in a tertiary care hospital for pregnant women with coronavirus disease 2019 (COVID-19) in India. The medical records of all antenatal or postnatal women who were admitted to COVID-19 facility from April 1 to June 30, 2021, were reviewed. The demographic characteristics, obstetric parameters, presence of comorbidities, disease severity, investigations, management, and fetal outcome were recorded.

Statistical Analysis The data were entered in MS Excel spreadsheet and analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0.

Result A total of 94 women were admitted to the COVID-19 facility; 54 (57.45%) were antenatal and 40 (42.55%) were postnatal, 75.53% of them were between 20 and 30 years of age, and 62.96% were multigravida. In addition, 42.55% were asymptomatic and 32.98, 9.58, and 14.89% had mild, moderate, and severe disease, respectively. Also, 42.59% of women had cesarean delivery. Among these, 14 (14.89%) required intensive care unit (ICU) admission, and 24.46% needed oxygen therapy. Comorbidities were present in 48.94%, with hypertensive disorder being the most common (14.89%). Common residual complaints were malaise, body ache, and cough. Among women admitted in the ICU, eight (57%) had comorbidities such as preeclampsia, diabetes, heart disease, and anemia. All these women required oxygen therapy, antibiotics, and thromboprophylaxis. Six among them received steroid (methylprednisolone) and four received antiviral drug (remdesivir). Three women succumbed to death. The mortality rate was 3.19%. Among the neonates, six babies were affected with SARS-CoV-2 and all recovered. On follow-up after discharge, one woman with rheumatic heart disease expired after 2 days of discharge and one woman had a spontaneous abortion.

Conclusion During the second wave, caused by the Delta variant, maximum requirement was for oxygen therapy, antiviral drugs, and steroids. We conclude that women with comorbidities and advanced period of gestation had a severe course and required critical care. The optimum care and counselling regarding possible outcome in such a vulnerable population is needed.

Keywords

COVID-19 - SARS-COV-2 - second wave of COVID-19 - pregnancy and COVID-19 - Delta variant - oxygen therapy - remdesivir


Publication History

Article published online:
08 August 2023

© 2023. National Academy of Medical Sciences (India). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • Reference

  • 1 WHO. WHO Director-General's opening remarks at the media briefing on COVID-19 - 11 March 2020. Accessed June 7, 2021 at: https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19—11-march-2020
    Google Scholar
  • 2 Government of India. Ministry of Health and Family Welfare. COVID-19. Accessed May 19, 2021 at: https://www.mohfw.gov.in/
    Google Scholar
  • 3 Kadiwar S, Smith JJ, Ledot S, Johnson M, Bianchi P, Singh N. et al. Were pregnant women more affected by COVID-19 in the second wave of the pandemic?. Lancet 2021; 397 (10284): 1539-1540
    CrossrefPubMedGoogle Scholar
  • 4 Li Y, Zhao R, Zheng S. et al. Lack of vertical transmission of severe acute respiratory syndrome coronavirus 2, China. Emerg Infect Dis 2020; 26 (06) 1335-1336
    CrossrefPubMedGoogle Scholar
  • 5 Wong SF, Chow KM, Leung TN. et al. Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome. Am J Obstet Gynecol 2004; 191 (01) 292-297
    CrossrefPubMedGoogle Scholar
  • 6 WHO. Tracking SARS-CoV-2 variants. Accessed June 14, 2021 at: https://www.who.int/activities/tracking-SARS-CoV-2-variants
    Google Scholar
  • 7 Clinical guidance for management of adult covid-19 patients. Accessed December 27, 2021 at: https://www.icmr.gov.in/pdf/covid/techdoc/COVID_Management_Algorithm_17052021.pdf
    Google Scholar
  • 8 Mehta N, Chen K, Hardy E, Powrie R. Respiratory disease in pregnancy. Best Pract Res Clin Obstet Gynaecol 2015; 29 (05) 598-611
    CrossrefPubMedGoogle Scholar
  • 9 Breslin N, Baptiste C, Gyamfi-Bannerman C. et al. Coronavirus disease 2019 infection among asymptomatic and symptomatic pregnant women: two weeks of confirmed presentations to an affiliated pair of New York City hospitals. Am J Obstet Gynecol MFM 2020; 2 (02) 100118
    CrossrefPubMedGoogle Scholar
  • 10 Yee J, Kim W, Han JM. et al. Clinical manifestations and perinatal outcomes of pregnant women with COVID-19: a systematic review and meta-analysis. Sci Rep 2020; 10 (01) 18126
    CrossrefPubMedGoogle Scholar
  • 11 Capobianco G, Saderi L, Aliberti S. et al. COVID-19 in pregnant women: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2020; 252: 543-558
    CrossrefPubMedGoogle Scholar
  • 12 Chen H, Guo J, Wang C. et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet 2020; 395 (10226): 809-815
    CrossrefPubMedGoogle Scholar
  • 13 Fan C, Lei D, Fang C. et al. Perinatal transmission of 2019 coronavirus disease-associated severe acute respiratory syndrome coronavirus 2: should we worry?. Clin Infect Dis 2021; 72 (05) 862-864
    CrossrefPubMedGoogle Scholar
  • 14 Chen Y, Peng H, Wang L. et al. Infants born to mothers with a new coronavirus (COVID-19). Front Pediatr 2020; 8: 104
    CrossrefPubMedGoogle Scholar
  • 15 Zhu H, Wang L, Fang C. et al. Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia. Transl Pediatr 2020; 9 (01) 51-60
    CrossrefPubMedGoogle Scholar
  • 16 Zhang L, Jiang Y, Wei M. et al. Analysis of the pregnancy outcomes in pregnant women with COVID-19 in Hubei Province [in Chinese]. Zhonghua Fu Chan Ke Za Zhi 2020; 55 (03) 166-171
    CrossrefPubMedGoogle Scholar
  • 17 Liu W, Wang Q, Zhang Q. et al. Coronavirus disease 2019 (COVID-19) during pregnancy: a case series. 2020; Preprints 2020020373
    Google Scholar
  • 18 Wang X, Zhou Z, Zhang J, Zhu F, Tang Y, Shen X. Corrigendum to: A case of 2019 novel coronavirus in a pregnant woman with preterm delivery. Clin Infect Dis 2021; 72 (09) 1684
    CrossrefPubMedGoogle Scholar
  • 19 Liu D, Li L, Wu X. et al. Pregnancy and perinatal outcomes of women with coronavirus disease (COVID-19) pneumonia: a preliminary analysis. AJR Am J Roentgenol 2020; 215 (01) 127-132
    CrossrefPubMedGoogle Scholar
  • 20 Zeng L, Xia S, Yuan W. et al. Neonatal early-onset infection with SARS-CoV-2 in 33 neonates born to mothers with COVID-19 in Wuhan, China. JAMA Pediatr 2020; 174 (07) 722-725
    CrossrefPubMedGoogle Scholar
  • 21 Yu N, Li W, Kang Q. et al. 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 2020; 20 (05) 559-564
    CrossrefPubMedGoogle Scholar
  • 22 Dong L, Tian J, He S. et al. Possible vertical transmission of SARS-CoV-2 from an infected mother to her newborn. JAMA 2020; 323 (18) 1846-1848
    PubMedGoogle Scholar
  • 23 Mahajan NN, Pophalkar M, Patil S. et al. Pregnancy outcomes and maternal complications during the second wave of coronavirus disease 2019 (COVID-19) in India. Obstet Gynecol 2021; 138 (04) 660-662
    CrossrefPubMedGoogle Scholar