Journal Article Epublish
PubMed: 40608806 DOI: 10.1371/journal.pone.0327174
Clinical characteristic and outcomes of pregnant women with COVID-19: The PROUDEST prospective cohort study.
PLoS One 20(7):e0327174
Authors: Lizandra Paravidine Sasaki, Geraldo Magela Fernandes, Ângelo Pereira da Silva, Yacara Ribeiro Pereira, Aleida Oliveira de Carvalho, Felipe Motta, David Alves de Araújo Junior, Maria Eduarda Canellas de Castro, Gabriela Profírio Jardim-Santos, Heidi Luise Schulte, Clara Correia de Siracusa, Isadora Pastrana Rabelo, Pedro Sadi Monteiro, Fabiola Cristina Ribeiro Zucchi, Agenor de Castro Moreira Dos Santos Junior, Ismael Artur Costa-Rocha, Jordana Grazziela Alves Coelho-Dos-Reis, Patricia Shu Kurizky, Rosana Tristão, Dayde Lane Mendonça Da Silva, Otávio de Toledo Nóbrega, Alexandre Anderson de Sousa Munhoz Soares, Cleandro Pires de Albuquerque, Ciro Martins Gomes, Laila Salmen Espindola, Olindo Assis Martins-Filho, Alberto Moreno Zaconeta, Licia Maria Henrique da Mota
Affiliations
- Programa de Pós-Graduação em Ciências Médicas, Universidade de Brasília (UnB), Brasília, Distrito Federal, Brazil.
- Hospital Universitário de Brasília, Universidade de Brasília (UnB), Brasília, Distrito Federal, Brazil.
- Programa de Pós-graduação em Ciências da Saúde, Universidade de Brasília (UnB), Brasília, Distrito Federal, Brazil.
- Faculdade de Medicina da Universidade de Brasília (UnB), Brasília, Distrito Federal, Brazil.
- Secretaria de Saúde do Distrito Federal (SES/DF), Brasília, Distrito Federal, Brazil.
- Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ-Minas), Belo Horizonte, MG, Brazil.
- Laboratório de Virologia Básica e Aplicada, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
- Programa de Pós-Graduação em Patologia Molecular, Universidade de Brasília (UnB), Brasília, Distrito Federal, Brazil.
Abstract
The present study intended to characterize the clinical features and outcomes of SARS-CoV-2 infection at distinct pregnancy trimesters. A total of 260 pregnant women with SARS-CoV-2 infection at any pregnancy trimester were enrolled in a prospective follow-up study. Clinical features were recorded between the SARS-CoV-2 infection diagnosis towards delivery and postpartum period. ANOVA and Chi-square/Fisher tests, Bi- and multivariate analyses were performed to verify the effect of predictors on disease outcome, adjusted for the pregestational variables. Data demonstrated that anosmia (64.6%), nasal congestion/discharge (61.5%), headache (60.8%), ageusia (58.5%) and myalgia (58.5%) were the most common symptoms observed amongst pregnant women with non-severe COVID-19. Fever (44.6%) and dyspnea (36.5%) were associated with higher disease severity. Gestational diabetes mellitus (35.8%), systemic arterial hypertension (18.1%), preterm delivery (11.5%) and superimposed preeclampsia (6.2%) were reported as adverse pregnancy outcomes amongst pregnant women with COVID-19. Parturients with acute COVID-19 and pregnant women infected at the 3rd trimester presented more severe or critical outcomes as compared to those infected at 2nd and 1st trimesters. Preterm labor (Odds Ratio = 3.64), acute fetal distress (Prevalence Ratio = 2.40) and Apgar 1st minute score ≤ 7 (Prevalence Ratio = 2.56) were adverse outcomes reported in parturients with acute COVID-19 and those with severe or critical outcomes. Together these findings demonstrated that SARS-CoV-2 infection during pregnancy was associated with relevant maternal and neonatal adverse outcomes. The understanding of the clinical and obstetric outcomes of COVID-19 during pregnancy can provide insights to establish the most suitable approach for clinical management of pregnant women.
MeSH
Diabetes Mellitus, Pregnant Women, Diabetes, Gestational, Pregnancy Trimesters, Pregnancy, Cohort Studies, Covid-19, Postpartum Period, Infections