GEÇİRİLMİŞ COVİD-19 ENFEKSİYONUN İLK TRİMESTER GEBELİK KAYIPLARI ÜZERİNE ETKİSİ

Öz

Amaç: Bu çalışmanın amacı, gebe kalmadan önceki 1 yıllık süreç içerisinde geçirilmiş Covid-19 enfeksiyonunun erken gebelik kayıpları üzerine etkisinin araştırılmasıdır. Gereç-Yöntem: Çalışma prospektif tanımlayıcı bir çalışma olup, 01.03.2021-01.09.2021 tarihleri arasında Ankara Dr Sami Ulus Kadın Doğum, Çocuk Sağlığı ve Hastalıkları E.A.H. Kadın Hastalıkları ve Doğum Bölümü Obstetrik Polikliniği’nde yürütülmüştür. Gebelik takibi nedeniyle ilk kontrolüne gelen 18-35 yaş arasındaki ilk trimesterdeki gebelerden gebe kalmadan önceki 1 yıl içerisinde Covid-19 enfeksiyonu geçirdiğini ifade eden gebeler çalışma grubuna (n=150), çalışma grubuna alınan gebeden sonra ilk trimesterinde başvuran, 18-35 yaş arasında olup gebelik öncesi Covid-19 enfeksiyonu geçirme öyküsü olmayan ilk gebe de kontrol grubuna dahil edilmiştir (n=150). Gebeler 20. gebelik haftasına kadar takip edilmiş ve iki grubun erken gebelik kaybı oranları (<20 hafta herhangi bir müdahale olmaksızın spontan abort yapma ya da intrauterin GS olmasına rağmen fetal kalp atımlarının yokluğu) karşılaştırılmıştır. Bulgular: Covid-19 enfeksiyonu geçiren gebelerden 8”i (%5,3), geçirmeyen gebelerden 9’u (%6,0) erken gebelik kaybı yaşamış olup, iki grup arasında erken gebelik kayıp oranları açısından istatistiksel olarak anlamlı bir fark saptanmamıştır (p>0.05). Çalışma grubunda gebelik kaybı yaşamayan gebelerin gebelikten ortalama 6,04±2,94 ay, gebelik kaybı yaşayan gebelerin ise ortalama 6,75±3,15 ay önce Covid-19 enfeksiyonu geçirdiği saptanmış olup istatistiksel açıdan anlamlı bir fark izlenmemiştir (p>0,05). Sonuç: Çalışmada gebelik öncesi geçirilen Covid-19 enfeksiyonu ile erken gebelik kaybı arasında bir ilişki saptanmamış olmasına rağmen, Covid-19 enfeksiyonunun, plasental vaskülopati üzerindeki etkisi göz önünde bulundurulduğunda erken gebelik kaybı ile ilişkisi larger prospektif çalışmalarla netleştirilmeli ve en azından gebelik öncesi dönemde anne adayları bu konuda doğru yönlendirilerek anksiyete yaşamaları engellenmelidir.

Anahtar Kelimeler

• Covid-19
• gebelik öncesi
• erken gebelik kaybı

THE EFFECT OF PAST COVID-19 INFECTION ON EARLY PREGNANCY LOSSES

Öz

Aim: The aim of this study was to investigate the effect of Covid-19 infection on early pregnancy losses within one year before pregnancy. Material-Method: The study is a prospective descriptive study that was carried out between 01.03.2021 and 01.09.2021, in the Obstetrics Outpatient clinic of the Obstetrics and Gynecology Department of Ankara Dr. Sami Ulus Gynecology, Child Health, and Diseases Training and Research Hospital. Among the pregnant women between the ages of 18-35 who came for their first control due to obstetric follow-up, the pregnant women in the first trimester who stated that they had Covid-19 infection within one year before pregnancy, were in the study group (n=150), and the pregnant women in the first trimester who did not have a history of Covid-19 infection before pregnancy was also included in the control group (n=150). The pregnant women were followed up to the 20th gestational week and the early pregnancy loss rates of the two groups (spontaneous abortion at <20 weeks without any intervention or the absence of fetal heartbeats despite intrauterine GS) were compared. Results: Eight (5.3%) pregnant women who had Covid-19 infection and 9 (6.0%) women who did not have Covid-19 infection experienced early pregnancy loss, and no statistically significant difference was found between the two groups in terms of early pregnancy loss rates (p> 0.05). In the study group, it was determined that the pregnant women who did not experience a pregnancy loss had an average of 6.04±2.94 months before pregnancy, and the pregnant women who had a pregnancy loss had an average of 6.75±3.15 months before the Covid-19 infection, and no statistically significant difference was observed (p>0, 05). Conclusion: Although there was no relationship between pre-conceptional Covid-19 infection and early pregnancy loss in the study, considering the effect of Covid-19 infection on placental vasculopathy, its relationship with early pregnancy loss should be clarified with larger prospective studies. In this regard,expectant mothers should be guided and their anxiety should be ameliorated at least in the pre-pregnancy period.

Anahtar Kelimeler

• Covid-19
• pre-conception
• early pregnancy loss

Kaynakça

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