Comparison of the pregnant and non-pregnant women of reproductive age hospitalized due to COVID-19 infection.

Abstract

COVID-19 affects pregnant women more severely than nonpregnant women of reproductive age. However, the rate of critical illness and fatality reported from other studies varied in a wide range in both groups. The study aims to investigate the clinical outcomes of COVID-19 in the pregnant and nonpregnant matched control patients admitted to the hospital. Pregnant and non-pregnant patients of reproductive age (18-45 years) infected with COVID-19 who were admitted to Ondokuz Mayıs University Hospital, Samsun, Turkey, from March 11 to December 11, 2020, were enrolled in the study. The clinical, radiological, and laboratory data of the patients were analyzed retrospectively. A total of 153 patients were investigated; 123 were nonpregnant and 30 were pregnant. Emergency delivery occurred in 5 (17%) pregnant women due to acute respiratory failure associated with COVID-19, and in 1 (3%) pregnant due to obstetric reasons. Four premature births, one perinatal death, and no stillbirth or miscarriage were reported. The rate of admission to the intensive care unit (ICU) [7/30 (23.3%) vs 3/123 (2.4%), p<0.001] and the need for invasive mechanical ventilation (IMV) [5/30 (17.0%) vs 2/123 (1.6%), p=0.003] were significantly higher in pregnant than in non-pregnant patients. However, hospital length of stay (HLOS) and mortality did not differ between groups: HLOS was median 4 vs 5 days; p=0.68, and mortality rate was 1/123 (0.8%) vs 0/30 (0%), p=0.62 in non-pregnant and pregnant patients respectively. We observed that COVID-19 has a more severe course in pregnant women versus the nonpregnant control group, but no difference was noted in terms of hospital length of stay and mortality. Overall case fatality rate of COVID-19 in either hospitalized pregnant or nonpregnant women of reproductive age was found to be much lower than the general hospitalized population worldwide.

Keywords

• COVID-19 infection
• pregnancy
• non-pregnant patient
• mortality
• critical illness

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