New Delhi: A study conducted by the Indian Council of Medical Research (ICMR) on Thursday revealed adverse outcomes in women with COVID-19 infection. These include severe COVID-19 disease, pregnancy loss and maternal death.
Although the study was confined to Maharashtra, it has raised a major concern of such infection and post-infection scenario among women. As many as 19 medical colleges in Maharashtra, that took part in the study, focused on the clinical characteristics and pregnancy outcomes of women with COVID-19 enrolled during the first wave of the pandemic in Maharashtra.
In the study from March 1, 2020, to January 31, 2021, data of 4,203 women with COVID-19 were analysed. Majority of the pregnant and post-partum women with COVID-19 were chosen from the Mumbai Metropolitan Region. Of the 4,203 women, 3,865 were registered during their ongoing pregnancy and 338 were enrolled during the post-partum period.
A total of 4,108 women conceived naturally while 95 required assisted reproductive technologies. Of these, only 3,250 women delivered during the study, 77 women had miscarriages, 15 women had ectopic pregnancies and 27 underwent medical termination of pregnancy (MTP). Another 834 women did not deliver during the study. Vaginal delivery occurred in 1,719 (53 per cent) of women and 1,531 (47 per cent) women delivered through caesarean section.
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Live birth occurred in 3,213 women with 3,189 singletons, 60 twins and one set of triplets, resulting in a total of 3,312 neonates born to mothers with COVID-19. Majority 3,669 (87.3 per cent) of the pregnant and post-partum women with COVID-19 were asymptomatic and only 534 (12.7 per cent) women were symptomatic.
Among severe COVID-19 cases, the most common presenting symptoms were shortness of breath, dry cough and fever. The most common pregnancy complication, as per the study, was pre-term delivery. As many as 528 women reported extreme pre-term delivery, hypertensive disorders in pregnancy were reported in 328 women, hypertension in 97 women, pre-eclampsia in 191 women and eclampsia in 40 women.
"Hypertensive disorders in pregnancy were significantly higher (48 per cent) in pregnant women with severe COVID-19 as compared to mild-moderate cases," the study said.
A total of 34 deaths were reported among pregnant and post-partum women with COVID-19. Of the 34 maternal deaths, 10 women died during the post-partum period.
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"The overall case fatality rate (CFR) in pregnant and post-partum cases with COVID-19 was 0.8 per cent. Higher CFR was observed in Pune (1.1 per cent), Marathwada (1.1 per cent), regions as compared to Vidarbha (0.8 per cent), Mumbai Metropolitan (0.7 per cent)," the study said.
This was the first large scale report of systematically collected, multicentre data on the clinical presentation, pregnancy outcomes and maternal deaths amongst women with COVID-19.
