Rajendiran Sathiyakala, Brazda Caitlin, Dalm Morgan A
Department of Obstetrics and Gynecology Gadsden Regional medical center, Gadsden, AL-35903, USA.
Department of Obstetrics and Gynecology Trinity Health, Muskegon, Michigan-49444, USA.
Spartan Med Res J. 2025 May 30;10(1):23-29. doi: 10.51894/001c.140342. eCollection 2025.
To examine the relationship between COVID-19 diagnosis timing during pregnancy and adverse maternal and fetal outcomes.
Pregnant women diagnosed with COVID-19 by a nasopharyngeal swab SARS-CoV-2 PCR between January 1, 2021, and December 31, 2021, irrespective of the pregnancy outcome, were included in the study. Patients not diagnosed with COVID-19 were included as a comparison group. The timing of COVID diagnosis was categorized by trimester (first trimester, <13 weeks; second trimester, 13 to <27 weeks; third trimester, >27 weeks). Maternal outcomes included placental abnormalities, HELLP syndrome, deep vein thrombosis, pulmonary embolism, and maternal death. Fetal outcomes included pregnancy loss, intrauterine growth restriction, preterm birth, stillbirth, and admission to the NICU. Quantitative data were analyzed using a one-way ANOVA and are presented as mean ± standard deviation (SD). Nominal data were compared using chi-square or Fisher's exact tests and are reported as frequency (percent). Statistical significance was set at p < 0.05.
A total of 289 COVID-affected pregnancies and 1706 non-COVID-19 pregnancies were included. Most patients, 189 (65.4%), were diagnosed with COVID-19 in the third trimester, 66 (22.8%) in the second trimester, and 34 (11.8%) in the first trimester. There was a statistically significant higher proportion of patients experiencing placental abnormalities in patients diagnosed with COVID-19 in the 3rd trimester with lowest occurrence in non-COVID-19 pregnancies, followed by patients diagnosed in the 1st and 2nd trimesters (p<0.001). Further, preterm delivery followed a similar frequency pattern, occurring most often in patients diagnosed with COVID-19 in the 3rd trimester (p<0.001).
Patients with COVID-19 infection in the third trimester of pregnancy face a heightened risk of adverse maternal-fetal outcomes. Further investigation into this relationship is warranted.
探讨孕期新冠病毒病（COVID-19）诊断时间与孕产妇及胎儿不良结局之间的关系。
纳入2021年1月1日至2021年12月31日期间经鼻咽拭子严重急性呼吸综合征冠状病毒2（SARS-CoV-2）聚合酶链反应（PCR）确诊为COVID-19的孕妇，无论妊娠结局如何。未诊断为COVID-19的患者作为对照组。COVID诊断时间按孕期分类（孕早期，<13周；孕中期，13至<27周；孕晚期，>27周）。孕产妇结局包括胎盘异常、溶血、肝酶升高和血小板减少综合征（HELLP综合征）、深静脉血栓形成、肺栓塞和孕产妇死亡。胎儿结局包括妊娠丢失、胎儿生长受限、早产、死产和入住新生儿重症监护病房（NICU）。定量数据采用单因素方差分析进行分析，并以均数±标准差（SD）表示。名义数据采用卡方检验或Fisher精确检验进行比较，并以频率（百分比）报告。设定统计学显著性为p<0.05。
共纳入289例受COVID影响的妊娠和1706例非COVID-19妊娠。大多数患者，189例（65.4%）在孕晚期被诊断为COVID-19，66例（22.8%）在孕中期，34例（11.8%）在孕早期。在孕晚期诊断为COVID-19的患者中，发生胎盘异常的患者比例在统计学上显著更高，在非COVID-19妊娠中发生率最低，其次是在孕早期和孕中期诊断的患者（p<0.001）。此外，早产遵循类似的频率模式，最常发生在孕晚期诊断为COVID-19的患者中（p<0.001）。
妊娠晚期感染COVID-19的患者面临母婴不良结局的风险增加。有必要对这种关系进行进一步研究。
