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Pregnancy Implication Related to the COVID-19 Pandemic

Document Type : Original Article

Authors

1 Department of Anatomical Sciences, and Pathology and Stem Cell Research Centre, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran

2 Department of Pathology, Pathology and Stem Cell Research Center, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran

3 Pathology and Stem Cell Research Centre, Physiology Research Center, Department of Physiology and Pharmacology, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran

4 Department of Basic Sciences, Faculty of Medicine, Kerman Branch, Islamic Azad University, Kerman, Iran

5 Department of Physiology and Pharmacology, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran

6 Department of Anatomical Sciences, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran

7 Department of Biostatistics, Faculty of Paramedical Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

Background: COVID-19 that is caused by severe acute respiratory syndrome coronavirus 2, is being classified as a pandemic and has influenced all aspects of human life. Although some groups, such as pregnant women, are at higher risk, the information on COVID-19 effects on pregnancy has remained limited yet.
Methods: This study aimed to evaluate the effects of the COVID-19 pandemic on the fetal mortality rate (FMR). The delivery status of all asymptomatic pregnant women hospitalized in 5 hospitals located in Kerman city, Iran, were checked three months before and three months during this pandemic.
Results: According to the results, compared to the non-COVID-19, the COVID-19 period increased FMR with an odds ratio of 1.40 (95% CI: 1.14-1.72), meaning that the coronavirus could increase the risk of fetal death by 40%.
Conclusion: The evidence suggests that more careful and accurate screening approaches are needed for asymptomatic pregnant individuals to avoid risks to the fetus and mother.

Keywords

Main Subjects

References
  1. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. doi: 10.1016/s0140-6736(20)30183-5.
  2. Abuelgasim E, Saw LJ, Shirke M, Zeinah M, Harky A. COVID-19: Unique public health issues facing Black, Asian and minority ethnic communities. Curr Probl Cardiol. 2020;45(8):100621. doi: 10.1016/j.cpcardiol.2020.100621.
  3. Zhao S, Lin Q, Ran J, Musa SS, Yang G, Wang W, et al. Preliminary estimation of the basic reproduction number of novel coronavirus (2019-nCoV) in China, from 2019 to 2020: a data-driven analysis in the early phase of the outbreak. Int J Infect Dis. 2020;92:214-7. doi: 10.1016/j.ijid.2020.01.050.
  4. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-13. doi: 10.1016/s0140-6736(20)30211-7.
  5. Centers for Disease Control and Prevention (CDC). Interim Infection Prevention and Control Recommendations for Patients with Confirmed 2019 Novel Coronavirus (2019- nCoV) or Patients Under Investigation for 2019-nCoV in Healthcare Settings. 2020. Available from: https://www.cdc. gov/coronavirus/2019-nCoV/hcp/infection-control.html. Accessed January 3, 2022.
  6. Centers for Disease Control and Prevention (CDC). Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus (2019-nCoV). 2020. Available from: https://www.cdc. gov/coronavirus/2019-ncov/hcp/guidance-homecare. html?CDC_AA_refValht tps%3A%2F%2Fwww.cdc. gov%2Fcoronavirus%2F2019-ncov%2Fguidance-home-care. html. Accessed January 3, 2022.
  7. Lipsitch M, Swerdlow DL, Finelli L. Defining the epidemiology of COVID-19 - studies needed. N Engl J Med. 2020;382(13):1194-6. doi: 10.1056/NEJMp2002125.
  8. Jordan RE, Adab P, Cheng KK. COVID-19: risk factors for severe disease and death. BMJ. 2020;368:m1198. doi: 10.1136/bmj. m1198.
  9. Siston AM, Rasmussen SA, Honein MA, Fry AM, Seib K, Callaghan WM, et al. Pandemic 2009 influenza A(H1N1) virus illness among pregnant women in the United States. JAMA. 2010;303(15):1517-25. doi: 10.1001/jama.2010.479.
  10. Rasmussen SA, Jamieson DJ, Honein MA, Petersen LR. Zika virus and birth defects--reviewing the evidence for causality. N Engl J Med. 2016;374(20):1981-7. doi: 10.1056/ NEJMsr1604338.
  11. Dashraath P, Wong JLJ, Lim MX, Lim LM, Li S, Biswas A, et al. Coronavirus disease 2019 (COVID-19) pandemic and pregnancy. Am J Obstet Gynecol. 2020;222(6):521-31. doi: 10.1016/j.ajog.2020.03.021.
  12. Ortiz EI, Herrera E, De La Torre A. Coronavirus (COVID 19) infection in pregnancy. Colomb Med (Cali). 2020;51(2):e4271. doi: 10.25100/cm.v51i2.4271.
  13. Li Y, Zhao R, Zheng S, Chen X, Wang J, Sheng X, et al. Lack of vertical transmission of severe acute respiratory syndrome coronavirus 2, China. Emerg Infect Dis. 2020;26(6):1335-6. doi: 10.3201/eid2606.200287.
  14. Liu W, Wang Q, Zhang Q, Chen L, Chen J, Zhang B, et al. Coronavirus disease 2019 (COVID-19) during pregnancy: a case series. Preprints. 2020. Available from: https://www. preprints.org/manuscript/202002.0373/v1.
  15. Kadir RA, Kobayashi T, Iba T, Erez O, Thachil J, Kazi S, et al. COVID-19 coagulopathy in pregnancy: critical review, preliminary recommendations, and ISTH registry-communication from the ISTH SSC for Women’s Health. J Thromb Haemost. 2020;18(11):3086-98. doi: 10.1111/ jth.15072.
  16. Liu H, Wang LL, Zhao SJ, Kwak-Kim J, Mor G, Liao AH. Why are pregnant women susceptible to COVID-19? An immunological viewpoint. J Reprod Immunol. 2020;139:103122. doi: 10.1016/j.jri.2020.103122.
  17. Zhu H, Wang L, Fang C, Peng S, Zhang L, Chang G, et al. Clinical analysis of 10 neonates born to mothers with 2019- nCoV pneumonia. Transl Pediatr. 2020;9(1):51-60. doi: 10.21037/tp.2020.02.06.
  18. Liu D, Li L, Wu X, Zheng D, Wang J, Liang B, et al. Pregnancy and Perinatal Outcomes of Women with COVID-19 Pneumonia: A Preliminary Analysis. 2020. Available from: https://ssrn.com/abstract = 3548758.
  19. Cosma S, Carosso AR, Cusato J, Borella F, Carosso M, Bovetti M, et al. Coronavirus disease 2019 and first-trimester spontaneous abortion: a case-control study of 225 pregnant patients. Am J Obstet Gynecol. 2021;224(4):391.e1-391.e7. doi: 10.1016/j.ajog.2020.10.005.
  20. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-9. doi: 10.1001/jama.2020.1585.
  21. Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet. 2020;395(10226):809-15. doi: 10.1016/s0140-6736(20)30360-3.
  22. Yan J, Guo J, Fan C, Juan J, Yu X, Li J, et al. Coronavirus disease 2019 in pregnant women: a report based on 116 cases. Am J Obstet Gynecol. 2020;223(1):111.e1-111.e14. doi: 10.1016/j. ajog.2020.04.014.
  23. Akhtar H, Patel C, Abuelgasim E, Harky A. COVID-19 (SARS-CoV-2) infection in pregnancy: a systematic review. Gynecol Obstet Invest. 2020;85(4):295-306. doi: 10.1159/000509290.
  24. Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet. 2020;395(10226):809-15. doi: 10.1016/s0140-6736(20)30360-3.
  25. Bateson DJ, Lohr PA, Norman WV, Moreau C, Gemzell- Danielsson K, Blumenthal PD, et al. The impact of COVID-19 on contraception and abortion care policy and practice: experiences from selected countries. BMJ Sex Reprod Health. 2020;46(4):241-3. doi: 10.1136/bmjsrh-2020-200709.
  26. Rasmussen SA, Smulian JC, Lednicky JA, Wen TS, Jamieson DJ. Coronavirus disease 2019 (COVID-19) and pregnancy: what obstetricians need to know. Am J Obstet Gynecol. 2020;222(5):415-26. doi: 10.1016/j.ajog.2020.02.017.
  27. Mohammed SH, Ali RM. Assessment of psychological risk factors for spontaneous abortion at maternity wards in Baghdad city hospitals. Indian J Forensic Med Toxicol. 2020;14(4):2425-9.
  28. Tomfohr-Madsen LM, Racine N, Giesbrecht GF, Lebel C, Madigan S. Depression and anxiety in pregnancy during COVID-19: a rapid review and meta-analysis. Psychiatry Res. 2021;300:113912. doi: 10.1016/j.psychres.2021.113912.
  29. Lebel C, MacKinnon A, Bagshawe M, Tomfohr-Madsen L, Giesbrecht G. Elevated depression and anxiety symptoms among pregnant individuals during the COVID-19 pandemic. J Affect Disord. 2020;277:5-13. doi: 10.1016/j. jad.2020.07.126.
  30. Moyer CA, Compton SD, Kaselitz E, Muzik M. Pregnancy-related anxiety during COVID-19: a nationwide survey of 2740 pregnant women. Arch Womens Ment Health. 2020;23(6):757-65. doi: 10.1007/s00737-020-01073-5.
  31. Baboolall U, Zha Y, Gong X, Deng DR, Qiao F, Liu H. Variations of plasma D-dimer level at various points of normal pregnancy and its trends in complicated pregnancies: a retrospective observational cohort study. Medicine (Baltimore). 2019;98(23):e15903. doi: 10.1097/md.0000000000015903.
  32. Giannis D, Ziogas IA, Gianni P. Coagulation disorders in coronavirus infected patients: COVID-19, SARS-CoV-1, MERS-CoV and lessons from the past. J Clin Virol. 2020;127:104362. doi: 10.1016/j.jcv.2020.104362.
  33. Iba T, Levy JH, Levi M, Thachil J. Coagulopathy in COVID-19. J Thromb Haemost. 2020;18(9):2103-9. doi: 10.1111/ jth.14975.
  34. Mucha SR, Dugar S, McCrae K, Joseph D, Bartholomew J, Sacha GL, et al. Coagulopathy in COVID-19: manifestations and management. Cleve Clin J Med. 2020;87(8):461-8. doi: 10.3949/ccjm.87a.ccc024.
  35. Lebel C, MacKinnon A, Bagshawe M, Tomfohr-Madsen L, Giesbrecht G. Corrigendum to elevated depression and anxiety symptoms among pregnant individuals during the COVID-19 pandemic journal of affective disorders 277 (2020) 5-13. J Affect Disord. 2021;279:377-9. doi: 10.1016/j. jad.2020.10.012.
  36. Mokhtari T, Hassani F, Ghaffari N, Ebrahimi B, Yarahmadi A, Hassanzadeh G. COVID-19 and multiorgan failure: a narrative review on potential mechanisms. J Mol Histol. 2020;51(6):613-28. doi: 10.1007/s10735-020-09915-3.
  37. Renu K, Prasanna PL, Valsala Gopalakrishnan A. Coronaviruses pathogenesis, comorbidities and multi-organ damage - a review. Life Sci. 2020;255:117839. doi: 10.1016/j. lfs.2020.117839.
  38. Mor G, Aldo P, Alvero AB. The unique immunological and microbial aspects of pregnancy. Nat Rev Immunol. 2017;17(8):469-82. doi: 10.1038/nri.2017.64.
  39. Aghaeepour N, Ganio EA, McIlwain D, Tsai AS, Tingle M, Van Gassen S, et al. An immune clock of human pregnancy. Sci Immunol. 2017;2(15):eaan2946. doi: 10.1126/sciimmunol. aan2946.
  40. Tan L, Wang Q, Zhang D, Ding J, Huang Q, Tang YQ, et al. Lymphopenia predicts disease severity of COVID-19: a descriptive and predictive study. Signal Transduct Target Ther. 2020;5(1):33. doi: 10.1038/s41392-020-0148-4.
  41. Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020;8(5):475-81. doi: 10.1016/s2213-2600(20)30079-5.
  42. Tetro JA. Is COVID-19 receiving ADE from other coronaviruses? Microbes Infect. 2020;22(2):72-3. doi: 10.1016/j. micinf.2020.02.006.
  43. Yu D, Rao S, Tsai LM, Lee SK, He Y, Sutcliffe EL, et al. The transcriptional repressor Bcl-6 directs T follicular helper cell lineage commitment. Immunity. 2009;31(3):457-68. doi: 10.1016/j.immuni.2009.07.002.
  44. Fried M, Kurtis JD, Swihart B, Pond-Tor S, Barry A, Sidibe Y, et al. Systemic inflammatory response to malaria during pregnancy is associated with pregnancy loss and preterm delivery. Clin Infect Dis. 2017;65(10):1729-35. doi: 10.1093/ cid/cix623.
  45. Abbassi-Ghanavati M, Greer LG, Cunningham FG. Pregnancy and laboratory studies: a reference table for clinicians. Obstet Gynecol. 2009;114(6):1326-31. doi: 10.1097/ AOG.0b013e3181c2bde8.
  46. Cui S, Chen S, Li X, Liu S, Wang F. Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia. J Thromb Haemost. 2020;18(6):1421-4. doi: 10.1111/jth.14830.
  47. Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020;18(4):844-7. doi: 10.1111/jth.14768.
  48. Thachil J, Tang N, Gando S, Falanga A, Cattaneo M, Levi M, et al. ISTH interim guidance on recognition and management of coagulopathy in COVID-19. J Thromb Haemost. 2020;18(5):1023-6. doi: 10.1111/jth.14810.
  49. Hunt B, Retter A, McClintock C. Practical Guidance for the Prevention of Thrombosis and Management of Coagulopathy and Disseminated Intravascular Coagulation of Patients Infected with COVID-19. Available from: https://thrombosisuk. org/downloads/T&H%20and%20COVID.pdf. Accessed April 28, 2020.
  50. Vlachodimitropoulou Koumoutsea E, Vivanti AJ, Shehata N, Benachi A, Le Gouez A, Desconclois C, et al. COVID-19 and acute coagulopathy in pregnancy. J Thromb Haemost. 2020;18(7):1648-52. doi: 10.1111/jth.14856.
  51. Martinelli I, Ferrazzi E, Ciavarella A, Erra R, Iurlaro E, Ossola M, et al. Pulmonary embolism in a young pregnant woman with COVID-19. Thromb Res. 2020;191:36-7. doi: 10.1016/j. thromres.2020.04.022.
  52. Mohammadi S, Abouzaripour M, Hesam Shariati N, Hesam Shariati MB. Ovarian vein thrombosis after coronavirus disease (COVID-19) infection in a pregnant woman: case report. J Thromb Thrombolysis. 2020;50(3):604-7. doi: 10.1007/ s11239-020-02177-6.
  53. Ferrazzo S, Gunduz-Cinar O, Stefanova N, Pollack GA, Holmes A, Schmuckermair C, et al. Increased anxiety-like behavior following circuit-specific catecholamine denervation in mice. Neurobiol Dis. 2019;125:55-66. doi: 10.1016/j. nbd.2019.01.009.
  54. Lenders JW. Pheochromocytoma and pregnancy: a deceptive connection. Eur J Endocrinol. 2012;166(2):143-50. doi: 10.1530/eje-11-0528.
  55. Misasi G, Pancetti F, Giannini A, Simoncini T, Mannella P. Pheochromocytoma diagnosed during pregnancy: a case report. Gynecol Endocrinol. 2020;36(7):650-3. doi: 10.1080/09513590.2020.1754392.
  56. Dunkel Schetter C. Psychological science on pregnancy: stress processes, biopsychosocial models, and emerging research issues. Annu Rev Psychol. 2011;62:531-58. doi: 10.1146/ annurev.psych.031809.130727.
  57. Li M, Chen L, Zhang J, Xiong C, Li X. The SARS-CoV-2 receptor ACE2 expression of maternal-fetal interface and fetal organs by single-cell transcriptome study. PLoS One. 2020;15(4):e0230295. doi: 10.1371/journal.pone.0230295.
  58. Narang K, Enninga EAL, Gunaratne M, Ibirogba ER, Trad ATA, Elrefaei A, et al. SARS-CoV-2 infection and COVID-19 during pregnancy: a multidisciplinary review. Mayo Clin Proc. 2020;95(8):1750-65. doi: 10.1016/j.mayocp.2020.05.011.
  59. Todros T, Masturzo B, De Francia S. COVID-19 infection: ACE2, pregnancy and preeclampsia. Eur J Obstet Gynecol Reprod Biol. 2020;253:330. doi: 10.1016/j.ejogrb.2020.08.007.
  60. Baud D, Greub G, Favre G, Gengler C, Jaton K, Dubruc E, et al. Second-trimester miscarriage in a pregnant woman with SARS-CoV-2 infection. JAMA. 2020;323(21):2198-200. doi: 10.1001/jama.2020.7233.
Journal of Kerman University of Medical Sciences
Volume 31, Issue 4
July and August 2024
Pages 158-164
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