Document Type : Original Article
Authors
1 Department of Obstetrics and Gynecology, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
2 Department of Community Medicine and Biostatistics, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
Abstract
Background: Pregnant individuals are considered a high-risk group for COVID-19, which has been linked to an elevated likelihood of adverse pregnancy outcomes. Nonetheless, the specific effect of SARS-CoV-2 infection on amniotic fluid volume is not fully understood. This study aimed to determine the incidence of amniotic fluid disorders (AFD) in pregnant women with COVID-19.
Methods: This cross-sectional analysis included 207 pregnant women diagnosed with COVID-19 at Alavi Hospital in Ardabil, Iran. Data were collected through patient interviews, physical assessments, medical records, and laboratory findings using a standardized checklist. Statistical analyses were conducted with SPSS software (version 25), considering a p-value below 0.05 as statistically significant.
Results: The mean age of participants was 28.3 ± 6.5 years. Among the cohort, 19 women (9.2%) with COVID-19 were diagnosed with an amniotic fluid disorder, with all cases identified as oligohydramnios. The occurrence of oligohydramnios showed significant associations with several factors: the trimester of COVID-19 infection (P=0.007), presence of dyspnea (P=0.004), extent of pulmonary involvement on imaging (P=0.027), overall disease severity (P=0.001), requirement for specific hospitalization wards (e.g., ICU) (P=0.001), delivery via cesarean section (P=0.021), and preterm birth (P=0.001).
Conclusion: The findings indicate a significantly higher incidence of oligohydramnios in women infected with COVID-19 during the third trimester, particularly among those exhibiting dyspnea and pulmonary involvement. Furthermore, oligohydramnios was significantly correlated with increased rates of cesarean delivery and preterm birth.
Highlights
Faranak Jalilvand (Google Scholar) (PubMed)
Keywords
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- Bulut C, Kato Y. Epidemiology of COVID-19. Turk J Med Sci. 2020;50(Si-1):563-70. doi: 10.3906/sag-2004-172
- Dhar Chowdhury S, Oommen AM. Epidemiology of COVID-19. J Dig Endosc. 2020;11(1):3-7. doi: 10.1055/s- 0040-1712187
- Halaji M, Heiat M, Faraji N, Ranjbar R. Epidemiology of COVID-19: an updated review. J Res Med Sci. 2021;26:82. doi: 10.4103/jrms.JRMS_506_20
- Shi Y, Wang G, Cai XP, Deng JW, Zheng L, Zhu HH, et al. An overview of COVID-19. J Zhejiang Univ Sci B. 2020;21(5):343- 60. doi: 10.1631/jzus.B2000083
- Ciotti M, Ciccozzi M, Terrinoni A, Jiang WC, Wang CB, Bernardini S. The COVID-19 pandemic. Crit Rev Clin Lab Sci. 2020;57(6):365-88. doi: 10.1080/10408363.2020.1783198
- Phoswa WN, Khaliq OP. Is pregnancy a risk factor of COVID-19? Eur J Obstet Gynecol Reprod Biol. 2020;252:605- 9. doi: 10.1016/j.ejogrb.2020.06.058
- Favre G, Pomar L, Baud D. Coronavirus disease 2019 during pregnancy: do not underestimate the risk of maternal adverse outcomes. Am J Obstet Gynecol MFM. 2020;2(3):100160. doi: 10.1016/j.ajogmf.2020.100160
- Ellington S, Strid P, Tong VT, Woodworth K, Galang RR, Zambrano LD, et al. Characteristics of women of reproductive age with laboratory-confirmed SARS-CoV-2 infection by pregnancy status - United States, January 22-June 7, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(25):769-75. doi: 10.15585/mmwr.mm6925a1
- Badr DA, Mattern J, Carlin A, Cordier AG, Maillart E, El Hachem L, et al. Are clinical outcomes worse for pregnant women at ≥ 20 weeks’ gestation infected with coronavirus disease 2019? A multicenter case-control study with propensity score matching. Am J Obstet Gynecol. 2020;223(5):764-8. doi: 10.1016/j.ajog.2020.07.045
- Mendoza M, Garcia-Ruiz I, Maiz N, Rodo C, Garcia-Manau P, Serrano B, et al. Pre-eclampsia-like syndrome induced by severe COVID-19: a prospective observational study. Bjog. 2020;127(11):1374-80. doi: 10.1111/1471-0528.16339
- Vivanti AJ, Vauloup-Fellous C, Prevot S, Zupan V, Suffee C, Do Cao J, et al. Transplacental transmission of SARS-CoV-2 infection. Nat Commun. 2020;11(1):3572. doi: 10.1038/ s41467-020-17436-6
- Garcia-Manau P, Garcia-Ruiz I, Rodo C, Sulleiro E, Maiz N, Catalan M, et al. Fetal transient skin edema in two pregnant women with coronavirus disease 2019 (COVID-19). Obstet Gynecol. 2020;136(5):1016-20. doi: 10.1097/ aog.0000000000004059
- Allotey J, Stallings E, Bonet M, Yap M, Chatterjee S, Kew T, et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ. 2020;370:m3320. doi: 10.1136/bmj.m3320
- Delahoy MJ, Whitaker M, O’Halloran A, Chai SJ, Kirley PD, Alden N, et al. Characteristics and maternal and birth outcomes of hospitalized pregnant women with laboratory-confirmed COVID-19 - COVID-NET, 13 States, March 1-August 22, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(38):1347-54. doi: 10.15585/mmwr.mm6938e1
- Khoury R, Bernstein PS, Debolt C, Stone J, Sutton DM, Simpson LL, et al. Characteristics and outcomes of 241 births to women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection at five New York City medical centers. Obstet Gynecol. 2020;136(2):273-82. doi: 10.1097/ aog.0000000000004025
- Breslin N, Baptiste C, Gyamfi-Bannerman C, Miller R, Martinez R, Bernstein K, et al. Coronavirus disease 2019 infection among asymptomatic and symptomatic pregnant women: two weeks of confirmed presentations to an affiliated pair of New York City hospitals. Am J Obstet Gynecol MFM. 2020;2(2):100118. doi: 10.1016/j.ajogmf.2020.100118
- London V, McLaren R Jr, Atallah F, Cepeda C, McCalla S, Fisher N, et al. The relationship between status at presentation and outcomes among pregnant women with COVID-19. Am J Perinatol. 2020;37(10):991-4. doi: 10.1055/s-0040-1712164
- Singh V, Choudhary A, Datta MR, Ray A. Maternal and neonatal outcome of pregnant women with SARS-CoV-2 infection during the first and second wave of COVID-19 in a tertiary care institute in Eastern India. Cureus. 2022;14(2):e22360. doi: 10.7759/cureus.22360
- Alibakhshi F, Javadnoori M, Ghanbari S. Pregnancy outcomes in women with COVID-19: a case-control study in Iran. J Midwifery Reprod Health. 2023;11(12):3664-71. doi: 10.22038/jmrh.2022.63589.1844
- Gomez UT, Francisco RP, Baptista FS, Gibelli M, Ibidi SM, de Carvalho WB, et al. Impact of SARS-CoV-2 on pregnancy and neonatal outcomes: an open prospective study of pregnant women in Brazil. Clinics (Sao Paulo). 2022;77:100073. doi: 10.1016/j.clinsp.2022.100073
- Soto-Torres E, Hernandez-Andrade E, Huntley E, Mendez- Figueroa H, Blackwell SC. Ultrasound and Doppler findings in pregnant women with SARS-CoV-2 infection. Ultrasound Obstet Gynecol. 2021;58(1):111-20. doi: 10.1002/uog.23642
- Jamal S, Masroor K, Tyagi A, Agarwal R. COVID-19 in pregnancy: our experience amidst second wave of COVID-19 at a teaching institute. Int J Reprod Contracept Obstet Gynecol. 2022;11(2):599-603. doi: 10.18203/2320-1770. ijrcog20220195
- Khoiwal K, Ravi AK, Mittal A, Pallapothu B, Priyadarshi M, Gaurav A, et al. Maternal-fetal characteristics of pregnant women with severe COVID disease and maternal-neonatal characteristics of neonates with early-onset SARS-CoV-2 infection: a prospective data analysis. Cureus. 2022;14(8):e27995. doi: 10.7759/cureus.27995
- Wladimiroff JW, Eik-Nes SH. Amniotic fluid and placental localization. In: Wladimiroff JW, Eik-Nes SH, eds. Ultrasound in Obstetrics and Gynaecology. Edinburgh: Elsevier; 2009. p. 109-20. doi: 10.1016/b978-0-444-51829-3.00006-4
- Twesigomwe G, Migisha R, Agaba DC, Owaraganise A, Aheisibwe H, Tibaijuka L, et al. Prevalence and associated factors of oligohydramnios in pregnancies beyond 36 weeks of gestation at a tertiary hospital in southwestern Uganda. BMC Pregnancy Childbirth. 2022;22(1):610. doi: 10.1186/ s12884-022-04939-x
- Bumrah S, Grover S, Kaur K, Rajora P, Tapasvi I. Clinico-epidemiologic profile and perinatal outcome of patients with oligohydramnios in third trimester in a tertiary care hospital. Int J Reprod Contracept Obstet Gynecol. 2023;12(5):1222-6. doi: 10.18203/2320-1770.ijrcog20231035
- Rossi AC, Prefumo F. Perinatal outcomes of isolated oligohydramnios at term and post-term pregnancy: a systematic review of literature with meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2013;169(2):149-54. doi: 10.1016/j. ejogrb.2013.03.011
- Karasek D, Baer RJ, McLemore MR, Bell AJ, Blebu BE, Casey JA, et al. The association of COVID-19 infection in pregnancy with preterm birth: a retrospective cohort study in California. Lancet Reg Health Am. 2021;2:100027. doi: 10.1016/j. lana.2021.100027
- Shah PS, Ye XY, Yang J, Campitelli MA. Preterm birth and stillbirth rates during the COVID-19 pandemic: a population-based cohort study. CMAJ. 2021;193(30):E1164-72. doi: 10.1503/cmaj.210081
- Di Toro F, Gjoka M, Di Lorenzo G, De Santo D, De Seta F, Maso G, et al. Impact of COVID-19 on maternal and neonatal outcomes: a systematic review and meta-analysis. Clin Microbiol Infect. 2021;27(1):36-46. doi: 10.1016/j. cmi.2020.10.007
- Li N, Han L, Peng M, Lv Y, Ouyang Y, Liu K, et al. Maternal and neonatal outcomes of pregnant women with coronavirus disease 2019 (COVID-19) pneumonia: a case-control study. Clin Infect Dis. 2020;71(16):2035-41. doi: 10.1093/cid/ ciaa352
- Mishra RK, Kumar S, Mohapatra S. Sudden onset oligohydramnios in asymptomatic COVID-19 disease. Res Sq [Preprint]. August 20, 2021. Available from: https:// europepmc.org/article/ppr/ppr385398.
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