Comparing Infection Profiles of Expectant Mothers with COVID-19 and Impacts on Maternal and Perinatal Outcomes between the First Two Waves of the Pandemic
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Data Analysis
2.3. Ethical Approval
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Number (%) of Patients Reporting Results | First Wave | Second Wave | p-Value | |
---|---|---|---|---|
n, % | 1295 (100) | 846 (65.3) | 449 (34.7) | |
Maternal characteristics | ||||
Age, mean, 95% CI | 1284 (99.2) | 33.3 (32.8–33.7) | 31.7 (31.1–32.3) | <0.001 |
Maternal age > 35 years, n, % | 1284 (99.2) | 358 (42.6) | 145 (32.7) | <0.001 |
Tobacco use, n, % | 1239 (95.7) | 94 (11.6) | 35 (8.2) | 0.054 |
BMI, mean, 95% CI | 1119 (86.4) | 26.4 (26.1–26.8) | 26.8 (26.3–27.4) | 0.193 |
Morbidities, n, % | 1182 (91.3) | 310 (40.2) | 155 (37.8) | 0.431 |
Nuliparous, n, % | 1281 (98.9) | 316 (37.9) | 175 (39.1) | 0.692 |
Symptoms at triage, n, % | 1103 (85.2) | 457 (62.4) | 155 (41.8) | <0.001 |
Pneumonia, n, % | 978 (75.5) | 104 (16.1) | 17 (5.1) | <0.001 |
Treatment, n, % | 1295 (100) | 656 (77.5) | 354 (78.8) | 0.590 |
Laboratory tests | ||||
Haemoglobin count (x1ꝰ/L), mean, 95% CI | 892 (68.9) | 12.2 (11.1–13.4) | 12.4 (10.6–14.2) | 0.891 |
Haematocrito count (x1ꝰ/L), mean, 95% CI | 875 (67.6) | 32.5 (31.7–33.3) | 31.7 (30.5–32.9) | 0.262 |
Leukocyte count (x1ꝰ/L), mean, 95% CI | 902 (69.7) | 37.2 (24.7–49.7) | 10.9 (6.8–15.2) | 0.003 |
Lymphocyte count (x1ꝰ/L), mean, 95% CI | 847 (65.4) | 3.6 (2.5–4.6) | 4.4 (3.3–5.6) | 0.319 |
Lymphocytopenia, n, % | 847 (65.4) | 191 (35.6) | 84 (27.0) | 0.009 |
Platelet count (x1ꝰ/L), mean, 95% CI | 899 (69.4) | 177.8 (169.8–185.7) | 186.9 (174.6–197.1) | 0.242 |
Thrombocytopenia, n, % | 899 (69.4) | 184 (31.4) | 93 (29.8) | 0.634 |
aPTT, mean, 95% CI | 641 (50.0) | 25.8 (24.1–27.5) | 26.4 (22.7–30.1) | 0.753 |
Obstetric and perinatal characteristics | ||||
Obstetric morbidities, n, % | 1057 (81.6) | 299 (43.5) | 150 (40.5) | 0.349 |
Gestational age at triage, mean, 95% CI | 1295 (100) | 33.6 (33.0–34.1) | 37.3 (37.0–37.6) | <0.001 |
Gestational age at delivery, mean, 95% CI | 1295 (100) | 38.5 (38.3–38.7) | 38.7 (38.4–38.9) | 0.185 |
Birthweight, mean, 95% CI | 1275 (98.5) | 3357.2 (3115.6–3198.9) | 3232.4 (3176.9–3288.0) | 0.036 |
Maternal and perinatal mortality | ||||
Maternal mortality, n, % | 1295 (100) | 2 (0.2) | 0 (0.0) | 0.547 |
Perinatal mortality, n, % | 1295 (100) | 9 (1.1) | 7 (1.6) | 0.439 |
Overall maternal morbidity | 1020 (78.8) | 305 (42.4) | 122 (41.7) | 0.617 |
COVID-19 maternal morbidity | 1295 (100) | 77 (9.1) | 16 (3.6) | <0.001 |
Oxygen therapy, n, % | 1295 (100) | 60 (7.1) | 13 (2.9) | 0.001 |
Mechanical ventilation, n, % | 1295 (100) | 15 (1.8) | 2 (0.5) | 0.029 |
Admission to ICU, n, % | 1295 (100) | 25 (3.0) | 11 (2.5) | 0.595 |
Non COVID-19 maternal morbidity | 1015 (78.4) | 276 (38.5) | 118 (39.6) | 0.743 |
C-section, n, % | 1293 (99.8) | 254 (30.1) | 108 (24.1) | 0.022 |
Haemorrhagic disorders, n, % | 938 (72.4) | 32 (4.7) | 11 (4.2) | 0.711 |
Hypertensive disorders, n, % | 1071 (82.7) | 25 (3.4) | 12 83.6) | 0.878 |
Perinatal morbidity | 1068 (82.5) | 144 (20.4) | 60 (16.6) | 0.137 |
Preterm birth, n, % | 1295 (100) | 105 (12.4) | 39 (8.7) | 0.039 |
Neonatal near miss, n, % | 1037 (80.1) | 41 (6.9) | 21 (5.9) | 0.964 |
Gestational age < 33 weeks, n, % | 1295 (100) | 36 (4.3) | 17 (3.8) | 0.683 |
Birthweight < 1750 g, n, % | 1275 (98.5) | 24 (2.9) | 10 (2.3) | 0.521 |
Apgar 5 min < 7, n, % | 1277 (98.6) | 10 (1.2) | 2 (0.5) | 0.165 |
Admission to NICU, n, % | 1295 (100) | 93 (11.0) | 41 (9.1) | 0.291 |
Maternal Morbidity | Perinatal Morbidity | |||
---|---|---|---|---|
First Wave | Second Wave | First Wave | Second Wave | |
OR/r | OR/r | OR/r | OR/r | |
Maternal characteristics | ||||
Age, r | 0.1 (0–0.2) | 0.1 (0–0.3) | 0.01 (−0.1–0.1) | 0 (−0.1–0.1) |
Maternal age > 35 years, OR | 1.5 (1.1–2.1) | 1.6 (1–2.6) | 1 (0.7–1.4) | 0.8 (0.4–1.5) |
Tobacco use, OR | 1 (0.6–1.6) | 1.7 (0.7–3.8) | 1.6 (0.9–2.8) | 1.6 (0.6–3.8) |
BMI, r | 0.2 (0.1–0.2) | 0.1 (0–0.2) | 0 (0–0) | 0 (−0.1–0.1) |
BMI ≧ 25, OR | 1.9 (1.3–2.6) | 1.3 (0.8–2.1) | 1.2 (0.7–1.6) | 1.1 (0.6–2.1) |
Morbidities, OR | 2.2 (1.6–3) | 1.6 (1–2.6) | 1.7 (1.1–2.5) | 1.7 (0.9–3.1) |
Nuliparous, OR | 1.2 (0.9–1.6) | 0.7 (0.4–1.1) | 1.4 (1–2) | 0.7 (0.4–1.2) |
Symptoms at triage, OR | 2.1 (1.5–3) | 1.2 (0.7–2.1) | 1.9 (1.3–2.9) | 2 (1.1–3.7) |
Pneumonia, OR | 2.9 (1.8–4.5) | 9.4 (2.1–43.3) | 1.1 (0.7–1.9) | 2.4 (0.8–7.4) |
Treatment, OR | 2.1 (1.4–3.2) | 2.8 (1.6–5.2) | 1.6 (1–2.6) | 1.2 (0.6–2.6) |
Laboratory tests | ||||
Haemoglobin count (x1ꝰ/L), r | 0 (−0.1–0) | 0 (−0.1–0.2) | 0.1 (−0.1–0) | −0.1 (−0.2–0) |
Haematocrito coun (x1ꝰ/L), r | 0 (−0.2–0) | 0 (−0.1–0.2) | 0.1 (−0.1–0) | 0 (−0.1–0.1) |
Leukocyte count (x1ꝰ/L), r | 0 (−0.1–0.1) | 0 (−0.1–0.2) | 0.1 (0–0.2) | 0 (−0.2–0.1) |
Lymphocite count (x1ꝰ/L), r | 0 (−0.1–0.1) | −0.1 (−0.2–0.1) | 0.1 (−0.1–0) | 0 (−0.12–0.1) |
Lymphocytopenia, OR | 1.9 (1.3–2.8) | 1.4 (0.7–2.6) | 0.9 (0.6–1.4) | 0.8 (0.4–1.7) |
Platelet count (x1ꝰ/L), r | −0.1 (−0.2–0) | −0.1 (−0.2–0.1) | 0 (−0.1–0.1) | 0 (−0.1–0.1) |
Thrombocytopenia, OR | 1.8 (1.2–2.6) | 1.5 (0.8–2.7) | 1.1 (0.7–1.8) | 1.1 (0.5–2.2) |
aPTT, r | 0 (−0.1–0.1) | −0.1 (−0.2–0.1) | 0 (−0.1–0.1) | 0 (−0.1–0.1) |
Obstetric and perinatal characteristics | ||||
Obstetric morbidities, OR | 1.4 (1–2) | 2 (1.2–3.3) | 2.1 (1.4–3) | 4.6 (2.3–9.1) |
Gestational age at triage, r | −0.1 (−0.2–0) | −0.1 (−0.2–0.1) | −0.1 (−0.1–0) | −0.4 (−0.5–−0.4) |
Gestational age at delivery, r | −0.2 (−0.3–−0.2) | −0.15 (−0.3–0) | −0.7 (−0.7–−0.6) | −0.6 (−0.7–−0.6) |
Birthweight, r | −0.1 (−0.2–−0.1) | −0.2 (−0.3–0) | −0.5 (−0.6–−0.5) | −0.4 (−0.6–−0.3) |
Maternal and perinatal mortality | ||||
Maternal mortality, n, % | n.a. | n.a. | 1 (n.a.–n.a.) | 1 (n.a.–n.a.) |
Perinatal mortality, OR | 8.3 (1–69.4) | 0.6 (0.1–3) | n.a. | n.a. |
Overall Maternal Morbidity | n.a. | n.a. | 3.8 (2.5–5.8) | 3.3 (1.7–6.3) |
COVID-19 Maternal Morbidity | n.a. | n.a. | 3 (1.8–5.1) | 10.4 (3.4–32.4) |
Oxygen therapy, OR | n.a. | n.a. | 1.7 (0.9–3.2) | 6.6 (1.9–22.3) |
Mechanical ventilation, OR | n.a. | n.a. | 10.4 (3.2–33.8) | 1 (n.a.–n.a.) |
Admission to ICU, OR | n.a. | n.a. | 11.6 (4.5–30.2) | 52.9 (6.6–426.8) |
Not COVID-19 Maternal Morbidity | n.a. | n.a. | 3.9 (2.6–5.8) | 3.4 (1.8–6.7) |
C-section, OR | n.a. | n.a. | 3.8 (2.6–5.5) | 3.2 (1.8–5.6) |
Haemorrhagic disorders, OR | n.a. | n.a. | 3.2 (1.5–6.8) | 2.6 (0.6–10.8) |
Hypertensive disorders, OR | n.a. | n.a. | 4.3 (1.7–10.6) | 23.5 (4.9–112.7) |
Perinatal morbidity | 3.84 (2.5–5.8) | 3.3 (1.7–6.3) | n.a. | n.a. |
Preterm birth, OR | 3.8 (2.4–6) | 3.5 (1.6–7.7) | n.a. | n.a. |
Apgar 5 min < 7, n, % | 1 (n.a.–n.a.) | 1 (n.a.–n.a.) | n.a. | n.a. |
Admission to NICU, OR | 5.2 (3.1–8.7) | 3.9 (1.8–8.5) | n.a. | n.a. |
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Cuñarro-López, Y.; Pintado-Recarte, P.; Hernández-Martín, C.; Paya-Martínez, P.; López-Pérez, R.; Cueto-Hernández, I.; Ruiz-Labarta, J.; Cano-Valderrama, Ó.; Martínez-Pérez, Ó.; Bravo-Arribas, C.; et al. Comparing Infection Profiles of Expectant Mothers with COVID-19 and Impacts on Maternal and Perinatal Outcomes between the First Two Waves of the Pandemic. J. Pers. Med. 2021, 11, 599. https://doi.org/10.3390/jpm11070599
Cuñarro-López Y, Pintado-Recarte P, Hernández-Martín C, Paya-Martínez P, López-Pérez R, Cueto-Hernández I, Ruiz-Labarta J, Cano-Valderrama Ó, Martínez-Pérez Ó, Bravo-Arribas C, et al. Comparing Infection Profiles of Expectant Mothers with COVID-19 and Impacts on Maternal and Perinatal Outcomes between the First Two Waves of the Pandemic. Journal of Personalized Medicine. 2021; 11(7):599. https://doi.org/10.3390/jpm11070599
Chicago/Turabian StyleCuñarro-López, Yolanda, Pilar Pintado-Recarte, Concepción Hernández-Martín, Pilar Paya-Martínez, Rocío López-Pérez, Ignacio Cueto-Hernández, Javier Ruiz-Labarta, Óscar Cano-Valderrama, Óscar Martínez-Pérez, Coral Bravo-Arribas, and et al. 2021. "Comparing Infection Profiles of Expectant Mothers with COVID-19 and Impacts on Maternal and Perinatal Outcomes between the First Two Waves of the Pandemic" Journal of Personalized Medicine 11, no. 7: 599. https://doi.org/10.3390/jpm11070599