Influence of the Human Development Index on the Maternal–Perinatal Morbidity and Mortality of Pregnant Women with SARS-CoV-2 Infection: Importance for Personalized Medical Care
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
- Mild—clinical symptoms mild and no sign of pneumonia on imaging.
- Moderate—fever and respiratory symptoms plus radiological findings of pneumonia.
- Severe—any of the following conditions:
- Respiratory distress (respiratory rate of ≥30 per min).
- Oxygen saturation in room air at rest ≤93%.
- Partial pressure of oxygen in arterial blood/fraction of inspired oxygen ≤300 mmHg.
- Critical cases—any of the following conditions:
- Respiratory failure and need for mechanical ventilation.
- Shock.
- Patients with failure of an organ requiring ICU care.
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 | Overall | Cases | Controls | p Value | |
---|---|---|---|---|---|
n, % | 2694 (100) | 2694 (100) | 1347 (50) | 1347 (50) | |
Maternal characteristics | |||||
Maternal age, mean, CI 95% | 2664 (98.9) | 32.6 (32.4–32.9) | 32.7 (32.3–33.0) | 32.6 (32.3–32.9) | 0.734 |
Tobacco, n, % | 2554 (94.8) | 293 (11.5) | 131 (10.2) | 162 (12.8) | 0.035 |
BMI, mean, CI 95% | 2314 (85.9) | 26.5 (26.3–26.8) | 26.6 (26.3–26.9) | 26.5 (26.2–26.8) | 0.532 |
Maternal morbidities, n, % | 2432 (90.3) | 893 (36.7) | 483 (39.2) | 410 (34.1) | 0.009 |
Nuliparous, n, % | 2670 (99.1) | 1059 (39.7) | 516 (48.7) | 543 (51.3) | 0.315 |
Symptomps at triage, n, % | 1457 (54.1) | 644 (44.2) | 632 (55.0) | 12 (3.9) | <0.001 |
Pneumonia, n, % | 1346 (50.0) | 124 (9.2) | 124 (12.2) | 0 (0.0) | <0.001 |
Obstetric and perinatal characteristics | |||||
Obstetric morbidities, n, % | 2246 (83.4) | 879 (39.1) | 468 (42.5) | 411 (35.9) | 0.001 |
GA at triage, mean, CI 95% | 2691 (99.9) | 36.9 (36.7–37.1) | 34.9 (34.5–35.3) | 38.9 (38.8–39.0) | <0.001 |
GA at delivery, mean, CI 95 % | 2694 (100) | 38.8 (38.7–38.9) | 38.5 (38.4–38.7) | 39.0 (38.9–39.1) | <0.001 |
Birthweight, mean, CI 95% | 2659 (98.7) | 3219.5 (3198.2–3240.8) | 3181.2 (3148.6–3213.7) | 3257.7 (3230.3–3285.1) | <0.001 |
Maternal and perinatal mortality | |||||
Maternal mortality, n, % | 2694 (100) | 2 (0.1) | 2 (0.1) | 0 (0) | 0.096 |
Perinatal mortality, n, % | 2694 (100) | 21 (0.8) | 16 (1.2) | 5 (0.4) | <0.001 |
Overall Maternal Morbidity | 1930 (71.6) | 741 (38.4) | 438 (41.3) | 303 (34.8) | 0.003 |
COVID-19 Maternal Morbidity | 2694 (100) | 96 (3.6) | 93 (6.9) | 3 (0.2) | <0.001 |
Oxygen therapy, n, % | 2694 (100) | 74 (2.8) | 73 (5.4) | 1 (0.1) | <0.001 |
Mechanical ventilation, n, % | 2694 (100) | 17 (0.6) | 17 (1.3) | 0 (0) | <0.001 |
Admission to ICU, n, % | 2694 (100) | 38 (1.4) | 36 (2.7) | 2 (0.2) | <0.001 |
Not COVID-19 Maternal Morbidity | 1925 (71.5) | 707 (36.7) | 405 (38.4) | 302 (34.7) | 0.096 |
C-section, n, % | 2687 (99.7) | 640 (23.8) | 373 (27.8) | 267 (19.9) | <0.001 |
Haemorrhagic maternal disorders, n, % | 1741 (64.6) | 81 (4.7) | 43 (4.4) | 38 (5.0) | 0.582 |
Hypertensive maternal disorders, n, % | 2157 (80.1) | 58 (2.7) | 40 (3.6) | 18 (1.7) | 0.006 |
Perinatal morbidity | 2165 (80.4) | 313 (14.5) | 211 (19.0) | 102 (9.7) | <0.001 |
GA< 37 weeks, n, % | 2694 (100) | 230 (8.5) | 149 (11.1) | 81 (6.0) | <0.001 |
Neonatal Near miss, n, % | 2642 (98.1) | 90 (3.4) | 65 (4.9) | 25 (1.9) | <0.001 |
GA < 33 weeks, n, % | 2694 (100) | 68 (2.5) | 53 (3.9) | 15 (1.1) | <0.001 |
Birthweight < 1750 grs, n, % | 2659 (98.7) | 47 (1.8) | 34 (2.6) | 13 (1.0) | 0.002 |
Apgar 5 minutes < 7, n, % | 2664 (98.9) | 24 (0.9) | 12 (0.9) | 12 (0.9) | 0.988 |
Admission to NICU, n, % | 2694 (100) | 166 (6.2) | 137 (10.2) | 29 (2.2) | <0.001 |
Number (%) of Patients Reporting Results | High/Medium/Low HDI | Very High HDI | p Value | |
---|---|---|---|---|
n, % | 2263 (84.0) | 696 (30.8) | 1567 (69.2) | |
Cases, n, % | 2263 (84.0) | 456 (65.5) | 678 (43.3) | <0.001 |
Control cases, n, % | 2263 (84.0) | 240 (34.5) | 889 (56.7) | <0.001 |
Maternal and perinatal mortality | ||||
Maternal mortality, n, % | 1549 (57.5) | 1 (0.2) | 1 (0.1) | 0.565 |
Perinatal mortality, n, % | 2263 (84.0) | 7 (1.0) | 10 (0.6) | 0.362 |
Overall Maternal Morbidity | 1659 (61.6) | 211 (39.4) | 423 (37.6) | 0.480 |
COVID-19 Maternal Morbidity | 2263 (84.0) | 42 (6.0) | 38 (2.4) | <0.001 |
Oxygen therapy, n, % | 2263 (84.0) | 33 (4.7) | 28 (1.8) | <0.001 |
Mechanical ventilation, n, % | 2263 (84.0) | 8 (1.2) | 9 (0.6) | 0.158 |
Admission to ICU, n, % | 2263 (84.0) | 18 (2.6) | 16 (1.0) | 0.007 |
Not COVID-19 Maternal Morbidity | 1656 (61.5) | 196 (36.7) | 411 (36.6) | 0.977 |
C-section, n, % | 2258 (83.8) | 172 (24.8) | 377 (24.1) | 0.729 |
Haemorrhagic maternal disorders, n, % | 1499 (55.6) | 27 (5.5) | 45 (4.5) | 0.364 |
Hypertensive maternal disorders, n, % | 1841 (68.3) | 22 (3.8) | 30 (2.4) | 0.106 |
Perinatal morbidity | 1801 (66.9) | 84 (14.6) | 179 (14.6) | 0.996 |
GA< 37 weeks, n, % | 2263 (84.0) | 56 (8.1) | 143 (9.1) | 0.399 |
Neonatal Near miss, n, % | 1768 (65.6) | 28 (4.9) | 45 (3.8) | 0.251 |
GA < 33 weeks, n, % | 2263 (84.0) | 23 (3.3) | 38 (2.4) | 0.242 |
Birthweight < 1750 grs, n, % | 2237 (83.0) | 16 (2.3) | 27 (1.8) | 0.369 |
Apgar 5 minutes < 7, n, % | 2239 (83.1) | 5 (0.7) | 13 (0.8) | 0.786 |
Admission to NICU, n, % | 2263 (84.0) | 52 (7.5) | 84 (5.4) | 0.056 |
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Cuñarro-López, Y.; Larroca, S.G.-T.; Pintado-Recarte, P.; Hernández-Martín, C.; Prats-Rodríguez, P.; Cano-Valderrama, Ó.; Cueto-Hernández, I.; Ruiz-Labarta, J.; Muñoz-Chápuli, M.d.M.; Martínez-Pérez, Ó.; et al. Influence of the Human Development Index on the Maternal–Perinatal Morbidity and Mortality of Pregnant Women with SARS-CoV-2 Infection: Importance for Personalized Medical Care. J. Clin. Med. 2021, 10, 3631. https://doi.org/10.3390/jcm10163631
Cuñarro-López Y, Larroca SG-T, Pintado-Recarte P, Hernández-Martín C, Prats-Rodríguez P, Cano-Valderrama Ó, Cueto-Hernández I, Ruiz-Labarta J, Muñoz-Chápuli MdM, Martínez-Pérez Ó, et al. Influence of the Human Development Index on the Maternal–Perinatal Morbidity and Mortality of Pregnant Women with SARS-CoV-2 Infection: Importance for Personalized Medical Care. Journal of Clinical Medicine. 2021; 10(16):3631. https://doi.org/10.3390/jcm10163631
Chicago/Turabian StyleCuñarro-López, Yolanda, Santiago García-Tizón Larroca, Pilar Pintado-Recarte, Concepción Hernández-Martín, Pilar Prats-Rodríguez, Óscar Cano-Valderrama, Ignacio Cueto-Hernández, Javier Ruiz-Labarta, María del Mar Muñoz-Chápuli, Óscar Martínez-Pérez, and et al. 2021. "Influence of the Human Development Index on the Maternal–Perinatal Morbidity and Mortality of Pregnant Women with SARS-CoV-2 Infection: Importance for Personalized Medical Care" Journal of Clinical Medicine 10, no. 16: 3631. https://doi.org/10.3390/jcm10163631