First effects of the COVID-19 pandemic: pregnancy complications, newborn health and expected reproductive losses

Abstract

Introduction. The pandemic of the novel coronavirus infection COVID-19 (NCI) has posed a number of questions for humanity, starting with the impact of the infection on the ability of fetation in a couple, pregnancy outcomes, its complications, and ending with the impact on the health of future generations, including the reproductive one.Aim. To analyze the register of pregnant women and newborns in the Amur Region with NCI to identify immediate complications of pregnancy and the neonatal period.Materials and methods. An analysis was made of the registry of pregnant women (n=966) with NCI, newborns from mothers with NCI (n=111) and infected from family members (n=21) in the period from May 1, 2020 to January 1, 2022. A general clinical study of pregnant women and newborns was performed, as well as an analysis of the vaccination of women registered for pregnancy in 2022. Standard statistical data processing methods were used.Results. 966 women were registered who underwent NCI during pregnancy, which accounted for 6.13% of all births, of which in 2020 – 16.9%, in 2021 –83%. In the Amur Region, the maternal mortality rate, as in the Russian Federation, increased during the pandemic and amounted to 38.2 in 2020, and 68.1 per 100 000 population in 2021; particularly from COVID-19 in 2020 – 12.8, in 2021 – 40.9 per 100 thousand population. At the same time, 17.8% had an asymptomatic course of the disease, 63.4% had a mild course, 17.7% had a moderate course, and 11.14% had a severe course with pathological changes in the lungs. The risk of lung tissue damage was increased by infection in the third trimester of pregnancy (RR – 1.73; 95% CI: 1.04-2.9), age over 30 years (RR – 1.24; 95% CI: 1.01-1 .53), overweight (RR –1.8; 95% CI: 1.5–2.14), and obesity (RR – 1.53: 95% CI: 1.2–1.8). The risk of developing complications of pregnancy significantly increased in women with pathological changes in the lungs (moderate and severe course), in comparison with pregnant women with mild NCI. It was found that 14.4% of newborns from mothers with NCI were born prematurely, 3.6% – in moderate asphyxia. The vertical transmission path was not registered in any case. In 33% of children infected in the neonatal period, NCI proceeded in the moderate, in 67% – in mild severity. Only one in three pregnant women are currently vaccinated. Of these, at the stage of preconception preparation, 77%, during pregnancy – 23%.Conclusion. NCI is a factor in the severe course of the disease and the development of pregnancy complications in women with pathological changes in the lungs, which increases the risk of maternal and infant mortality.