Labor in women with the new coronavirus infection (COVID-19) and HIV infection

Abstract

BACKGROUND:HIV and COVID-19 remain some of global health problems today. Complications of these diseases, pregnancy and labor, as well as the perinatal condition of newborns can make a significant contribution to the deterioration of the demographic situation in this country. Summarizing the foreign and domestic literature, one may assess the impact of each individual pathogen on the condition of the pregnant woman and the fetus. However, we have not found data on the associative or antagonistic form of symbiosis of these pathogens, as well as on the joint effect on the pregnancy, labor and the condition of newborns in the available literature. AIM:The aim of this work was to analyze the outcomes of labor in women with the new coronavirus infection (COVID-19) and HIV infection. MATERIALS AND METHODS:We performed a retrospective analysis of birth histories of 63 women who were delivered in S.P. Botkin Clinical Infectious Diseases Hospital (Saint Petersburg, Russia) in the period from April 2020 to March 2022. Of these, 26 birth histories are of women with a combination of HIV infection and COVID-19, and 37 birth histories of women with HIV infection alone. We assessed the severity of COVID-19 in pregnant women with HIV infection, the course of labor, complications during childbirth and the condition of newborns. RESULTS:The groups did not differ in the duration of labor, the frequency of labor abnormalities, the volume of blood loss during delivery, the frequency of postpartum complications and the condition of newborns after one and five minutes on the Apgar scale. The duration of the anhydrous interval was significantly longer in women with HIV infection who did not suffer from COVID-19. The frequency of cesarean section was significantly higher in pregnant women with HIV infection and COVID-19. According to pathological examination, inflammatory changes in the placenta and signs characteristic of viral infection occurred more often in the group of women with HIV infection and COVID-19. CONCLUSIONS:The presence of COVID-19 affects the course of labor in patients with HIV infection. However, the frequency of caesarean section in the group of patients with HIV infection and COVID-19 was significantly higher due to obstetric reasons, and was not related to the severity of the mothers condition and the prenatal state of the fetus due to the infectious process. Inflammatory changes in the placenta and signs of a viral infection are more common in patients with COVID-19 and HIV infection. These data suggest that the combined course of these diseases may have a greater negative impact on the fetus than in women with HIV infection who do not suffer from COVID-19.