CASES OF PREGNANT WOMEN WITH COVID-19 AND INFLUENCE OF COMORBITIES ON PREGNANCY OUTCOMES

Main Article Content

Mariana Machado Pinto
Rafaela Stenger Xavier
Marina Martins Dallabrida
Ana Emilia Siegloch
Bruna Fernanda da Silva

Abstract

The objective of this study was to characterize pregnant women with COVID-19 and the influence of comorbidities on pregnancy outcomes in Serra Catarinense. The descriptive, cross-sectional, documentary study with a quantitative approach was carried out by collecting data from the electronic medical records of pregnant women who were admitted to a maternity hospital in Serra Catarinense. A total of 5083 medical records were analyzed, from May 2021 to October 2022. Of these, 542 medical records of pregnant women positive for COVID were included in the study, and sociodemographic and behavioral data, obstetric history, previous and/or acquired comorbidities, and data related to COVID-19 were collected, such as the quarter in which the patient tested positive for the disease, if you needed clinical hospitalization or in the Intensive Care Unit and data regarding vaccination for COVID-19. Data were analyzed using descriptive statistics and bivariate analysis, using Pearson's chi-square and Fisher's exact tests. The occurrence of pregnant women who tested positive for COVID-19 was 10.7% (542), the majority being white pregnant women, single, with paid work and complete high school. Pregnant women with previous and/or gestational comorbidities were associated with the occurrence of adverse maternal outcomes compared to pregnant women without comorbidities. Pregnant women who had a positive COVID-19 test in the first trimester of pregnancy were associated with prolonged hospitalization due to adverse maternal outcomes, such as postpartum hemorrhage, preeclampsia, respiratory complications due to COVID-19, abortion and preterm labor, when compared to pregnant women who tested positive in other trimesters. However, further studies are needed to identify the real interference of COVID-19 in pregnancy. In this study, adverse gestational outcomes in pregnant women who had COVID-19 were associated with the occurrence of comorbidities during pregnancy, showing that there is a need for greater attention to adherence and quality in prenatal care.

Article Details

How to Cite
PINTO, M. M.; XAVIER, R. S.; DALLABRIDA, M. M.; SIEGLOCH, A. E.; SILVA, B. F. da. CASES OF PREGNANT WOMEN WITH COVID-19 AND INFLUENCE OF COMORBITIES ON PREGNANCY OUTCOMES. Conjuncture Bulletin (BOCA), Boa Vista, v. 15, n. 45, p. 201–228, 2023. DOI: 10.5281/zenodo.8330085. Disponível em: https://revista.ioles.com.br/boca/index.php/revista/article/view/2062. Acesso em: 3 jul. 2024.
Section
Articles

References

AGARWAL, N. et al. “Coronavirus disease 2019 in pregnancy: maternal and perinatal outcome”. Journal of Education and Health Promotion, vol. 10, n. 1, 2021.

AMURES - Associação dos Municípios da Região Serrana. Institucional. Lages: AMURES, 2021. Disponível em: . Acesso em: 04/07/2023.

ANVISA - Agência Nacional de Vigilância Sanitária. Vacinas contra a COVID-19. Brasília: ANVISA, 2023. Disponível em: . Acesso em: junho/2023.

ATTINI, R. et al. “COVID-19 in pregnancy: influence of body weight and nutritional status on maternal and pregnancy outcomes - a review of literature and meta-analysis”. Nutrients, vol. 15, 2023.

BARTON, J. R.; SAADE, G. R.; SIBAI, B. M. “A proposed plan for prenatal care to minimize risks of COVID-19 to patients and providers: focus on hypertensive disorders of pregnancy”. American Journal of Perinatology, vol. 37, n. 8, 2020.

BRAGA, T. C, et al. “Avanços recentes na síntese do remdesivir, molnupiravir (eidd-2801) e tenofovir: moléculas promissoras no tratamento da covid-19”. Química Nova, vol. 45, n. 1, 2022.

BRASIL. Decreto - Lei n. 14.190, de 29 de julho de 2021. Brasília: Planalto, 2021a. Disponível em: . Acesso em: 03/03/2022.

BRASIL. Diretrizes para diagnóstico e tratamento da COVID-19. Brasília: Ministério da Saúde, 2020d. Disponível em: . Acesso em: 04/02/2022.

BRASIL. Guia de Vigilância Epidemiológica. Brasília: Ministério da Saúde, 2020c. Disponível em: . Acesso em: 04/02/2022.

BRASIL. Guia de Vigilância Epidemiológica. Brasília: Ministério da Saúde, 2022a. Disponível em: . Acesso em: 02/02/2023.

BRASIL. Nota Informativa n. 13/2020 - SE/GAB/SE/MS. Brasília: Ministério da Saúde, 2020b. Disponível em: . Acesso em: 03/03/2023.

BRASIL. Nota Técnica n. 2/2021 SECOVID/GAB/SECOVID/MS. Brasília: Ministério da Saúde, 2021b. Disponível em: . Acesso em: 03/03/2022.

BRASIL. O Programa de Humanização do Pré-natal e Nascimento. Brasília: Ministério da Saúde, 2002. Disponível em: Acesso em: 04/08/2023.

BRASIL. Plano nacional de operacionalização da vacinação contra a covid-19. Brasília: Ministério da Saúde, 2022b. Disponível em: . Acesso em: 05/03/2022.

BRASIL. Portaria n. 1.565, de 18 de junho de 2020. Brasília: Ministério da Saúde, 2020e. Disponível em: < www.saude.gov.br>. Acesso em: 04/02/2022.

BRASIL. Protocolo de Manejo Clínico da Covid-19 na Atenção Especializada. Brasília: Ministério da Saúde, 2020a. Disponível em: . Acesso em: 03/02/2023.

BRASIL. Resolução n. 466, de 12 de dezembro de 2012. Brasília: Conselho Nacional de Saúde, 2012. Disponível em: . Acesso em: 28/07/2023.

CAGNAZZO, T. D. O.; ANDRÉO, B. G. C. “COVID – 19: cuidados farmacêuticos durante a pandemia”. Revista Brasileira Multidisciplinar, vol. 23, n. 1, 2020.

CANANI, R. G. et al. “Prevalência de sífilis gestacional e fatores associados: um panorama da Serra Catarinense”. Revista Científica de Enfermagem, vol. 12, n. 37, 2022.

CHOI, G. B. et al. “The maternal interleukin-17a pathway in mice promotes autism-like phenotypes in offspring”. Science, vol. 351, n. 6276, 2016.

COLLIGNON, P. “COVID‐19 and future pandemics: is isolation and social distancing the new norm?”. Internal Medicine Journal, vol. 51, n. 5, 2021.

CONDE-AGUDELO, A.; ROMERO, R. “SARS-CoV-2 infection during pregnancy and risk of preeclampsia: a systematic review and meta-analysis”. American Journal of Obstetrics and Gynecology, vol. 226, n. 1, 2021.

CORNUDELLA, R. S. et al. “Screening of severe acute respiratory syndrome coronavirus-2 infection during labor and delivery using polymerase chain reaction and immunoglobulin testing”. Life Sciences, vol. 271, n. 119200, 2021.

CORVILLO´N, P. D. et al. “Routine screening for SARS CoV-2 in unselected pregnant women at delivery”. PLoS One, vol. 15, n. 9, 2020.

CROVETTO, F. et al. “Impact of severe acute respiratory syndrome coronavirus 2 infection on pregnancy outcomes: a population-based study”. Clinical Infectious Diseases, vol. 73, n. 10, 2021.

DEY, M. et al. “Pregnancy outcome in first 50 Sar-Cov-2 positive patients a tour center”. Gynecology Obstetrics and Reproductive Medicine, vol. 27, n. 1, 2021.

FDA - Federal Drug Administration. Coronavirus (COVID-19) Drugs. Maryland: FDA, 2023. Disponível em: . Acesso em: 08/08/2023.

FIGO - International Federation Of Gynecology And Obstetrics. What is COVID-19. London: FIGO, 2023. Disponível em: . Acesso em: 05/03/2023.

FIOCRUZ - Fundação Oswaldo Cruz. Principais Questões sobre COVID-19 e Gestação: Atenção Pré-Natal e em Maternidades. Rio de Janeiro: FIOCRUZ, 2020.

GUPTA, P.; KUMAR, S.; SHARMA, S. S. “SARS‐CoV‐2 prevalence and maternal‐perinatal outcomes among pregnant women admitted for delivery: Experience from COVID‐19‐dedicated maternity hospital in Jammu, Jammu and Kashmir (India)”. Journal Medical Virology, vol. 93, n. 9, 2021.

HUANG, C. et al. “Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China”. Lancet, vol. 395, n. 10223, 2020.

HUIJUN, C. et al. “Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records”. American Journal of Obstetrics and Gynecology, vol. 395, n. 10226, 2020.

IBGE - Instituto Brasileiro de Geografia e Estatística. Censo demográfico de 2022. Rio de Janeiro: IBGE, 2022. Disponível em: . Acesso em: 03/02/2023.

JAFARI, M. et al. “Clinical characteristics and outcomes of pregnant women with COVID-19 and comparison with control patients: A systematic review and meta-analysis”. Medical Virology, vol. 31, n. 5, 2021.

JAMIESON, D. J.; RASMUSSEN, S. A. “An update on COVID-19 and pregnancy”. American Journal Obstetrics and Gynecology, vol. 226, n. 2, 2022.

JANUSZEWSKI, M. et al. “Is the course of COVID-19 different during pregnancy? A retrospective comparative study”. International Journal of Environmental Research and Public Health, vol. 18, n. 22, 2021.

JIN, Y. H. et al. “A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version)”. Military Medical Research, vol. 7, n. 4, 2020.

JIRANO, L. J. R. et al. “Citocinas, sistema nervioso y esquizofrenia”. Revista Medica del Instituto Mexicano del Seguro Social, vol. 57, n. 2, 2019.

KAUARK, F. S.; MANHÃES, F. C.; MEDEIROS, C. H. Metodologia da pesquisa: um guia prático. Itabuna: Editora Via Litterarum, 2010.

LOKKEN, E. M. et al. “Disease severity, pregnancy outcomes, and maternal deaths among pregnant patients with severe acute respiratory syndrome coronavirus 2 infection in Washington State”. American Journal of Obstetrics and Gynecology, vol. 225, n. 1, 2021.

MAI, C. M.; KRATZER, P. M.; MARTINS, W. “Assistência de enfermagem em mulheres com pré-eclâmpsia e/ou eclâmpsia: uma revisão integrativa da literatura”. Boletim de Conjuntura (BOCA), vol. 8, n. 23, 2021.

MARTINS, M. M. et al. “Adequação da assistência pré-natal durante a pandemia de COVID-19: estudo observacional com mulheres pós-parto”. Revista Brasileira de Ginecologia e Obstetrícia, vol. 44, n. 4, 2022.

MARU, S. et al. “Universal screening for SARS-CoV-2 infection among pregnant women at Elmhurst Hospital Center, Queens, New York”. PLoS One, vol. 15, n. 9, 2020.

MENDOZA, M. et al. “Pre‐eclampsia‐like syndrome induced by severe COVID‐19: a prospective observational study”. BJOG: An International Journal of Obstetrics and Gynecology, vol. 127, n. 11, 2020.

NHI - National Institutes Of Health. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines COVID-19: therapeutic management of hospitalized adults with COVID-19. Maryland: NHI, 2022. Disponível em: Acesso em: 04/02/2023.

NISHIOKA, S. A. “São comuns reações cutâneas às vacinas contra COVID-19 de plataforma de RNA mensageiro?”. UNASUS [2021]. Disponível em: . Acesso em: 04/04/2023.

NUNES, J. S. et al. “A Influência da pré-eclâmpsia, idade materna avançada e obesidade materna nos resultados neonatais em mulheres com diabetes gestacional”. Revista Brasileira de Ginecologia e Obstetrícia, vol. 42, n. 10, 2020.

OOBR - Observatório Obstétrico Brasileiro. “SRAG: Síndrome respiratória aguda grave em gestantes e puérperas”. OOBR [2023]. Disponível em: . Acesso em: 03/08/2023.

OPAS - Organização Panamericana de Saúde. “Histórico da pandemia de COVID-19”. OPAS [2021]. Disponível em: . Acesso em: 02/08/2023.

OPAS - Organização Panamericana de Saúde. “OMS declara fim da Emergência de Saúde Pública de Importância Internacional referente à COVID-19”. OPAS [2023]. Disponível em: . Acesso em: 02/08/2023.

PINTO, M. M. Caracterização de gestantes com COVID-19 na Serra Catarinense (Dissertação de Mestrado em Ambiente e Saúde). Lages: UNIPLAC, 2023.

POON, L. C. et al. “Global interim guidance on coronavirus disease 2019 (COVID- 19) during pregnancy and puerperium from FIGO and allied partners: Information for healthcare professional”. International Journal of Gynecology and Obstetrics, vol. 149, n. 3, 2020.

PRADO, M. F. et al. “Análise da subnotificação da COVID-19 no Brasil”. Revista Brasileira de Terapia Intensiva, vol. 32, n. 2, 2020.

PRASAD, S. et al. “Systematic review and meta-analysis of the effectiveness and perinatal outcomes of COVID-19 vaccination in pregnancy”. Nature Comunication, vol. 13, n. 1, 2022.

RAMIREZ, D. W. E.; KLINKHAMMER, M. D.; ROWLAND, L. C. “COVID‐19 Transmission during Transportation of 1st to 12th Grade Students: Experience of an Independent School in Virginia”. The Journal of School Health, vol. 91, n. 9, 2021.

REN, L. et al. “Identification of a novel coronavirus causing severe pneumonia in human: a descriptive study”. Chinese Medical Journal, vol. 5, 2020.

SACCONE, G. et al. “Maternal and perinatal outcomes of pregnant women with SARS‐CoV‐2 infection”. Ultrasound in Obstetrics and Gynecology, vol. 57, n. 2, 2021.

SANTA CATARINA. Boletim Epidemiológico COVID-19. Florianópolis: Secretaria Estadual de Saúde, 2023. Disponível em: . Acesso em: 04/08/2023.

SANTA CATARINA. Hospital Geral e Maternidade Tereza Ramos. Florianópolis: Secretaria Estadual de Saúde, 2018. Disponível em: . Acesso em: 05/05/2021.

SANTA CATARINA. Nota Técnica Conjunta n. 006/2021-DAPS/SPS, DIVE/SUV E LACEN/SUV. Florianópolis: Secretaria Estadual de Saúde, 2021. Disponível em: . Acesso em: 05/05/2021.

SANTA CATARINA. Plano de ação regional da rede cegonha. Florianópolis: Secretaria Estadual de Saúde, 2013. Disponível em: Acesso em: 07/04/2023.

SANTOS, P. A. et al. “Diabetes gestacional na população atendida pelo sistema público de saúde no Brasil: prevalência e fatores de risco”. Revista Brasileira de Ginecologia e Obstetrícia, vol. 42, n. 1, 2020.

SATHIYA, R.; RAJENDRAN, J.; SUMATHI, S. “COVID-19 and preeclampsia: overlapping features in pregnancy”. Rambam Maimonides Medical Journal, vol. 13, n. 1, 2022.

SBPC - Sociedade Brasileira de Patologia Clínica/Medicina. Diagnóstico Laboratorial da COVID-19. Rio de Janeiro: SBPC, 2020. Disponível em: . Acesso em: 03/02/2022.

SENHORAS, E. M. “Coronavírus e educação: análise dos impactos assimétricos”. Boletim de Conjuntura (BOCA), vol. 2, n. 5, 2020.

SINGH, P. et al. “COVID 19 suspicion and diagnosis in pregnancy: A big conundrum”. Journal of Family Medicine and Primary Care, vol. 11, n. 10, 2022.

SUTTON, D. et al. “Universal screening for SARS-CoV-2 in women admitted for delivery”. The New England Journal of Medicine, vol. 382, n. 22, 2020.

VANGEEL, L. et al. “Remdesivir, Molnupiravir and Nirmatrelvir remain active against SARS-CoV-2 Omicron and other variants of concern”. Antirival Research, vol. 198, n. 105252, 2022.

VELHO, M. B.; SANTOS, E. K. A.; COLLAÇO, V. S. “Parto normal e cesárea: representações sociais de mulheres que os vivenciaram”. Revista Brasileira de Enfermagem, vol. 67, n. 2, 2014.

VITIELLO, A. et al. “Advances in the Omicron variant development”. Journal of Internal Medicine, vol. 292, n. 1, 2022.

VOUGA, M. et al. “Maternal outcomes and risk factors for COVID-19 severity among pregnant women”. Scientific Reports, vol. 11, n. 13898, 2021.

WASTNEDGE, E. A. N. et al. “Pregnancy and COVID-19”. Physiological Reviews, vol. 101, n. 1, 2021.

WHO - World Health Organization. Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected. Genebra: WHO, 2020a. Disponível em: . Acesso em: 22/02/2022.

WHO - World Health Organization. Definition and categorization of the timing of mother-to-child transmission of SARS-CoV-2. Genebra: WHO, 2021b. Disponível em: . Acesso em: 05/04/2023.

WHO - World Health Organization. Tracking SARS-CoV-2 variants. Genebra: WHO, 2022. Disponível em: . Acesso em 05/03/2022.

WHO - World Health Organization. Tracking SARS-CoV-2 variants. Genebra: WHO, 2023. Disponível em: Acesso em 05/03/2023.

WHO - World Health Organization. Who sage roadmap for prioritizing use of covid-19 vaccines. Genebra: WHO, 2020b. Disponível em: < www.who.int>. Acesso em 03/03/2022.

WHO -World Health Organization. COVID-19 vaccines: safety surveillance manual. Genebra: WHO, 2021a. Disponível em: . Acesso em 04/03/2022.

WU, Y. C; CHEN, C. S; CHAN, Y. J. “The outbreak of COVID-19: An overview”. Journal of The Chinese Medical Association, vol. 83, n. 3, 2020.

XAVIER, P. B et al. “Impactos da COVID-19 no trabalho colaborativo na atenção primária à saúde”. Boletim de Conjuntura (BOCA), vol. 15, n. 44, 2023.

YEE, J et al. “Clinical manifestations and perinatal outcomes of pregnant women with COVID-19: a systematic review and meta-analysis”. Scientific Reports, vol. 10, n. 18126, 2020.

ZHANG, W. et al. “The use of anti-inflammatory drugs in the treatment of people with severe coronavirus disease 2019 (COVID-19): the experience of clinical immunologists from China”. Clinical Immunology, vol. 214, n. 108393, 2020.