Факторы риска антенатальной гибели плода у беременных женщин с отягощенным акушерским анамнезом, перенесших COVID

Abstract

Objective. To investigate the significance and prognostic value of risk factors for intrauterine fetal demise (IUFD) in women with complicated obstetric history (COH) who had COVID-19 in the second and third trimesters of pregnancy. Patients and methods. A retrospective study of 5027 medical records of pregnant women, postpartum women and neonates who received treatment in obstetric institutions in Almaty with positive PCR results for SARS-CoV-2 in the second and third trimesters of pregnancy was conducted. IUFD occurred in 46 (0.9%) pregnant women. Results. The risk of IUFD increased with prolongation of COVID-19 treatment during pregnancy (OR = 8.673, 95% CI: 4.252-17.692), in the absence of therapy with low-molecular-weight heparin (OR = 4.835, 95% CI: 2.471-9. 459) and was also characteristic of moderate and severe COVID-19 (OR = 4.2667, 95% CI: 1.0603-17.1689), with history of maternal anemia and acute respiratory viral infections (ARVI) (OR = 3.524, 95% CI: 1.643-7.559 and OR = 4.117, 95% CI: 1.881-9.010, respectively). Meanwhile, the absence of antibiotic and corticosteroid therapy was associated with a lower risk of IUFD (OR = 0.415, 95% CI: 0.184-0.937 and OR = 0.278, 95% CI: 0.142-0.547, respectively). Conclusion. The risk of IUFD in pregnant women with COH and COVID-19 during pregnancy increased significantly with the duration of COVID-19 treatment, with moderate and severe course, and with the deficiency of anticoagulant therapy. At the same time, the absence of glucocorticosteroids and antibacterial agents showed a negative association with IUFD. Key words: intrauterine fetal demise, antibiotic therapy, anticoagulants, pregnancy, glucocorticosteroid therapy, COVID-19