СРАВНИТЕЛЬНЫЙ АНАЛИЗ ИСХОДОВ БЕРЕМЕННОСТИ ПОСЛЕ ИНФЕКЦИИ COVID-19, ПЕРЕНЕСЕННОЙ ВО ВТОРОМ И ТРЕТЬЕМ ГЕСТАЦИОННЫХ ПЕРИОДАХ

Abstract

Introduction. Issues of providing medical care to pregnant women in the setting of COVID-19 infection remain a priority for physicians of many health professions, since it is this disease an increased incidence of adverse outcomes for both mothers and fetuses is associated with in recent years. Aim. To study the peculiarities of pregnancy course and outcomes after COVID-19 infection that has developed in the second and/or third gestation periods. Materials and Methods. Birth histories for 2021 were analyzed. Group 1 (n=30) consisted of patients with COVID-19 infection developed in the second trimester, group 2 (n=69) of those with the infection developed in the third trimester. We studied the anamnesis details, pregnancy and labor complications, and perinatal outcomes. Statistical analysis has been performed using Excel MS and Statistica 7.0 programs. The data obtained are presented as mean values (M) and standard deviation (SD), as well as the absolute (n) and relative (%) frequencies of observations. To establish the significance of differences between two mean values of parameters, Student’s t-test was used, and Pearson’s χ2 criterion was used for qualitative parameters (differences at p<0.05 were considered significant). Results and Discussion. It was found that the course of pregnancy after COVID-19 infection, regardless of the disease manifestation times (p>0.05), is associated with developing placental insufficiency (30.0 % in group 1 and 50.7 % in group 2), the symptoms of threatened abortion (46.7 and 53.6%, respectively), hypertensive disorders (18.7 and 24.6%, respectively), anemia (43.3 and 46.4%, respectively), colpitis (10.0 and 27.5%, respectively), bacterial vaginosis (20.0 and 17.4%, respectively), and the premature rupture of fetal membranes (16.6 and 15.9%, respectively), with the prevalence of at term deliveries (86.7 and 97.1%, respectively; p=0.05), but with an increase in the incidence of the infantile asphyxia in 53.3 and 52.2%, respectively. Cerebral ischemia (40.0 and 36.2%, respectively), congenital developmental anomalies (30.0 and 10.1%, respectively; p=0.01), perinatal hypoxic damage of the central nervous system (23.3 and 5.8%, respectively; p=0.01), neonatal jaundice (23.3 and 4.7%, respectively; p=0.004), and intrauterine pneumonia (10.0 and 5.8%, respectively) prevailed in the structure of neonatal morbidity. Conclusions. Pregnant women are 2.3 times more likely to be infected with COVID-19 in the third trimester compared to the incidence in the second trimester. The course of pregnancy after COVID-19 infection is accompanied by forming placental insufficiency with the development of gestational complications, without affecting the timing of delivery, but increasing the frequency of the need for surgical aids in labor in the manifestation of infection in the third trimester. The incidence of neonatal morbidity increases statistically significantly with the clinical manifestations of COVID-19 infection in mothers in the second trimester.