Факторы риска заболеваемости острыми респираторными вирусными инфекциями у беременных. Эффективность профилактических мер

Abstract

Objective. To identify risk factors for acute respiratory viral infections (ARVI) (influenza and novel coronavirus infection (NCI) COVID-19) in pregnant women and evaluate the effectiveness of pharmacological prevention. Patients and methods. During the first phase, 152 individual medical records of pregnant women were retrospectively studied: 102 women (the first main group) with acute respiratory viral infections and 50 pregnant women who had no acute respiratory viral infections (the control group). The second phase was a prospective comparative study: the second main group (n = 100) – pregnant women who received recombinant interferon α-2b (IFN-α2b) with vitamins E and C as preventive treatment; the comparison group (n = 100) – without preventive treatment. Results. Risk factors for the incidence of ARVI included anemia (χ2 = 0.003), obesity (χ2 = 0.026), cardiovascular diseases (χ2 = 0.060), diabetes mellitus (χ2 = 0.050), frequent ARVI in medical history (χ2 = 0.028), nicotine intoxication (χ2 = 0.008), urinary tract infections (χ2 < 0.001). The second phase: 10% of pregnant women who received preventive treatment had mild forms of influenza and NCI; 2% of women had a moderate form. In the second main group, 33% of pregnant women were sick (OR = 2.852, 95% CI = 1.354–6.005, χ2 = 0.005): 26% of women had a mild form, 6% of women had a moderate form and 1% of women had a severe form. In the second main group, threatened miscarriage (χ2 < 0.001), preterm birth (χ2 < 0.001), gestational pyelonephritis (χ2 = 0.006), placental insufficiency (χ2 < 0.001), pre-eclampsia (χ2 = 0.006), congenital anomalies of the fetus (χ2 = 0.017) and intrauterine infection (χ2 < 0.001) were more frequent. Conclusions. Among risk factors for ARVI during pregnancy were anemia, obesity, diabetes mellitus, and nicotine intoxication. Preventive treatment with recombinant IFNα-2b with vitamins E and C reduced the incidence of acute respiratory viral infections in pregnant women by 2.8 times and improved perinatal outcomes by 4.7 times. Key words: pregnancy, acute respiratory viral infections, prevention