Фактори ризику акушерських і перинатальних ускладнень після перенесеного захворювання COVID-19

Abstract

Purpose - to identify risk factors for obstetric and perinatal complications after COVID-19. Materials and methods. 21 patients with severe course of COVID-19 (the Group 1) and 126 pregnant women with moderate severity of the disease - the Group 2 were comprehensively examined. The odds ratio (OR) was calculated with a 95% confidence interval (CI), significance level - p<0.05. Results. A high level of inflammation markers demonstrated the highest OR values: the 1st, the 3rd, the 5th place - increased procalcitonin (OR=48.4; 95% CI: 13.5-173.0), interleukin-6 (OR=39.1; 95% CI: 4.3-355.8), C-reactive protein (OR=8.5; 95% CI: 2.6-27.8), which in SARS-CoV-2 indicate a severe course of the disease. The indicator “difficulty of breathing” (OR=8.5; 95% CI: 2.6-27.8), which clearly reflects the severity of the disease in coronavirus disease, was in the 2nd place. The 4th in the indicator “increase in D-dimer to 10,000 ng/ml and above” (OR=13.2; 95% CI: 1.1-152.3), which indicates a high risk of thrombosis. The level of OR is also significantly high in the indicators “III-IV degree obesity” (OR=8.0; 95% CI: 2.3-28.0), “increased aspartate aminotransferase” (OR=6.9; 95% CI 2.4-20.1), “vitamin D deficiency” (OR=5.0; 95% CI: 1.4-17.7). Conclusions. The pathogenetic mechanisms of the development of perinatal complications in SARS-CoV-2 include: a high level of inflammatory processes mediated by the severity of the course of the disease, a violation of the immune system (hyperreaction - “cytokine storm”), prothrombotic changes in the hemostasis system, vitamin D deficiency, obesity and an increase in transaminases. The study was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was adopted by the Local Ethics Committee of the institution specified in the work. Informed consent from women was obtained for the study. No conflict of interests was declared by the authors.