ABSTRACT
INTRODUCTION: Pregnant women are at increased risk of contracting COVID-19 due to several factors and therefore require special attention. However, the consequences of the COVID-19 pandemic on pregnant women and their newborns remain uncharted. The PregCovid registry aims to document the impact of SARS-CoV-2 infection on pregnant, postpartum women and their newborns. The aim of the registry is also to determine mother-to-child transmission of SARS-CoV-2 infection in India. METHODS AND ANALYSIS: PregCovid is a hospital-based registry for capturing information of pregnant, postpartum women with COVID-19 and their newborns in India. Medical case records of pregnant and postpartum women with a laboratory-confirmed diagnosis of COVID-19 will be captured in real-time using an online electronic patient record software. The data analysis will be carried out for symptoms, the severity of COVID-19, pregnancy complications, maternal morbidity and mortality, neonatal complications, mother-to-child transmission, etc. Data analysis will be carried out for different waves of the COVID-19 pandemic for rapid response and developing strategies well in advance to manage pregnant women infected with SARS-CoV-2. The evidence generated from the registry will be regularly shared with the appropriate authorities for policy decisions. Thus, the registry data may be useful for planning the strategies for better management of pregnant women with COVID-19. ETHICS AND DISSEMINATION: The study has been approved by the Institutional Ethics Committees of all the participating study sites under the Medical Education and Drugs Department, Government of Maharashtra, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai and ICMR-National Institute for Research in Reproductive and Child Health, Mumbai, India. The results from this study will be disseminated with local, state, and national health authorities, collaborators and the general population on the study website (https://pregcovid.com) as well as dissemination through scientific meetings and publications. TRIAL REGISTRATION NUMBER: CTRI/2020/05/025423.
Subject(s)
COVID-19 , Pregnant Women , COVID-19/epidemiology , Female , Hospitals , Humans , India/epidemiology , Infant, Newborn , Infectious Disease Transmission, Vertical/prevention & control , Pandemics , Pregnancy , Prospective Studies , Registries , SARS-CoV-2ABSTRACT
Background & objectives: The PregCovid registry was established to document the clinical presentations, pregnancy outcomes and mortality of pregnant and post-partum women with COVID-19. Methods: The PregCovid registry prospectively collects information in near-real time on pregnant and post-partum women with a laboratory-confirmed diagnosis of SARS-CoV-2 from 19 medical colleges across the State of Maharashtra, India. Data of 4203 pregnant women collected during the first wave of the COVID-19 pandemic (March 2020-January 2021) was analyzed. Results: There were 3213 live births, 77 miscarriages and 834 undelivered pregnancies. The proportion of pregnancy/foetal loss including stillbirths was six per cent. Five hundred and thirty-four women (13%) were symptomatic, of which 382 (72%) had mild, 112 (21%) had moderate, and 40 (7.5%) had severe disease. The most common complication was preterm delivery (528, 16.3%) and hypertensive disorders in pregnancy (328, 10.1%). A total of 158 (3.8%) pregnant and post-partum women required intensive care, of which 152 (96%) were due to COVID-19 related complications. The overall case fatality rate (CFR) in pregnant and post-partum women with COVID-19 was 0.8 per cent (34/4203). Higher CFR was observed in Pune (9/853, 1.1%), Marathwada (4/351, 1.1%) regions as compared to Vidarbha (9/1155, 0.8%), Mumbai Metropolitan (11/1684, 0.7%), and Khandesh (1/160, 0.6%) regions. Comorbidities of anaemia, tuberculosis and diabetes mellitus were associated with maternal deaths. Interpretation & conclusions: The study demonstrates the adverse outcomes including severe COVID-19 disease, pregnancy loss and maternal death in women with COVID-19 in Maharashtra, India.
Subject(s)
COVID-19 , Pregnancy Complications, Infectious , Female , Humans , India/epidemiology , Infant, Newborn , Pandemics , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Pregnancy Outcome/epidemiology , Pregnant Women , Registries , SARS-CoV-2ABSTRACT
OBJECTIVE: To assess clinical presentations, pregnancy complications, and maternal and neonatal outcomes among women with multiple gestation pregnancy (MGP) and confirmed SARS-CoV-2 (COVID-19) infection and to compare the data with a pre-pandemic period. METHODS: A retrospective study at a dedicated COVID-19 Hospital in Mumbai, India. Data were obtained from the PregCovid Registry of pregnant and postpartum women with PCR-confirmed SARS-CoV-2 infection from April to September, 2020. Data were also compared with a cohort of women with MGP attending the hospital pre-pandemic (n = 63). RESULTS: Data from 879 women (singleton pregnancy, n = 859; MGP, n = 20) with COVID-19 were assessed. The twinning rate was 34.2 per 1000 births. As compared with singleton pregnancies, a higher proportion of women with MGP and Covid-19 delivered preterm (P = 0.001). Spontaneous abortions were also higher in the MGP group than in the singleton group (P = 0.055). The incidence of pre-eclampsia/eclampsia was higher in the COVID-19 MGP group than in both the COVID-19 singleton (41.6% vs. 7.9%) and pre-pandemic MGP (50.0% vs. 12.7%) groups. CONCLUSION: There was a higher risk of pre-eclampsia among women with MGP and COVID-19. Women with MGP and COVID-19 infection should receive special attention with a multidisciplinary approach to both maternal and neonatal care during the pandemic.