ABSTRACT
Pregnant women are an interesting population to study in the context of the current Coronavirus Disease 2019 (COVID-19);studies are still controversial in concluding if pregnancy is a protective condition or a risk factor for a more severe form of the illness. We estimated rate of positive serology for SARS-CoV-2 in a population of healthy pregnant women, compared to a population of non-pregnant women of the same age and geographic area. We also made a comparison between the two groups in terms of previous symptoms and lifestyle. This is a transversal study including pregnant women, above 18 weeks of gestation, aged between 18 and 40 years. The control group consisted of 588 non pregnant women from the same area and the same age group. A total of 344 pregnant women and 588 non pregnant women were recruited. The rate of positive serology for SARS-CoV-2 was significantly lower in the pregnant group: 9/344 (2.6%) versus 75/588 (12.8%) in the non-pregnant group (p < 0.0001). The two groups were similar in terms of occupation and in the self-re-ported habit to leave the house during the lockdown. Our hypothesis to explain this result is that pregnant women might have adopted a more prudential lifestyle, due to their special condition, which may have led them to behave with more caution, i.e., concerning the responsibility of wearing all the disposable personal protective equipment, and keeping the recommended 6 feet distance from other people.
ABSTRACT
BACKGROUND In response to the COVID-19 pandemic, drastic measures for social distancing have been introduced also in Italy, with a substantial impact in delicate conditions like pregnancy and puerperium. The study aimed to investigate the changes in lifestyle, access to health services, and mental wellbeing during the first Italian lockdown in a sample of Italian pregnant women and new mothers. METHODS We carried out a web-based survey to evaluate how pregnant women and new mothers were coping with the lockdown. We collected data about healthy habits (physical exercise and dietary habits), access to health services (care access, delivery and obstetric care, neonatal care, and breastfeeding), and mental wellbeing (psychological wellbeing and emotive support). Descriptive analysis was performed for both groups of participants, whereas a Poisson analysis was used to measure the association between some structural variables (age, education, socio-economic data, partner support, contact, free time, previous children, and pregnancy trimester) and anxiety or depression, difficulties in healthy eating and reduction in physical activity after lockdown started. Chi2 and Adjusted Prevalence Ratios were estimated only for pregnant women. RESULTS We included 739 respondents (response rate 85.8 %), 600 were pregnant (81.2 %), and 139 (18.8 %) had delivered during lockdown (new mothers). We found a high score for anxiety and depression in 62.8 % of pregnant women and 61.9 % of new mothers. During the lockdown, 61.8 % of pregnant women reduced their physical exercise, and 44.3 % reported eating in a healthier way. 94.0 % of new mothers reported to have breastfed their babies during the hospital stay. Regarding the perceived impact of restrictive measures on breastfeeding, no impact was reported by 56.1 % of new mothers, whereas a negative one by 36.7 %. CONCLUSIONS The high prevalence of anxiety and depressive symptoms in pregnant women and new mothers should be a public health issue. Clinicians might also recommend and encourage 'home' physical exercise. On the other hand, about half of the sample improved their approach towards healthy eating and a very high breastfeeding rate was reported soon after birth: these data are an interesting starting point to develop new strategies for public health.
ABSTRACT
INTRODUCTION Pregnant women are an interesting population to study in the context of the current Coronavirus Disease 2019 (COVID-19);studies are still controversial in concluding if pregnancy is a protective condition or a risk factor for a more severe form of the illness particularly when the cardiorespiratory system is affected [1,2]. Some theories support the hypothesis that, since COVID-19 is an immune condition marked by reduced lymphocytes and elevated selected proinflammatory cytokines, and similar immune expression has been demonstrated in pregnancy, pregnant women might be on higher risk for a severe form of the illness [3]. Pregnancy itself can be considered an immunological paradox: the woman must develop an immunological tolerance towards a semi-allogenic fetus, which has exposed pregnant women in history to an increased risk of infection, especially viral with maternal and neonatal unfavourable outcomes [4,5]. According to other authors, immunomodulatory mechanisms employed by the pregnant status may mitigate violent immune response, may soften cytokine storm, tightly associated with severely ill COVID-19 patients, and potentially reduce SARS-CoV-2 transmission [6]. We estimated the rate of positive serology for SARS-CoV-2 in a population of healthy pregnant women, compared to a population of non-pregnant women of the same age and geographic area. We also made a comparison between the two groups in terms of previous symptoms and lifestyle. METHODS This is a transversal study including 344 pregnant women, above 18 weeks of gestation, aged between 18 and 40, attending the obstetrical clinic of the 'Maggiore della Carità' Hospital-Novara. The control group consisted of 588 non-pregnant women from the same area and the same age group. Women consented to participate in the study after being informed on the nature of the research and data managing and processing;an informed consent was therefore signed. Recruitment period was from 27th April 2020 to 1st July 2020. RESULTS A total of 344 pregnant women and 588 non-pregnant women were recruited. The rate of positive serology for SARS-CoV-2 was significantly lower in the pregnant group: 9/ 344 (2.6%) vs 75/588 (12.8%) in the non-pregnant group (p < .0001). The two groups were similar in terms of occupation and in the self-reported habit to leave the house during the lockdown. Furthermore, our study does not demonstrate important differences between pregnant and non-pregnant in symptomatology except that pregnant women mostly have fever and cough while symptoms for non-pregnant women were more varied. CONCLUSIONS Pregnant women are less infected than the equivalent female population. This could be either a better immunological response or due to a more prudential lifestyle. Pregnant women might have adopted a more prudential lifestyle, due to their special condition, which may have lead them to behave with more caution, concerning the responsibility of wearing all the disposable personal protective equipment, and keeping the recommended 6 feet distance from other people.