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1.
Voprosy Ginekologii, Akusherstva i Perinatologii ; 21(3):28-35, 2022.
Article in Russian | EMBASE | ID: covidwho-2033519

ABSTRACT

Objective. To assess the effectiveness of different preventive measures for novel coronavirus infection in pregnant women. Patients and Methods. This study included 125 pregnant women hospitalized with moderate to severe laboratory-confirmed SARS-CoV-2 infection between September and November 2021 (the fourth pandemic wave), and 175 pregnant women who were not infected with COVID-19 during the same period. All women in these two groups were comparable for gestational age (II–III trimesters, 24–39 weeks), age (20–40 years), social status, parity, body mass index, and had no known COVID-19 risk factors. Results. Our findings revealed that vaccination 3-5 months before pregnancy (OR = 4.12;95% CI 1.28–13.27;χ2 = 0.022), inconsistent use and/or non-timely replacement of face masks (OR = 5.71;95% CI 2.83–11.51) were associated with the increased risk of COVID-19 in the second and third trimesters of gestation. It was showed that systematic (once in the morning at 24–48-hour intervals) intranasal administration of recombinant interferon alpha-2b (IFN-α;Grippferon) as compared with a single application after exposure to COVID-19 reduced the disease incidence rate and there was no evident risk of illness (OR = 0.08;95% CI 0.05–0.14;19.2% vs 74,3%, p < 0.001). This can be explained by the fact that women were mostly infected in unpredictable conditions (e.g., 29.2% of pregnant women were infected from family members, 23.9% had unknown source of exposure). The use of umifenovir, not currently authorised for the medication-assisted prevention of COVID-19 in pregnant women, and rectal administration of IFN-α suppositories did not reduce the disease incidence rate. Rectal use of IFN-α suppositories by pregnant women off-label increased the incidence (32.0 vs 15.4%, p = 0.001) and risk of developing novel coronavirus infection (OR = 2.58;95% CI 1.48–4.50). Conclusion. There is a need to improve awareness among pregnant women about the mandatory and timely vaccination against COVID-19 during pregnancy and the importance of strict adherence to wearing face masks. Increased efforts should be made to monitor and inform pregnant women about the use of only authorised medication-assisted preventive measures of SARS-CoV-2 infection, such as intranasal administration of recombinant IFN α-2b (Grippferon). During the epidemic rise in COVID-19 cases, the systematic intranasal administration of recombinant interferon-based medication Grippferon (once in the morning at 24–48-hour intervals) is recommended for pregnant women.

2.
Akusherstvo i Ginekologiya (Russian Federation) ; 2022(5):53-58, 2022.
Article in Russian | EMBASE | ID: covidwho-1988722

ABSTRACT

Objective: To evaluate the dynamics of vaccination against the new coronavirus infection COVID-19 in pregnant women in the Far Eastern and Siberian Federal Districts from October 29, 2021 to December 24, 2021. Materials and methods: A total of 127787 pregnant women were monitored for vaccination from October 29, 2021 to December 24, 2021 in 11 regions of the Far Eastern Federal District and 10 regions of the Siberian Federal District. The findings were presented by the chief obstetricians-gynecologists of the regions. Statistical processing of the obtained data was carried out using the software package Microsoft Excel 2007. The level of null hypothesis testing was considered to be statistically significant at p<0.05. Results: According to the presented data, 126897 pregnant women were registered in the regions of the Far East and Siberia as of October 29, 2021, and 127787 women as of December 24, 2021. The results of the study showed an extremely low percentage of preconception specific prevention in pregnant women in the Far East and Siberia as of October 29, 2021. This indicator increased within two months by more than 2.26 times, namely from 4.2% to 9.5%. During monitoring, the proportion of vaccinated women before 22 weeks gestation increased by 2.1 times, from 0.7 to 1.5%;after 22 weeks gestation, it increased by 3.7 times, from 1.5 to 5.5%. The proportion of pregnant women who were ill with COVID-19 or vaccinated in the regions of the Far Eastern and Siberian Federal Districts increased from 13.0% to 26.3% during the monitoring period (p<0.001). There were no serious adverse events during COVID-19 vaccination with the Gam-COVID-Vac vaccine (Sputnik V) in 9667 pregnant women. Conclusion: Despite the absence of serious adverse events during COVID-19 vaccination with the Gam-COVID-Vac (Sputnik V) vaccine in pregnant women, it is necessary to conduct further detailed studies of the safety of vaccination during pregnancy, and also to develop a set of organizational measures aimed at increasing compliance with vaccination against COVID-19 at the period of pregnancy planning.

3.
Akusherstvo i Ginekologiya (Russian Federation) ; 2022(4):47-54, 2022.
Article in Russian | Scopus | ID: covidwho-1847925

ABSTRACT

Objective: To assess the morbidity, clinical course, maternal and perinatal outcomes of the new coronavirus infection COVID-19 in pregnant women in the Far Eastern and Siberian Federal Districts based on the results of 2020–2021. Materials and methods: The latest information on COVID-19 in pregnant women, women in labor and women who recently gave birth was analyzed. The findings were presented by the chief obstetricians-gynecologists of the regions in the period from March 11, 2020 to December 25, 2021. Results: A total of 27,210 cases of COVID-19 in pregnant, parturient and puerperal women were registered during the 2-year pandemic. The morbidity rate in these women was 2.4 times higher compared to the general population: 18988.0 vs 8019.5 per 100,000 people. SARS-CoV-2 infection was asymptomatic in 24.2% of mothers;it was mild in 50.0%, moderate in 21.3%, severe in 3.7%, and extremely severe in 0.8%. Pregnant women were more often hospitalized and stayed in intensive care and anesthesiology units compared to patients in the general population (5.5% vs 1.9%, p<0.001), and invasive mechanical ventilation (IMV) was used less often (0.7% vs 1.4%, p<0.05). There were 6,416 (23.6%) patients who gave birth to 6,512 children. Preterm delivery was in 18.5% (6.1% in Russia);cesarean sections – 38.8% (30.1% in Russia);operative vaginal delivery – 0.3% (0.13% in Russia). There were 81 (0.3%) deaths among mothers with COVID-19 (2.5% of cases among the population, p<0.001). Perinatal losses were registered in 156 cases (2.4%): stillbirths – 141 (2.17%), early neonatal mortality – 15 (0.23%). COVID-19(+) was revealed in 165 (2.5%) newborns. Conclusion: The incidence of COVID-19 in pregnant women was significantly higher than in general population during the 2-year pandemic, but the disease is characterized by more frequent hospitalization to intensive care and anesthesiology units, by lower demand for IMV and lower mortality rate. The second year of the pandemic was characterized by a more unfavorable course of COVID-19 in mothers and by an increase in the severe forms of the disease and indicators of maternal and perinatal mortality. The rates of preterm delivery and cesarean section in patients with COVID-19 were higher than in the general population. The incidence of SARS-CoV-2 virus isolation in newborns decreased significantly (from 6.2 to 2.5%). Further studies in this area are necessary. The morbidity rate of COVID-19 in pregnant women in Siberia and the Far East is higher than in the general population, but the disease is characterized by a lower need for IMV and a lower mortality rate. The rates of preterm birth and cesarean section are higher in patients with COVID-19 than in the general population. Finding of the SARS-CoV-2 RNA in newborns suggests vertical transmission of the infection. © A group of authors, 2022.

4.
Akusherstvo i Ginekologiya (Russian Federation) ; 2022(3):4-14, 2022.
Article in Russian | Scopus | ID: covidwho-1842634
5.
Gynecology ; 23(5):421-427, 2021.
Article in Russian | Scopus | ID: covidwho-1599948

ABSTRACT

Aim. To compare risk factors, features of COVID-19 course and outcomes in pregnant women during epidemic increase in incidence in 2020 and 2021. Materials and methods. The study included 163 pregnant women with laboratory-confirmed SARS-CoV-2 infection within May - December 2020 (1st-2nd waves of the epidemic) and 158 pregnant women who had new coronavirus infection within May - August 2021 (3rd wave of the epidemic). Patients in all groups were comparable in age (18-35 years), social status, parity, body mass index, and had no known risk factors for COVID-19. Results. Iron deficiency anemia, smoking, belonging to the Buryat ethnic group were recognized as persistent risk factors for COVID-19 in pregnant women. Over the 1st year of the pandemic, in pregnant women, the following clinical manifestations of novel coronavirus infection were commonly seen: anosmia (87.7%), somnolence (68.7%), shortness of breath even with a mild lung damage (68.1%). In the 3rd wave of the 2nd year of the pandemic, the leading signs and symptoms were cough (70.3% vs 38.7%, p<0.001), runny nose (46.2% vs 3.7%, p<0001), sore throat (367% vs 37%, p<0.001);an increase in body temperature above 38°C (19.6% vs 7,4%, p=0.006), pneumonia detected by computed tomography (61.4% vs 21.4%;p<0.001). There was a significant increase in the incidence of severe lung lesions (with computed tomography 3-4: 17.7% vs 4.9%;p<0.001) and admissions to intensive care units (11.4% vs 6.4%;p= 0041). There was a need for invasive mechanical ventilation (1.89% vs 0%;p=0.118). There was 1 death (0.63% vs 0%;p= 0.492), which was associated with the fulminant course of COVID-19. Conclusion. Persistent COVID-19 confounders in pregnant women who have no known risk factors in the third trimester of gestation are iron deficiency anemia, smoking, and belonging to the Buryat ethnic group. The clinical course of SARS-CoV-2 infection has changed and became more unfavorable: symptoms of acute respiratory disease (cough, runny nose, sore throat) began to prevail, the rate and severity of pneumonia and rate of mortality increased. © 2021 Consilium Medikum. All right reserved.

6.
Russian Journal of Human Reproduction ; 27(5):114-120, 2021.
Article in Russian | Scopus | ID: covidwho-1573839

ABSTRACT

Objective. To provide a comparative assessment of comorbid factors and the clinical course of the COVID-19 in pregnant women who died and survived a critical condition (near miss) in the Siberian and Far Eastern Federal Districts of Russia. Material and methods. Design was a retrospective study. The analysis of the primary medical documentation of pregnant women and postpartum women with a severe course of COVID-19 from April 1, 2020 to May 25, 2021 was carried out. Mathematical analysis included methods of descriptive statistics, analysis of contingency tables, where the value of χ2 was estimated, the achieved level of significance (p);calculation of the odds ratio (OR) at a 95% confidence interval (95% CI). Results. 10.842 cases of COVID-19 of pregnant women were registered in the Far Eastern Federal District and the Siberian Federal District. The incidence rate in pregnant women was 2.7 times higher than among the general population: 8833.5 vs. 3289.1 per 100 thousand population (8.8% vs. 3.2%;p<0.001). The proportion of deaths in pregnant women, women in labor and parturient women was 0.19%, among the population — 2.3% (p<0.001). The highest risk of maternal mortality (MM) is associated with obesity (OR=80.3;95% CI 9.34-690.19), slightly lower — with diabetes (OR=11.3;95% CI 2.0-63.27);chronic arterial hypertension (OR=17.2;95% CI 1.80-163.62);respiratory diseases (OR=12.2;95% CI 1.19-123.96);anemia (OR=4.5;95% CI 1.28-16.02). CT grade 3-4 lung damage on admission was associated with a 9-fold increase in the risk of death (OR=9.1;95% CI 3.03-27.14). The risk factors for MM were delay of antibacterial (OR=4.6;95% CI 11.24-16.87) and glucocorticoid (OR=3.4;95% CI 1.24-9.16) therapy. Anticoagulant therapy was prescribed statistically significantly later in the MM group (5.3±1.2 vs. 3.5±1.1;p=0.048). Conclusion. The risk of maternal mortality in COVID-19 is associated with co-morbid factors — obesity, diabetes, chronic arterial hypertension, respiratory diseases, and anemia, delay of antibacterial and glucocorticoid therapy. Timely anticoagulant therapy and delivery are key factors to preventing maternal mortality. Cesarean section for obstetric indications does not increase the risk of poor outcome, while operative delivery with intractable respiratory failure and refractory septic shock is associated with a high risk of maternal death. © 2021, Media Sphera Publishing Group. All rights reserved.

7.
Gynecology ; 23(3):255-259, 2021.
Article in Russian | Scopus | ID: covidwho-1404294

ABSTRACT

Aim. To identify confounding factors, features of the clinical course and outcomes of COVID-19 in pregnant and non-pregnant patients of early reproductive age who have no known risk factors and premorbid background. Materials and methods. The study included 163 pregnant women in the third trimester of gestation, 100 non-pregnant women with laboratory-confirmed SARS-CoV-2 infection and 100 pregnant women who did not get sick. Patients of all groups were comparable in age (18-35 years), social status, parity, body mass index, had no known risk factors for COVID-19;those who got sick were treated simultaneously. Results. Statistically significant associations were revealed between COVID-19 infection in the pregnant and iron deficiency anemia, vegetovascular dystonia, belonging to the Buryat ethnicity, and smoking. Pregnant women with COVID-19 were more likely to have no symptoms (23.3% vs 5%;p<0.001) or had a mild course of the disease (58.9% vs 24%;p<0.001). In non-pregnant patients, the course of infection was more often moderate (61% vs 14.7%;p<0.001) or severe (10% vs 3.1%;p=0.038). Clinical manifestations of new coronavirus infection (NCV) in pregnant women were dominated by anosmia (87.7% vs 40%;p<0.001), drowsiness (68.7% vs 17%;p<0.001), dyspnea, even with a mild lung lesion (68.1% vs 19%;p<0.001), headache (41.7% vs 24%;p=0.006), arthralgia (29.4% vs 16%;p=0.021), while fever above 38 °C (7.4% vs 28%;p<0.001) and cough (38.7% vs 61%;p<0.001) were much less common. With computed tomography, pneumonia in pregnant women was diagnosed several times less often (21.4% vs 87.4%;p<0.001). In the non-pregnant group, there was one death (1% vs 0%;p=0.201) associated with late hospitalization for severe NCI with grade 4 pulmonary involvement as shown on computed tomography. Conclusion. Confounders of COVID-19 in pregnant women who have no known risk factors in the third trimester of gestation are iron deficiency anemia, vegetovascular dystonia, belonging to the Buryat subpopulation, and smoking. In pregnant women, the main clinical symptoms of SARS-CoV-2 infection, with the exception of loss of smell, were nonspecific and characteristic of the physiological course of late gestation: drowsiness, dyspnea, joint pain. The predominance of mild or asymptomatic forms of infection, the lower incidence of pneumonia, and the absence of deaths in pregnant women suggests a more favorable course of COVID-19 NCI. © 2021 Consilium Medikum. All rights reserved.

8.
Gynecology ; 23(1):43-47, 2021.
Article in Russian | Scopus | ID: covidwho-1368110

ABSTRACT

Aim. To assess the incidence, clinical course, outcomes of a novel coronavirus infection (NKI) COVID-19 for mother and child in the population of pregnant women in the Far Eastern (FEFD) and Siberian Federal Districts (SFD). Materials and methods. The study design: a population-based epidemiological prospective study. We analyzed operative information on NKI COVID-19 incidence and features of clinical course in pregnant women, women in labor and parturient women as well as maternal and perinatal outcomes for March 11 to December 25, 2020 which were provided by the FEFD and SFD chief obstetricians-gynecologists. Mathematical analysis included methods of descriptive statistics, analysis of contingency table, where the value of χ2, the achieved level of significance (p) was estimated. Results. In the FEFD and SFD, over the COVID-19 2020 epidemic, the SARS-CoV-2 virus was revealed in 8485 pregnant women, women in labor and postpartum women (5.9% of pregnant women subjected to regular medical check-up;1.71% of the sick entire population). The incidence rate in pregnant women was 3.0 times higher than in the entire population: 5933,2 vs 1960,8 per 100 thousand (p<0.001). Among SARS-CoV-2 infected patients, 27.4% (2324) were asymptomatic, 52.7% (4471) have mild, 16.6% (1388) - moderate, 2.5% (210) - severe 0,5% (39) - extremely severe clinical course. In the intensive care and anesthesiology departments, 3.57% of pregnant women and 2.24% of the entire population (p<0.001) have been treated. Rate of using invasive artificial lung ventilation in pregnant women was lower than in the population: 0.48% vs 1.05% (p<0.001). 27.97% (2373) of women with confirmed NKI COVID-19 completed pregnancy. 81,7% of mothers delivered on time, 18.3% - prematurely. Cesarean delivery was performed in 42,0% of women, operative vaginal delivery (vacuum extraction, obstetric forceps) was registered in 0.2% of cases. 12 (0.14%) mothers died. The maternal mortality rate was 505.69 per 100 thousand live births (0.51% of patients with COVID-19 who gave birth). Mortality rates and the proportion of deaths in the entire population were statistically significantly higher: 1948.93 per 100 thousand sick population and 1.95% (p<0.001), respectively. 37 (1.56%) cases of perinatal losses were registered, of which 31 (1.30%) - stillbirths, 6 (0.26%) - early neonatal mortality. The SARS-CoV-2 virus was revealed in 148 (6.2%) newborns with the observance of anti-epidemic measures and separation of the mother and child immediately after delivery. Conclusion. The rate of revealing SARS-CoV-2 virus in pregnant women, women in labor and parturient women in Siberia and the Far East was 3.0 times higher than in the entire population, while clinical course of infectious process was less severe (less need for invasive mechanical ventilation, lower mortality rate). In mothers with COVID-19, preterm birth rate was 3.0 times higher, caesarean delivery rate -1.4 times higher compared with the average population indicators. Reveling SARS-CoV-2 virus RNA in 6.2% of newborns suggests the possibility of vertical transmission of the infection. © Gynecology 2021.

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