RAMIFICATION OF COVID-19 INFECTION AT THE TIME OF DELIVERY

ABSTRACT

Background- For successful management of Covid-19 pregnancy, adequate information and understanding of its clinical presentation and impact of the disease on pregnant mothers and their newborns is required. Aim- To describe the clinical manifestations of COVID -19 infection in pregnant women during peripartum period and to study the clinical outcomes of neonates born to these mothers. Methods- This prospective study was conducted at a COVID-19 Hospital of North India, from May 2021 to July 2021.All Covid-19 positive pregnant women who presented at the time of labor (symptomatic or asymptomatic) were included in the study. Follow up of these women and their newborns was done till discharge and neonates were further followed up till 28 days of life. Results-Total 70 patients were included in the study (24.2% symptomatic and 75.7% asymptomatic). Eighteen (25.7%) were NVD and 52(74.2%) were LSCS. LSCS was done more in symptomatic subjects (p<0.05). Frequency of AFD is higher in symptomatic subjects(p value< 0.05).Co morbidities noted were PIH, GDM, hypothyroidism and anemia in 15(21.4%), 2(2.8%), 11(15.7%) and 22(31.4%) respectively. All study women were successfully discharged. There were 69 live births(53(76.8%) term and 16(23.1%) preterms)and 1 IUD. Two (2.8%) babies were tested positive for COVID19. Both remained asymptomatic and discharged. Total 11 neonates required NICU admission due to non covid reasons. Number of deaths among neonates were 2 (2.8%). During followup visits 5(9.09%) neonates required readmission in NICU. Inadequate weight gain was seen in 3(5.4%) babies. None developed COVID related symptoms. Conclusion- COVID 19 infection during pregnancy is not associated with severe clinical presentation, high mortality and morbidity. There may be an association between symptomatic COVID19 pregnant women and AFD. There is high incidence of prematurity and LBW in neonates born to COVID positive mothers.