EP04.15: COVID‐19 and pregnancy outcomes: a multifaceted analysis of maternal and fetal health

Abstract

To assess impact of COVID-19 on hospitalised pregnant women. Retrospective study (150 women, Jan 1st-May 1st, 2022, Tunis hospitals). Medical records reviewed for demographics, clinical presentation, paraclinical findings, and maternal/fetal outcomes. The study population (aged 28-38 years) had diverse educational backgrounds (26% with university degrees) and half were non-working spouses. While most reported no significant medical history, 10% had controlled asthma and 17% a prior pregnancy loss. Vaccination rates were high (79%), with 40% vaccinated pre-pregnancy and 24% during pregnancy (Pfizer most common, 45%). Most received prenatal care (78%), but pre-existing complications (gestational diabetes 12%, gestational hypertension 8%, pre-eclampsia 3%) were present in some. Diagnosis relied on RT-PCR tests (78%). Common COVID-19 symptoms (fever 36%, cough 31%, dyspnea 31%) were reported in 73% of women. Cases were mostly mild (84%) with no maternal deaths. Treatment focused on symptom management (97%), antibiotics (95%), vitamins (97%), and oxygen therapy (32%). Anticoagulants (99%) and corticosteroids (81%) were frequently used. COVID-19 infection was associated with increased risk of preterm delivery (20%), respiratory distress (9%), and miscarriage (5%). Psychological distress was observed in all women. Delivery outcomes were significantly impacted, with a substantial rise in Caesarean sections (85%) and a preterm birth rate mirroring deliveries (33%). Stillbirth rate was concerning (12%). Neonatal COVID-19 infection occurred in 6% (mostly asymptomatic). Most newborns had good Apgar scores (82%), but some required resuscitation (11%) and NICU admission (33%). This study found predominantly mild COVID-19 in hospitalised pregnant women, with many vaccinated. Complications like preterm birth and Caesarean sections were observed. Continued vaccination efforts and close monitoring throughout pregnancy are crucial.