Clinical and anamnestic risk factors for early delivery and severity of viral pneumonia in pregnant women: a retrospective cohort single-center study
AbstractBackground. Analysis and prediction of early delivery in severe cases of viral pneumonia will allow planning timely routing of pregnant women.
The aim of the study was to evaluate clinical and anamnestic risk factors for early delivery and severity of viral pneumonia among pregnant women.
Material and methods. Retrospective cohort single-center study performed at the tRegional Clinical Hospital No. 2” in Krasnodar. Inclusion criteria: SARS-CoV-2 RNA positive; pregnancy at 22.0–41.6 weeks; known maternal outcome. Exclusion criteria: negative SARS-CoV-2 RNA result; unknown maternal outcome.
The patients were divided into two groups: group 1 – 81 pregnant women who gave birth due to viral pneumonia; group 2 – 69 pregnant women admitted with pneumonia and discharged after treatment. During the first day after hospitalization, clinical and anamnestic parameters, clinical manifestations of viral pneumonia, laboratory and instrumental research data were analyzed.
Results. The groups differed statistically significantly in body mass index [30,0 (27,0–32,0) kg/m2 in the group 1 and 27,0 (24,0–30,2) kg/m2 in the group 2], gestational age at the time of hospitalization [249 (230–264) days in the group 1 and 203 (179–228) days in the group 2], number of days of illness preceding hospitalization [7 (5–10) days in the group 1 and 9 (7–11) days in the group 2]. Of the clinical symptoms, only the frequency of respiratory movements on admission was significant between the groups 1 and 2 [19 (18–20) vs 18 (18–19)]. From diagnostic studies, differences were obtained in the volume of lung damage [55 (45–75)% and 35 (25–45)%], the level of D-dimer [1,4 (0,9–1,9) μg/ml and 0,9 (0,6–1,6) μg/ml], C-reactive protein level [86,1 (59,7–141,3) mg/l and 56,9 (36,0–88,8) mg/l]. Date of delivery in the group 1 was 254 (233–265) days, in the group 2 – 275 (270–280) days. The frequency of cesarean section in the group 1 was 83%, in the group 2 – 36%. In 31 (46%) patients of the group 1, the indication for cesarean section was the increase in signs of respiratory failure. Newborns from group 1 received a worse Apgar score at 1 and 5 minutes of life and had a lower birth weight and body length at birth.
Conclusion. The data obtained indicate the difficulties of predicting the severity of pneumonia and early delivery at the outpatient stage, therefore it is necessary to make a timely decision on hospitalization of pregnant women with viral pneumonia.
Keywords: early delivery; viral pneumonia; risk factors; Kaplan–Meier curve; Cox proportional hazards model
Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
Data availability statement. The data supporting the conclusions of this study are available from the corresponding author upon reasonable request. The data and statistical methods presented in this article have been statistically peer-reviewed by the journal editor, a certified biostatistician.
Compliance with ethical principles. The research conducted complies with the standards of the Declaration of Helsinki. A retrospective analysis of an observational study was performed. All hospitalized patients consented to the analysis of the obtained data.
Contribution. Concept and research design – Krivonosova N.V., Yarovaya E.B.; data collection – Krivonosova N.V.; analysis and interpretation of results – Krivonosova N.V., Krivonosov G.S.; literature review – Krivonosova N. V.; carrying out statistical analysis – Krivonosov G.S., Yarovaya E.B.; writing the text – Krivonosova N.V.; editing – Krivonosova N.V., Yarovaya E. B., Krivonosov G.S., Shapovalova O.A.
For citation: Krivonosova N.V., Yarovaya E.B., Krivonosov G.S., Shapovalova O.A. Clinical and anamnestic risk factors for early delivery and severity of viral pneumonia in pregnant women: a retrospective cohort single-center study. Akusherstvo i ginekologiya: novosti, mneniya, obuchenie [Obstetrics and Gynecology: News, Opinions, Training]. 2024; 12 (4): 24–33. DOI: https://doi.org/10.33029/2303-9698-2024-12-4-24-33 (in Russian)
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