The New Indian Journal of OBGYN. Epub Ahead of Print
Comparison of feto-maternal outcomes during the two ways of COVID-19 in a tertiary care hospital of Karnataka
Suma KB, Poornima M, Sahanak Gowda
ABSTRACT
Background: Several countries witnessed a two-wave pattern during coronavirus disease-19 (COVID-19) pandemic, with India being no exception. This epidemic had markedly affected pregnant women also. Objectives: This study aimed to compare fetomaternal outcomes during the first and second waves of COVID-19 in North India. Methods: This retrospective observational comparative study included patients admitted during COVID-19 first wave and second wave in a tertiary care hospital. The inclusion criteria were confirmed RT-PCR or ground glass opacities on HRCT for COVID-19. From the records, the details of demographic characteristics, obstetric history, COVID-19 severity, and investigations were recorded. The maternal outcomes assessed were mode of delivery, ICU admission and mortality. The fetal outcomes assessed were mortality, preterm births, Apgar score, vertical transmission, and other complications. P value <0.05 was considered statistically significant. Results: The patients were in the age group of 30s in both COVID-19 first wave and second wave (P=0.333), with an equivalent obstetric history of parity and gestational age. COVID-19 second wave had significantly higher patients with COVID-19 pneumonia (58.33% vs. 3.70%, P<0.0001), significantly lesser patients with hypertension (2.08% vs. 18.52%, P=0.021), significantly more severity category 2 (41.67% vs. 0.00%, P<0.0001), and significantly more deranged LDH (29.17% vs. 3.70%, P=0.007). First and second waves had similar cesarean section rates (66.67% vs. 63.16%). ICU admissions were required more in COVID-19 second wave but statistically no difference was found (26.32% vs. 16.67%, P=0.514). Maternal mortality was seen only in a single case of COVID-19 first wave and two cases of COVID-19 second wave. Compared to COVID-19 first wave, COVID-19 second wave had comparable preterm births, Apgar score, ARDS, vertical transmission, fever, cough, cyanosis, feed intolerance, and tachypnea (P>0.05). Conclusion: The second wave of the COVID-19 pandemic caused more severe disease among pregnant as well as peripartum women compared to the first wave. This necessitates our preparation for the third wave to control fetomaternal complications.