Association between the degree of severity of COVID-19 infection during pregnancy and preterm premature rupture of membranes in a level III hospital in Peru

Authors

DOI:

https://doi.org/10.17843/rpmesp.2023.404.12957

Keywords:

Severity of Illness Index, Coronavirus Infections, Premature Rupture of Fetal Membranes, Pregnant Women, Peru

Abstract

Objectives. To determine the association between the degree of severity of COVID-19 infection during pregnancy and preterm premature rupture of  membranes (PPROM) in a level III hospital in Peru. Materials and Methods. Cross-sectional, analytical and observational study in women older than 18 years diagnosed with COVID-19 infection during  pregnancy, between the years 2020 and 2022. Clinical and obstetric variables were collected. The chi-square and Fisher’s exact tests were used for the descriptive analysis. For the multivariate analysis, we calculated the prevalence ratio by using Poisson regression in crude and adjusted models. All statistical tests were performed considering a value of p<0.05 as significant and with a confidence level of 95%. Results. We analyzed data from 163 pregnant women with COVID-19, of which 9.2% had PPROM; all were symptomatic cases. Mild COVID-19 cases were 1.10 times more likely to have PPROM (RPa=1.10; 95%CI: 1.02-1.18) and moderate/severe cases were 1.64 times more likely (RPa=1.64; 95%CI: 1.43-1.87), compared to asymptomatic cases. Conclusions. We identified that a higher degree of severity of COVID-19 infection during pregnancy was associated with a higher probability of having PPROM.

 

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References

WHO Coronavirus (COVID-19) Dashboard [Internet]. [citado el 21 de mayo del 2023]. Disponible en: https://covid19.who.int.

Akhtar H, Patel C, Abuelgasim E, Harky A. COVID-19 (SARS-CoV-2) Infection in Pregnancy: A Systematic Review. Gynecol Obstet Invest [Internet]. 2020 [citado el 21 de mayo del 2023];85(4):295–306. doi: 10.1159/000509290.

Ministerio de Salud. Sala de Situación SE 08 - 2021 [Internet]. Perú: Centro Nacional de Epidemiología, Prevención y Control de Enfermedades - MINSA; 2021 [citado el 21 de mayo del 2023]. Disponible en: https://www.dge.gob.pe/portal/docs/vigilancia/sala/2021/SE08/mmaterna.pdf.

Dávila-Aliaga C, Hinojoza-Pérez R, Espinola-Sánchez M, Torres-Marcos E, Guevara-Ríos E, Espinoza-Vivas Y, et al. Resultados materno-perinatales en gestantes con COVID-19 en un hospital nivel III del Perú. Rev Peru Med Exp Salud Pública [Internet]. 2021 [citado el 21 de mayo del 2023];38(1):58–63. doi: https://doi.org/10.17843/rpmesp.2021.381.6358.

Locatelli A, Consonni S. Obstetrics Evidence Based Guidelines. 3ra ed. Boca Raton: CRC Press; 2017. 227–242 p.

Addisu D, Melkie A, Biru S. Prevalence of Preterm Premature Rupture of Membrane and Its Associated Factors among Pregnant Women Admitted in Debre Tabor General Hospital, North West Ethiopia: Institutional-Based Cross-Sectional Study. Obstet Gynecol Int [Internet]. 2020 [citado el 21 de mayo del 2023];2020:4034680. doi: 10.1155/2020/4034680.

Juárez-Peralta M, Loo-Valverde M. Rotura prematura de membranas y su asociación con neumonía neonatal en gestantes atendidas en un Hospital terciario de Lima, Perú. Rev Peru Investig Matern Perinat [Internet]. 2021 [citado el 21 de mayo del 2023];9(2):16–20. doi: 10.33421/inmp.2020199.

Bahrami R, Schwartz DA, Karimi-Zarchi M, Javaheri A, Alireza S, Ferdosian F, et al. Meta-analysis of the frequency of intrauterine growth restriction and preterm premature rupture of the membranes in pregnant women with COVID-19. Turk J Obstet Gynecol [Internet]. 2021 [citado el 21 de mayo del 2023];18(3):263-244. doi: 10.4274/tjod.galenos.2021.74829.

Cruz S, De la Cruz ML, Carmona P, Abascal-Saiz A, Pintando P, González L, et al. Pregnancy Outcomes and SARS-CoV-2 Infection: The Spanish Obstetric Emergency Group Study. Viruses [Internet]. 2021 [citado el 21 de mayo del 2023];13(5):853. doi: 10.3390/v13050853.

Instituto Nacional Materno Perinatal. Boletín Estadístico 2020 [Internet]. Lima: INMP; 2020 [citado el 21 de mayo del 2023]. Disponible en: https://www.inmp.gob.pe/institucional/boletines-estadisticos/1422371837.

Menon R, Fortunato SJ. Infection and the role of inflammation in preterm premature rupture of the membranes. Best Pract Res Clin Obstet Gynaecol [Internet]. 2007 [citado el 21 de mayo del 2023];21(3):467–78. doi: 10.1016/j.bpobgyn.2007.01.008.

García LF. Immune Response, Inflammation, and the Clinical Spectrum of COVID-19. Front Immunol [Internet]. 2020 [citado el 21 de mayo del 2023];11:1441. doi: 10.3389/fimmu.2020.01441.

Facchetti F, Bugatti M, Drera E, Tripodo C, Sartori E, Cancila V, et al. SARS-CoV2 vertical transmission with adverse effects on the newborn revealed through integrated immunohistochemical, electron microscopy and molecular analyses of Placenta. EBioMedicine [Internet]. 2020 [citado el 21 de mayo del 2023];59:102951. doi: 10.1016/j.ebiom.2020.102951.

Sharps MC, Hayes DJL, Lee S, Zou Z, Brady CA, Almoghrabi Y, et al. A structured review of placental morphology and histopathological lesions associated with SARS-CoV-2 infection. Placenta [Internet]. 2020 [citado el 21 de mayo del 2023];101:13–29. doi: 10.1016/j.placenta.2020.08.018.

Maeda MFY, Brizot ML, Gibelli MABC, Ibidi SM, Carvalho WB, Hoshida MS, et al. Vertical transmission of SARS‐CoV2 during pregnancy:

A high‐risk cohort. Prenat Diagn [Internet]. 2021 [citado el 21 de mayo del 2023];10.1002/pd.5980. doi: 10.1002/pd.5980.

Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet Lond Engl [Internet]. 2020 [citado el 21 de mayo del 2023];395(10226):809–15. doi: 10.1016/S0140-6736(20)30360-3.

Metz TD, Clifton RG, Hughes BL, Sandoval G, Saade GR, Grobman WA, et al. Disease Severity and Perinatal Outcomes of Pregnant Patients With Coronavirus Disease 2019 (COVID-19). Obstet Gynecol [Internet]. 2021 [citado el 21 de mayo del 2023];137(4):571-580. doi: 10.1097/AOG.0000000000004339.

Lassi ZS, Ana A, Das JK, Salam RA, Padhani ZA, Irfan O, et al. A systematic review and meta-analysis of data on pregnant women with confirmed COVID-19: Clinical presentation, and pregnancy and perinatal outcomes based on COVID-19 severity. J Glob Health [Internet]. 2021 [citado el 21 de mayo del 2023];11:05018. doi: 10.7189/jogh.11.05018.

Angulo-Fernandez K, Olivera-Rojas A, Mougenot B, Herrera P. Asociación entre los síntomas de la infección por la COVID-19 y los resultados materno-perinatales adversos en gestantes de un hospital de referencia. Rev Peru Med Exp Salud Publica [Internet]. 2023 [citado el 21 de mayo del 2023];40(1):34-41. doi: https://doi.org/10.17843/rpmesp.2023.401.11205.

Guevara-Ríos E. Gestación en época de pandemia por coronavirus. Rev Peru Investig Materno Perinat [Internet]. 2021 [citado el 21 de mayo del 2023];9(2):7–8. doi: https://doi.org/10.33421/inmp.2020196.

Ministerio de Salud. Prevención, diagnóstico y tratamiento de personas afectadas por COVID-19 en el Perú [Internet]. Perú: MINSA; 2020 [citado el 21 de mayo del 2023]. Disponible en: https://cdn.www.gob.pe/uploads/document/file/582567/Prevención__Diagnóstico_y_Tratamiento_de_personas_afectadas_por_COVID-19_en_el_Perú_.PDF?v=1588182165.

Schmitz T, Sentilhes L, Lorthe E, Gallot D, Madar H, Doret-Dion M, et al. Preterm premature rupture of the membranes: Guidelines for clinical practice from the French College of Gynaecologists and Obstetricians (CNGOF). Eur J Obstet Gynecol Reprod Biol [Internet]. 2019 [citado el 21 de mayo del 2023];236:1-6. doi: 10.1016/j.ejogrb.2019.02.021.

Diriba K, Awulachew E, Getu E. The effect of coronavirus infection (SARS-Cov-2, MERS-CoV, and SARS-CoV) during pregnancy and the

possibility of vertical maternal-fetal transmission: a systematic review and meta-analysis. Eur J Med Res [Internet]. 2020 [citado el 21 de mayo del 2023];25(1):39. doi: 10.1186/s40001-020-00439-w.

Di Mascio D, Khalil A, Saccone G, Rizzo G, Buca D, Liberati M, et al. Outcome of coronavirus spectrum infections (SARS, MERS, COVID-19) during pregnancy: a systematic review and meta-analysis. Am J Obstet Gynecol MFM [Internet]. 2020 [citado el 21 de mayo del 2023];2(2)100107. doi: 10.1016/j.ajogmf.2020.100107.

Motwani R, Deshmukh V, Kumar A, Kumari C, Raza K, Krishna H. Pathological involvement of placenta in COVID-19: a systematic review. Infez Med [Internet]. 2022 [citado el 21 de mayo del 2023];30(2):157-167. doi: 10.53854/liim-3002-1.

Corbetta-Rastelli CM, Altendahl M, Gasper C, Goldstein JD, Afshar Y, Gaw SL. Analysis of placental pathology after COVID-19 by timing and severity of infection. Am J Obstet Gynecol MFM [Internet]. 2023 [citado el 21 de mayo del 2023];5(7):100981. doi: 10.1016/j.ajogmf.2023.100981.

Meyer JA, Roman AS, Limaye M, Grossman TB, Flaifel A, Vaz MJ, et al. Association of SARS-CoV-2 placental histopathology findings with maternal-fetal comorbidities and severity of COVID-19 hypoxia. J Matern Fetal Neonatal Med [Internet]. 2022 [citado el 21 de mayo del 2023];35(25):8412-8418. doi: 10.1080/14767058.2021.1977791.

Celik E, Vatansever C, Ozcan G, Kapucuoglu N, Alatas C, Besli Y, et al. Placental deficiency during maternal SARS-CoV-2 infection. Placenta [Internet]. 2022 [citado el 21 de mayo del 2023];117:47-56. doi: 10.1016/j.placenta.2021.10.012.

Carbone L, Trinchillo MG, Di Girolamo R, Raffone A, Saccone G, Iorio GG, et al. COVID-19 vaccine and pregnancy outcomes: A systematic review and meta-analysis. Int J Gynaecol Obstet [Internet]. 2022 [citado el 21 de mayo del 2023];00:1-11. doi: 10.1002/ijgo.14336.

Published

2023-12-18

Issue

Section

Original Article

How to Cite

1.
Palma A, Niño-Huertas A, Bendezu-Quispe G, Herrera-Añazco P. Association between the degree of severity of COVID-19 infection during pregnancy and preterm premature rupture of membranes in a level III hospital in Peru. Rev Peru Med Exp Salud Publica [Internet]. 2023 Dec. 18 [cited 2024 Jun. 12];40(4):432. Available from: https://rpmesp.ins.gob.pe/index.php/rpmesp/article/view/12957

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