Hematologic abnormalities and pregnancy outcomes in pregnant women with COVID-19
DOI:
https://doi.org/10.32007/jfacmedbagdad.6441976Keywords:
Peripheral Blood System, Maternal Outcomes, Pregnant Women, COVID-19.Abstract
Background: Since declaring coronavirus disease 19 as a pandemic by the World Health Organization, a great concern was directed toward pregnant women and their fetuses. Despite the substantial impact of COVID-19 disease on pregnancy, there is a scarcity of national researches discussing this important issue.
Objectives: To study the relationship between peripheral blood abnormalities and COVID-19 in pregnant women.
Patients and methods: A case control study was conducted in the labour wards of Baghdad Teaching Hospital in the Medical complex / Baghdad /Iraq during the period from 1st of February till 31st of July, 2021. Fifty pregnant women diagnosed with COVID-19 disease were compared to 50 healthy pregnant women as controls. The pregnant women enrolled in the study were tested by COVID-19-Reverse transcription RT-PCR test upon admission to hospital. The confirmation of COVID-19 diagnosis was done according to the Iraqi guidelines approved by the Iraqi Ministry of Health.
Results: Dyspnea was a significant clinical presentation of pregnant women with COVID-19 disease. Those women had abnormal white blood cell count, lymphocytopenia, high neutrophil to lymphocyte ratio, high platelets to lymphocyte ratio and mild to moderate anemia which were significant when compared to controls. The maternal and neonatal morbidity and mortality rates were higher among pregnant women with COVID-19 disease. Abnormalities in peripheral blood system parameters like lymphocyte count, neutrophils count, platelets count and hemoglobin level were predictors of maternal morbidity and mortality.
Conclusions: The clinical presentations and hematological abnormalities are useful in the diagnosis of COVID-19 disease in pregnant women and may be used as predictors of maternal and neonatal morbidity and mortality.
Downloads
References
Rasmussen SA, Jamieson DJ. Pregnancy, Postpartum Care, and COVID-19 Vaccination in 2021. JAMA 2021; 325(11):1099-1100.
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 2020; 2(2):100107.
Bourne T, Kyriacou C, Coomarasamy A, Al-Memar M, Leonardi M, Kirk E, et al. ISUOG Consensus Statement on rationalization of early-pregnancy care and provision of ultrasonography in context of SARS-CoV-2. Ultrasound Obstet Gynecol 2020; 55(6):871-878.
Cascella M, Rajnik M, Cuomo A, Dulebohn SC, Di Napoli R. Features, Evaluation and Treatment Coronavirus (COVID-19) (Online). 2020. Availaable at: https://www.ncbi.nlm.nih.gov/pubmed/32150360
Hosier H, Farhadian SF, Morotti RA, Deshmukh U, Lu-Culligan A, Campbell KH, et al. SARS-CoV-2 infection of the placenta. J Clin Invest 2020; 130(9):4947-4953.
Creanga AA, Syverson C, Seed K, Callaghan WM. Pregnancy-Related Mortality in the United States, 2011-2013. Obstet Gynecol 2017; 130(2):366-373.
Ahmed I, Azhar A, Eltaweel N, Tan BK. First COVID-19 maternal mortality in the UK associated with thrombotic complications. Br J Haematol 2020; 190(1):e37-e38.
The Royal College of Obstetricians and Gynaecologists Information for healthcare professionals’ coronavirus (COVID-19) infection and abortion care (Online).2020. Available at: https://www.rcog.org.uk/en/guidelines-research
Zambrano LD, Ellington S, Strid P, Galang RR, Oduyebo T, Tong VT, et al; CDC COVID-19 Response Pregnancy and Infant Linked Outcomes Team. Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status - United States, January 22-October 3, 2020. MMWR Morb Mortal Wkly Rep 2020; 69(44):1641-1647.
El-Goly AM, Metwally AA. Diagnosis of COVID-19 Infection in Pregnancy. Covid-19 Infections and Pregnancy 2021; 39-62.
Afshar Y, Gaw SL, Flaherman VJ, Chambers BD, Krakow D, Berghella V, et al. Clinical Presentation of Coronavirus Disease 2019 (COVID-19) in Pregnant and Recently Pregnant People. Obstet Gynecol 2020; 136(6):1117-1125.
Aslam S, Gondal M, Tahira T, Huma Z, Mumtaz M, Zahir M, et al. Varied Clinical Presentations of COVID-19 in Pregnant Women in Tertiary Care Hospital of Lahore-Pakistan. P J M H 2021; 15 (6): 1266-1268.
Sun S, Cai X, Wang H, He G, Lin Y, Lu B, et al. Abnormalities of peripheral blood system in patients with COVID-19 in Wenzhou, China. Clin Chim Acta 2020; 507:174-180.
Hapshy V, Aziz D, Kahar P, Khanna D, Johnson KE, Parmar MS. COVID-19 and Pregnancy: Risk, Symptoms, Diagnosis, and Treatment [published online ahead of print, 2021 Apr 21]. SN Compr Clin Med 2021; 1-7.
Sun G, Zhang Y, Liao Q, Cheng Y. Blood Test Results of Pregnant COVID-19 Patients: An Updated Case-Control Study. Front Cell Infect Microbiol 2020; 10:560899.
Terpos E, Ntanasis-Stathopoulos I, Elalamy I. Hematological findings and complications of COVID-19. Am J Hematol 2020; 95: 834- 847.
Lombardi A, Trombetta E, Cattaneo A, Castelli V, Palomba A, Tirone M, et al. Early Phases of COVID-19 Are Characterized by a Reduction in Lymphocyte Populations and the Presence of Atypical Monocytes. Front Immunol 2020; 11:560330.
Chen G, Liao Q, Ai J, Yang B, Bai H, Chen J. Immune Response to COVID-19 During Pregnancy. Front Immunol 2021; 12:675476.
Zhang C, Chu H, Pei YV and Zhang J. Laboratory Effects of COVID-19 Infection in Pregnant Women and Their Newborns: A Systematic Review and Meta-Analysis. Front. Glob. Women’s Health 2021; 2:647072.
Lira SC, Espinosa MG. Differences in the neutrophil/lymphocyte ratio and the platelet/lymphocyte ratio in pregnant women with and without COVID-19. Int J Gynaecol Obstet 2021. doi: 10.1002/ijgo.13840. Online ahead of print.
Gajbhiye RK, Sawant MS, Kuppusamy P, Surve S, Pasi A, Prusty RK, et al. Differential impact of COVID-19 in pregnant women from high-income countries and low- to middle-income countries: A systematic review and meta-analysis. Int J Gynaecol Obstet 2021; 155(1):48-56.
Al-Kuraishy HM, Al-Maiahy TJ, Al-Gareeb AI, Musa RA, Ali ZH. COVID-19 pneumonia in an Iraqi pregnant woman with preterm delivery. Asian Pac J Reprod 2020; 9: 1-3.
Karasek D, Baer RJ, McLemore MR, Bell AJ, Blebu BE, Casey JA, et al. The association of COVID-19 infection in pregnancy with preterm birth: A retrospective cohort study in California. The Lancet Regional Health – Americas 2021; 2: 100027.
Mullins E, Hudak ML, Banerjee J, Getzlaff T, Townson J, Barnette K, et al. Pregnancy and neonatal outcomes of COVID-19: Co-reporting of common outcomes from PAN-COVID and AAP-SONPM registries. Ultrasound Obstet Gynecol 2021; 57(4):573-581.
Downloads
Published
Issue
Section
License
Copyright (c) 2022 Huda Mozer AbdAlraheem, Rawaa D. M. AlJanabi
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Permit others to copy and distribute the manuscript; to extract, revise, and create another derivative
works of or from the manuscript (e.g., a translation); to incorporate the manuscript into a
collective work; and to text or data mine the article, even for commercial purposes, provided that
the author(s) is/are credited; the article's modifications should not harm the author's honor or
reputation; and the article should not be altered in a way that would cause the author to lose them
reputation. The Creative Commons Attribution 4.0 International License (CC BY 4.0) has more
information.