Implications of COVID-19 for obstetric and neonatal outcomes
Implicaciones de COVID-19 en los resultados obstétricos y neonatales
Implicações da COVID-19 para desfechos obstétricos e neonatais
Jozéli Fernandes de Lima; Tassiane Ferreira Langendorf; Raquel Einloft Kleinubing; Silvana Silveira; Letícia Becker Vieira; Stela Maris de Mello Padoin
Abstract
Objective To analyze the implications of COVID-19 on obstetric and neonatal outcomes among hospitalized pregnant women.
Method This retrospective, documentary, and analytical cohort study was conducted at a hospital in southern Brazil. The study population consisted of 126 pregnant women admitted between 2020 and 2022. Data were collected from April to June 2023 using epidemiological bulletins and electronic medical records and analyzed using the Statistical Package for the Social Sciences software.
Results The pregnant women had a gestational age of ≥37 weeks (50.4%), obesity (22.2%), and chronic hypertension (19.0%). Emergency cesarean sections occurred in 43.7% of cases, and only 27% of them were vaccinated. Mechanical ventilation was required in 10.3% of cases, and 4.8% of them were admitted to the intensive care unit. Severe Acute Respiratory Syndrome was associated with prematurity and reduced skin-to-skin contact and breastfeeding in the first hour of life.
Conclusion and implications for practice Pregnant women are a vulnerable group to the implications of COVID-19, which can have negative effects on obstetric and neonatal outcomes. Prevention and adequate monitoring are the main implications for practice when infection occurs.
Keywords
Resumen
Palabras clave
Resumo
Objetivo: Analisar as implicações da COVID-19 nos desfechos obstétricos e neonatais de gestantes hospitalizadas.
Método: Este estudo de coorte, retrospectivo, documental e analítico foi realizado em um hospital no Sul do Brasil. Sua população foi composta por 126 gestantes internadas entre 2020 e 2022. As variáveis foram coletadas de abril a junho de 2023, usando boletins epidemiológicos e prontuários eletrônicos, e analisadas no software Statistical Package for the Social Sciences.
Resultados: As gestantes tinham idade gestacional ≥37 semanas (50.4%), obesidade (22.2%) e hipertensão crônica (19.0%). Cesáreas de emergência ocorreram em 43.7% dos casos, e só 27% delas estavam vacinadas. Ventilação mecânica foi necessária em 10.3% dos casos, e 4.8% delas foram internadas em unidade de terapia intensiva. A Síndrome Respiratória Aguda Grave esteve associada à prematuridade e redução no contato pele-a-pele e amamentação na primeira hora de vida.
Conclusão e implicações para a prática: Gestantes são um grupo vulnerável às implicações da COVID-19 que podem ser negativos em desfechos obstétricos e neonatais. A prevenção e o monitoramento adequado são as principais implicações para a prática quando ocorre a infecção.
Palavras-chave
References
1 Vivanti AJ, Mattern J, Vauloup-Fellous C, Jani J, Rigonnot L, El Hachem L et al. Retrospective description of pregnant women infected with severe acute respiratory syndrome Coronavirus 2, France. Emerg Infect Dis. 2020;26(9):2069-76.
2 World Health Organization. WHO-convened global study of origins of SARS-CoV-2: China Part. Geneva: WHO; 2021.
3 Ministério da Saúde (BR), Secretaria de Atenção Primária à Saúde, Departamento de Ações Programáticas e Estratégicas. Manual de Recomendações para a Assistência à Gestante e Puérpera frente à Pandemia de Covid-19. 2ª ed. Brasília: Ministério da Saúde; 2021.
4 Observatório Obstétrico Brasileiro. OOBr SRAG: Síndrome respiratória aguda grave em gestantes e puérperas. São Paulo: OOBr; 2021.
5 Cañedo MC, Lopes TIB, Rossato L, Nunes IB, Faccin ID, Salomé TM et al. Impact of COVID-19 pandemic in the Brazilian maternal mortality ratio: a comparative analysis of Neural Networks Autoregression, Holt-Winters exponential smoothing, and Autoregressive Integrated Moving Average models. PLoS One. 2024;19(1):e0296064.
6 Been JV, Burgos Ochoa L, Bertens LCM, Schoenmakers S, Steegers EAP, Reiss IKM. Impact of COVID-19 mitigation measures on the incidence of preterm birth: a national quasi-experimental study. Lancet Public Health. 2020;5(11):e604-11.
7 Rasmussen SA, Jamieson DJ. COVID-19 and pregnancy. Infect Dis Clin North Am. 2022;36(2):423-33.
8 Nações Unidas no Brasil. Os objetivos de desenvolvimento sustentável no Brasil [Internet]. Brasília: Nações Unidas; 2015 [citado 2025 jun 25]. Disponível em:
9 Gonçalves BMM, Franco RPV, Rodrigues AS. Maternal mortality associated with COVID-19 in Brazil in 2020 and 2021: Comparison with non-pregnant women and men. PLoS One. 2021;16(12):e0261492.
10 Wu YC, Chen CS, Chan YJ. The outbreak of COVID-19: an overview. J Chin Med Assoc. 2020;83(3):217-20.
11 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. 2021;11:05018.
12 Asmariyah A, Novianti N, Suriyati S. Tingkat kecemasan ibu hamil pada masa pandemi covid-19 di kota bengkulu. Journal Of Midwifery. 2021;9(1):1-8.
13 Pinto MM, Xavier RS, Dallabrida MM, Siegloch AE, Silva BF. Cases of pregnant of comorbities on pregnancy outcomes. Boletim de Conjuntura. 2023;15(45):201-28.
14 Rondelli G, Jardim D, Hamad G, Luna E, Marinho W, Mendes L et al. Assistência às gestantes e recém-nascidos no contexto da infecção covid-19: uma revisão sistemática. Desafios. 2020;7(3):48-74.
15 Allotey J, Fernandez S, Bonet M, Stallings E, Yap M, Kew T et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ. 2020;370:m3320.
16 Li N, Han L, Peng M, Lv Y, Ouyang Y, Liu K et al. Maternal and neonatal outcomes of pregnant women with coronavirus disease 2019 (COVID-19) pneumonia: a case-control study. Clin Infect Dis. 2020;71(16):2035-41.
17 Ministério da Saúde (BR), Secretaria de Atenção Especializada à Saúde, Departamento de Atenção Hospitalar, Domiciliar e de Urgência. Protocolo de manejo clínico da Covid-19 na Atenção Especializada. 1ª ed. Brasília: Ministério da Saúde; 2020.
18 International Confederation of Midwives. Los derechos de las mujeres en el parto deben ser respetados durante la pandemia de Coronavirus. Den Haag: ICM; 2020.
19 Camargo ELS, Sousa AFL, Reis AS, Fortunato MR, Gouveia IA, Mendes IAC et al. Determining factors for COVID-19 vaccine hesitancy among Brazilians: a study using structural equation modeling. Rev Bras Enferm. 2024;77(Suppl 2):e20240112.
20 Prasad S, Kalafat E, Blakeway H, Townsend R, O’Brien P, Morris E et al. Systematic review and meta-analysis of the effectiveness and perinatal outcomes of COVID-19 vaccination in pregnancy. Nat Commun. 2022;13(1):2414.
21 Andrade LH, Santos GG, Sordi MAP, Nunes HRC, Parada CMGL. Factors associated with the evolution of COVID-19 in pregnant women: a Brazilian population-based study. Rev Esc Enferm USP. 2023;57:e202320042.
22 Delahoy MJ, Whitaker M, O’Halloran A, Chai SJ, Kirley PD, Alden N et al. Characteristics and maternal and birth outcomes of hospitalized pregnant women with laboratory-confirmed COVID-19 - COVID-NET, 13 States, March 1-August 22, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(38):1347-54.
23 Januszewski M, Ziuzia-Januszewska L, Jakimiuk AA, Wierzba W, Gluszko A, Zytynska-Daniluk J et al. Is the Course of COVID-19 Different during Pregnancy? A Retrospective Comparative Study. Int J Environ Res Public Health. 2021;18(22):12011.
24 Almeida JP, Santana VS, Santos KMD, Abe AHDM, Vieira LTQ. Hospitalizations for SRAG and COVID-19 deaths in brazilian pregnant women: an analysis of the sad reality. Brazilian Journal of Health Review. 2021;4(3):13446-60.
25 Kunjumon B, Wachtel EV, Lumba R, Quan M, Remon J, Louie M et al. Breast milk and breastfeeding of infants born to SARS-CoV-2 positive mothers: a prospective observational cohort study. Am J Perinatol. 2021;38(11):1209-16.
26 United Nations Children’s Fund. Infant and young child feeding in the context of COVID-19: Brief No. 2 (v1), 30 March 2020. New York: UNICEF; 2020.
27 Mullins E, Evans D, Viner RM, O’Brien P, Morris E. Coronavirus in pregnancy and delivery: rapid review. Ultrasound Obstet Gynecol. 2020;55(5):586-92.
28 Nascimento GNXD, Mendes VA, Bittencourt MN, Silva CG, Ribeiro MRR, Ferreira GE. Experiência do paciente com cuidados de Enfermagem na hospitalização pela COVID-19: incidentes críticos percebidos. Esc Anna Nery. 2024;28:e20240084. https://doi.org/10.1590/2177-9465-EAN-2024-0084pt.
Accepted date:
09/09/2025
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email