Análise da relação entre gestação e infecção pela covid-19

Abstract

OBJECTIVE: To analyze the relationship between COVID-19 infection and clinical and obstetric outcomes in pregnant women admitted to hospital. METHODOLOGY: this was a quantitative, retrospective and analytical documentary study. The setting was the Health Surveillance Unit, the Women's Health Unit and the Intensive Care Unit (ICU) of the University Hospital of Santa Maria. The sources of information for data collection were internal epidemiological bulletins, internal reports and electronic medical records of pregnant women diagnosed positive for COVID-19 who were admitted to the Women's Health Unit or ICU at HUSM between 2020 and 2022. The sample consisted of 126 pregnant women infected with COVID-19 who were hospitalized. The data was collected from April to June 2023 using a google forms of our own. Afterwards, the database generated by google forms was statistically analyzed using the Statistical Package for the Social Sciences software. RESULTS: The descriptive data showed that 50.4% of the pregnant women had a gestational age greater than 37 weeks, had morbidity conditions related to obesity (22.2%), gestational diabetes (19.8%), chronic hypertension (19%) and pre-eclampsia (12%). Emergency cesarean sections were performed in 43.7% of cases. Regarding the newborns, 46.8% were full-term, 30.2% were breastfed in the first hour of life and 41.3% experienced skin-to-skin contact. Most of the cases were asymptomatic and only 27% of the pregnant women had been vaccinated. Ventilatory support was required in 10.3% of cases, and 4.8% were admitted to the COVID-19 ICU, with a median length of stay of 14 days. Of these, 3.2% used invasive ventilation and 2.4% required a prone maneuver. The majority of pregnant women (97.6%) were discharged from hospital. Analysis of the variables found that pregnant women with a cough were 12% and those with dyspnea 26.1% more likely to have a prolonged hospital stay or risk of ICU admission. Hypertension was the most statistically significant maternal morbidity for increased length of stay. Both Coronavirus Influenza Syndrome and Severe Acute Respiratory Syndrome were significantly related to ICU admissions in the population analyzed. SARS is related to cases of prematurity and reduced skin-to-skin contact and breastfeeding in the first hour of life. FINAL CONSIDERATIONS: Pregnant women are a vulnerable group for COVID-19 and can present negative outcomes that can culminate in the health of the fetus/NB. We hope to invest in professional training with up-to-date evidence for the management of this group; foster academic training with a theoretical and reflective basis; as well as future research to identify cases of long COVID-19 syndrome and how the growth and development of children whose mothers were infected during pregnancy will occur.