Pregnancy Status and Intensive Care Outcomes in Women with Suspected or Confirmed COVID-19
Pregnancy Status and ICU Outcomes in COVID-19
DOI:
https://doi.org/10.71350/ajaic.3Keywords:
Pregnancy, COVID-19, Intensive care unit, Mechanical ventilation, PostpartumAbstract
Background: Pregnant women with Coronavirus Disease 2019 (COVID-19) may experience a more severe clinical course compared with non-pregnant women of reproductive age. This study aimed to compare demographic characteristics, laboratory findings, and intensive care unit outcomes between pregnant/postpartum and non-pregnant women admitted to the intensive care unit with suspected or confirmed COVID-19.
Materials and Methods: This retrospective observational study included 56 women of reproductive age admitted to the intensive care unit between March 2020 and December 2021 with suspected or confirmed COVID-19. Twenty-eight patients were pregnant/postpartum and 28 were non-pregnant. Demographic data, laboratory parameters, radiological findings, and intensive care support therapies were retrospectively obtained from hospital electronic medical records and patient files.
Results: Respiratory distress was the most common presenting symptom (62.5%). Lymphocyte count was significantly higher (p=0.011), whereas hemoglobin levels were significantly lower (p=0.044) in pregnant/postpartum patients compared with non-pregnant patients. D-dimer levels were also significantly elevated in the pregnant/postpartum group (p=0.034). No statistically significant differences were observed between groups regarding invasive mechanical ventilation, high-flow nasal oxygen requirement, non-invasive mechanical ventilation requirement, vasopressor requirement, continuous renal replacement therapy requirement, extracorporeal membrane oxygenation (ECMO) requirement, mortality, bacterial infection, or length of ICU stay (all p>0.05). Although not reaching statistical significance, mortality and ECMO requirement were numerically higher in pregnant/postpartum patients. Most patients did not receive anti-cytokine therapy (78.5%), and Anakinra was the most commonly administered agent (12.5%).
Conclusion: Pregnant/postpartum women with suspected or confirmed COVID-19 demonstrated significant differences in lymphocyte count, hemoglobin, and D-dimer levels compared with non-pregnant women of reproductive age. Although intensive care outcomes were generally comparable between groups, mortality and ECMO requirement were numerically higher in pregnant/postpartum patients. These findings may indicate a tendency toward greater clinical severity in pregnant/postpartum patients during severe respiratory infections.
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