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GEÇİRİLMİŞ COVİD-19 ENFEKSİYONUN İLK TRİMESTER GEBELİK KAYIPLARI ÜZERİNE ETKİSİ

Year 2022, Volume: 19 Issue: 2, 1314 - 1319, 01.07.2022
https://doi.org/10.38136/jgon.1116546

Abstract

Amaç: Bu çalışmanın amacı, gebe kalmadan önceki 1 yıllık süreç içerisinde geçirilmiş Covid-19 enfeksiyonunun erken gebelik kayıpları üzerine etkisinin araştırılmasıdır.
Gereç-Yöntem: Çalışma prospektif tanımlayıcı bir çalışma olup, 01.03.2021-01.09.2021 tarihleri arasında Ankara Dr Sami Ulus Kadın Doğum, Çocuk Sağlığı ve Hastalıkları E.A.H. Kadın Hastalıkları ve Doğum Bölümü Obstetrik Polikliniği’nde yürütülmüştür. Gebelik takibi nedeniyle ilk kontrolüne gelen 18-35 yaş arasındaki ilk trimesterdeki gebelerden gebe kalmadan önceki 1 yıl içerisinde Covid-19 enfeksiyonu geçirdiğini ifade eden gebeler çalışma grubuna (n=150), çalışma grubuna alınan gebeden sonra ilk trimesterinde başvuran, 18-35 yaş arasında olup gebelik öncesi Covid-19 enfeksiyonu geçirme öyküsü olmayan ilk gebe de kontrol grubuna dahil edilmiştir (n=150). Gebeler 20. gebelik haftasına kadar takip edilmiş ve iki grubun erken gebelik kaybı oranları (<20 hafta herhangi bir müdahale olmaksızın spontan abort yapma ya da intrauterin GS olmasına rağmen fetal kalp atımlarının yokluğu) karşılaştırılmıştır.
Bulgular: Covid-19 enfeksiyonu geçiren gebelerden 8”i (%5,3), geçirmeyen gebelerden 9’u (%6,0) erken gebelik kaybı yaşamış olup, iki grup arasında erken gebelik kayıp oranları açısından istatistiksel olarak anlamlı bir fark saptanmamıştır (p>0.05). Çalışma grubunda gebelik kaybı yaşamayan gebelerin gebelikten ortalama 6,04±2,94 ay, gebelik kaybı yaşayan gebelerin ise ortalama 6,75±3,15 ay önce Covid-19 enfeksiyonu geçirdiği saptanmış olup istatistiksel açıdan anlamlı bir fark izlenmemiştir (p>0,05).
Sonuç: Çalışmada gebelik öncesi geçirilen Covid-19 enfeksiyonu ile erken gebelik kaybı arasında bir ilişki saptanmamış olmasına rağmen, Covid-19 enfeksiyonunun, plasental vaskülopati üzerindeki etkisi göz önünde bulundurulduğunda erken gebelik kaybı ile ilişkisi larger prospektif çalışmalarla netleştirilmeli ve en azından gebelik öncesi dönemde anne adayları bu konuda doğru yönlendirilerek anksiyete yaşamaları engellenmelidir.

References

  • 1. Chinn J, Sedighim S, Kirby KA, et al. Characteristics and Outcomes of Women With COVID-19 Giving Birth at US Academic Centers During the COVID-19 Pandemic. JAMA Netw Open 2021; 4:e2120456.
  • 2. Elshafeey F, Magdi R, Hindi N, et al. Hamilelik ve doğum sırasında COVID-19'un sistematik bir kapsam incelemesi. Int J Gynaecol Obstet 2020; 150:47.
  • 3. Hikmet F, Méar L, Edvinsson Åsa, et al. . The protein expression profile of ACE2 in human tissues. Mol Syst Biol 2020;16:e9610.
  • 4. Jing Y, Run-Qian L, Hao-Ran W, et al. . Potential influence of COVID-19/ACE2 on the female reproductive system. Mol Hum Reprod 2020;26:367–73.
  • 5. Hoffmann M, Kleine-Weber H, Schroeder S, et al. . SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell 2020;181:271–80.
  • 6. Qin Wei S, Bilodeau-Bertrand M, Liu S, Auger N. The impact of COVID-19 on pregnancy outcomes: a systematic review and meta-analysis. CMAJ 2021;193(16):E540-E548.
  • 7. Martinez-Perez O, Rodriguez PP, Hernandez MM, Pardilla MBE, Perez N, Hernanzed MRV et. al. The association between SARS-CoV-2 infection and preterm delivery: a prospective study with a multivariable analysis. BMC Pregnancy Childbirth. 2021; 21(1):273.
  • 8. Ahlberg M, Neovius M, Saltvedt S, Söderling J, Petterson K, Brandkvist C, Stephansson O. Association of SARS-CoV-2 Test Status and Pregnancy Outcomes. JAMA. 2020;324(17):1782-1785.
  • 9. Freiesleben NC, Egerup P, Hviid KVR, Severinsen ER, Kolte AM, Westergard D, Olsen LF et al. SARS-CoV-2 in first trimester pregnancy: a cohort study. Hum Reprod. 2021;36(1):40-47.
  • 10. Kazemi SN, Hajikhani B, Didar H, Hosseini SS, Haddadi S, Khalili F, Mirsaeidi M, Nasiri MJ. COVID-19 and cause of pregnancy loss during the pandemic: A systematic review. PloS One. 2021;16(8):e0255994.
  • 11. Allotey J, Stallings E, Bonet M, Yap M, Chatterjee S, 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.
  • 12. Lokken EM, Taylor GG, Huebner EM, et al. Higher severe acute respiratory syndrome coronavirus 2 infection rate in pregnant patients. Am J Obstet Gynecol 2021; 225:75.e1.-75.e16.
  • 13. Kasehagen L, Byers P, Taylor K, Kittle T, Reborts C, Collier BR, Ricaldi JN, Green J, Zapat LB, Beauregard J, Dobbs T. COVID-19-Associated Deaths After SARS-CoV-2 Infection During Pregnancy - Mississippi, March 1, 2020-October 6, 2021. MMWR Morb Mortal Wikly Rep. 2021;70(47):1646-1648.
  • 14. Metz TD, Clifton RG, Hughes BL, Sandoval G, Saade GR, Grobman WA, et al. National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network Disease Severity and Perinatal Outcomes of Pregnant Patients With Coronavirus Disease 2019 (COVID-19). Obstet Gynecol. 2021;137(4):571.
  • 15. Chinn J, Sedighim S, Kirby KA, Hohmann S, Hameed AB, Jolley J, Nguyen NT (2021) Characteristics and outcomes of women with COVID-19 giving birth at US academic centers during the COVID-19 pandemic. JAMA Netw Open 4(8):e2120456.
  • 16. Ko JY, DeSisto CL, Simeone RM, Ellington S, Galang RR, Titilope O et al. Adverse Pregnancy Outcomes, Maternal Complications, and Severe Illness Among US Delivery Hospitalizations With and Without a Coronavirus Disease 2019 (COVID-19) Diagnosis. Clin Infect Dis. 2021 Jul 15;73(Suppl 1):S24-S31. doi: 10.1093/cid/ciab344.
  • 17. Hcini N, Maamri F, Picone O, Carod JF, Lambert V, Mathieu M, Carles G, Pomar L. Maternal, fetal and neonatal outcomes of large series of SARS-CoV-2 positive pregnancies in peripartum period: A single-center prospective comparative study. Eur J Obstet Gynecol Reprod Biol. 2021;257:11-18.
  • 18. Conde-Agudelo A, Romero R . SARS-CoV-2 infection during pregnancy and risk of preeclampsia: a systematic review and meta-analysis. Am J Obstet Gynecol. 2022;226(1):68. Epub 2021 Jul 21.
  • 19. Cavalcante MB, Bezerra Cavalcante CT, Melo Cavalcante AN, Sarno M, Barini R, Kwak-Kim J. COVID-19 and miscarriage: From immunopathological mechanisms to actual clinical evidence. J Reprod Immuno. 2021;148:103382.
  • 20. Gonzalez Rodriguez L, Oreja Cuesta AB, Pardo Pumar MI, Ferriols-Perez E, Pedro Carulla R, Bernardo Vega R, Vaquerizo Ruiz O et al. SARS-CoV-2 infection in early first-trimester miscarriages: a prospective observational study. Reprod Biomed Online. 2022;44(1):127-130.
  • 21. Rotshenker-Olshinka K, Volodarsky-Perel A, Steiner N, Rubenfeld E, Dahan MH. COVID-19 pandemic effect on early pregnancy: are miscarriage rates altered in asymptomatic women? Arch Gynecol Obstet. 2021; 303(3): 839–845.
  • 22. Saçıntı KG, Kalafat E, Şükür YE, Koç A. Increased incidence of first-trimester miscarriage during the COVID-19 pandemic. Ultrasound Obstet Gynecol 2021;57(6):1013-1014.
  • 23. Baud D, Greub G, Favre G, Gengler C, Jaton K, Dubruc E, Pomar L. Second-Trimester Miscarriage in a Pregnant Woman With SARS-CoV-2 Infection. JAMA. 2020;323(21):2198-2200.
  • 24. Hsu AL, Guan M, Johannesen E, Stephens AJ, Khaleel N, Kagan N, Tuhlei BC, Wan XF. Placental SARS-CoV-2 in a pregnant woman with mild COVID-19 disease. J Med Virol. 2021;93(2):1038-1044.

THE EFFECT OF PAST COVID-19 INFECTION ON EARLY PREGNANCY LOSSES

Year 2022, Volume: 19 Issue: 2, 1314 - 1319, 01.07.2022
https://doi.org/10.38136/jgon.1116546

Abstract

Aim: The aim of this study was to investigate the effect of Covid-19 infection on early pregnancy losses within one year before pregnancy.
Material-Method: The study is a prospective descriptive study that was carried out between 01.03.2021 and 01.09.2021, in the Obstetrics Outpatient clinic of the Obstetrics and Gynecology Department of Ankara Dr. Sami Ulus Gynecology, Child Health, and Diseases Training and Research Hospital. Among the pregnant women between the ages of 18-35 who came for their first control due to obstetric follow-up, the pregnant women in the first trimester who stated that they had Covid-19 infection within one year before pregnancy, were in the study group (n=150), and the pregnant women in the first trimester who did not have a history of Covid-19 infection before pregnancy was also included in the control group (n=150). The pregnant women were followed up to the 20th gestational week and the early pregnancy loss rates of the two groups (spontaneous abortion at <20 weeks without any intervention or the absence of fetal heartbeats despite intrauterine GS) were compared. Results: Eight (5.3%) pregnant women who had Covid-19 infection and 9 (6.0%) women who did not have Covid-19 infection experienced early pregnancy loss, and no statistically significant difference was found between the two groups in terms of early pregnancy loss rates (p> 0.05). In the study group, it was determined that the pregnant women who did not experience a pregnancy loss had an average of 6.04±2.94 months before pregnancy, and the pregnant women who had a pregnancy loss had an average of 6.75±3.15 months before the Covid-19 infection, and no statistically significant difference was observed (p>0, 05).
Conclusion: Although there was no relationship between pre-conceptional Covid-19 infection and early pregnancy loss in the study, considering the effect of Covid-19 infection on placental vasculopathy, its relationship with early pregnancy loss should be clarified with larger prospective studies. In this regard,expectant mothers should be guided and their anxiety should be ameliorated at least in the pre-pregnancy period.

References

  • 1. Chinn J, Sedighim S, Kirby KA, et al. Characteristics and Outcomes of Women With COVID-19 Giving Birth at US Academic Centers During the COVID-19 Pandemic. JAMA Netw Open 2021; 4:e2120456.
  • 2. Elshafeey F, Magdi R, Hindi N, et al. Hamilelik ve doğum sırasında COVID-19'un sistematik bir kapsam incelemesi. Int J Gynaecol Obstet 2020; 150:47.
  • 3. Hikmet F, Méar L, Edvinsson Åsa, et al. . The protein expression profile of ACE2 in human tissues. Mol Syst Biol 2020;16:e9610.
  • 4. Jing Y, Run-Qian L, Hao-Ran W, et al. . Potential influence of COVID-19/ACE2 on the female reproductive system. Mol Hum Reprod 2020;26:367–73.
  • 5. Hoffmann M, Kleine-Weber H, Schroeder S, et al. . SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell 2020;181:271–80.
  • 6. Qin Wei S, Bilodeau-Bertrand M, Liu S, Auger N. The impact of COVID-19 on pregnancy outcomes: a systematic review and meta-analysis. CMAJ 2021;193(16):E540-E548.
  • 7. Martinez-Perez O, Rodriguez PP, Hernandez MM, Pardilla MBE, Perez N, Hernanzed MRV et. al. The association between SARS-CoV-2 infection and preterm delivery: a prospective study with a multivariable analysis. BMC Pregnancy Childbirth. 2021; 21(1):273.
  • 8. Ahlberg M, Neovius M, Saltvedt S, Söderling J, Petterson K, Brandkvist C, Stephansson O. Association of SARS-CoV-2 Test Status and Pregnancy Outcomes. JAMA. 2020;324(17):1782-1785.
  • 9. Freiesleben NC, Egerup P, Hviid KVR, Severinsen ER, Kolte AM, Westergard D, Olsen LF et al. SARS-CoV-2 in first trimester pregnancy: a cohort study. Hum Reprod. 2021;36(1):40-47.
  • 10. Kazemi SN, Hajikhani B, Didar H, Hosseini SS, Haddadi S, Khalili F, Mirsaeidi M, Nasiri MJ. COVID-19 and cause of pregnancy loss during the pandemic: A systematic review. PloS One. 2021;16(8):e0255994.
  • 11. Allotey J, Stallings E, Bonet M, Yap M, Chatterjee S, 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.
  • 12. Lokken EM, Taylor GG, Huebner EM, et al. Higher severe acute respiratory syndrome coronavirus 2 infection rate in pregnant patients. Am J Obstet Gynecol 2021; 225:75.e1.-75.e16.
  • 13. Kasehagen L, Byers P, Taylor K, Kittle T, Reborts C, Collier BR, Ricaldi JN, Green J, Zapat LB, Beauregard J, Dobbs T. COVID-19-Associated Deaths After SARS-CoV-2 Infection During Pregnancy - Mississippi, March 1, 2020-October 6, 2021. MMWR Morb Mortal Wikly Rep. 2021;70(47):1646-1648.
  • 14. Metz TD, Clifton RG, Hughes BL, Sandoval G, Saade GR, Grobman WA, et al. National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network Disease Severity and Perinatal Outcomes of Pregnant Patients With Coronavirus Disease 2019 (COVID-19). Obstet Gynecol. 2021;137(4):571.
  • 15. Chinn J, Sedighim S, Kirby KA, Hohmann S, Hameed AB, Jolley J, Nguyen NT (2021) Characteristics and outcomes of women with COVID-19 giving birth at US academic centers during the COVID-19 pandemic. JAMA Netw Open 4(8):e2120456.
  • 16. Ko JY, DeSisto CL, Simeone RM, Ellington S, Galang RR, Titilope O et al. Adverse Pregnancy Outcomes, Maternal Complications, and Severe Illness Among US Delivery Hospitalizations With and Without a Coronavirus Disease 2019 (COVID-19) Diagnosis. Clin Infect Dis. 2021 Jul 15;73(Suppl 1):S24-S31. doi: 10.1093/cid/ciab344.
  • 17. Hcini N, Maamri F, Picone O, Carod JF, Lambert V, Mathieu M, Carles G, Pomar L. Maternal, fetal and neonatal outcomes of large series of SARS-CoV-2 positive pregnancies in peripartum period: A single-center prospective comparative study. Eur J Obstet Gynecol Reprod Biol. 2021;257:11-18.
  • 18. Conde-Agudelo A, Romero R . SARS-CoV-2 infection during pregnancy and risk of preeclampsia: a systematic review and meta-analysis. Am J Obstet Gynecol. 2022;226(1):68. Epub 2021 Jul 21.
  • 19. Cavalcante MB, Bezerra Cavalcante CT, Melo Cavalcante AN, Sarno M, Barini R, Kwak-Kim J. COVID-19 and miscarriage: From immunopathological mechanisms to actual clinical evidence. J Reprod Immuno. 2021;148:103382.
  • 20. Gonzalez Rodriguez L, Oreja Cuesta AB, Pardo Pumar MI, Ferriols-Perez E, Pedro Carulla R, Bernardo Vega R, Vaquerizo Ruiz O et al. SARS-CoV-2 infection in early first-trimester miscarriages: a prospective observational study. Reprod Biomed Online. 2022;44(1):127-130.
  • 21. Rotshenker-Olshinka K, Volodarsky-Perel A, Steiner N, Rubenfeld E, Dahan MH. COVID-19 pandemic effect on early pregnancy: are miscarriage rates altered in asymptomatic women? Arch Gynecol Obstet. 2021; 303(3): 839–845.
  • 22. Saçıntı KG, Kalafat E, Şükür YE, Koç A. Increased incidence of first-trimester miscarriage during the COVID-19 pandemic. Ultrasound Obstet Gynecol 2021;57(6):1013-1014.
  • 23. Baud D, Greub G, Favre G, Gengler C, Jaton K, Dubruc E, Pomar L. Second-Trimester Miscarriage in a Pregnant Woman With SARS-CoV-2 Infection. JAMA. 2020;323(21):2198-2200.
  • 24. Hsu AL, Guan M, Johannesen E, Stephens AJ, Khaleel N, Kagan N, Tuhlei BC, Wan XF. Placental SARS-CoV-2 in a pregnant woman with mild COVID-19 disease. J Med Virol. 2021;93(2):1038-1044.
There are 24 citations in total.

Details

Primary Language English
Subjects Obstetrics and Gynaecology
Journal Section Research Articles
Authors

Çağanay Soysal 0000-0002-4381-6099

Elif Yilmaz 0000-0001-5107-6492

Publication Date July 1, 2022
Submission Date May 16, 2022
Acceptance Date June 12, 2022
Published in Issue Year 2022 Volume: 19 Issue: 2

Cite

Vancouver Soysal Ç, Yilmaz E. THE EFFECT OF PAST COVID-19 INFECTION ON EARLY PREGNANCY LOSSES. JGON. 2022;19(2):1314-9.