The Association Between COVID-19 Infection and Preterm Complications in Salah Al-Din General Hospital

ABSTRACT

Background: The release of inflammatory cytokines is considered to have a role in COVID-19's pathogenesis. However, irregularities in the formation of blood clots may have also had a role in the fatal outcome Aim: To determine if COVID-19 infection is linked to preterm birth, premature membrane rupture, admission to the neonatal intensive care unit, stillbirth, placental abruption, or maternal mortality. Patients and methods: In the months between October 2021 and March 2022, researchers in the Department of Gynecology and Obstetrics at the Salah Al-din Teaching Hospital in the Iraqi province of Salah Al-din conducted a cross-sectional study. Women who presented to the Gynecology and Obstetrics Department with symptoms suggesting a COVID 19 infection and premature birth difficulties made for a convenient sample. Fifty females participated in the research. Characteristics of the participants were reported as both raw numbers and percentages. The Chi-square test and Fisher's exact test were used to evaluate the differences in clinical features and complications between the infected and healthy pregnant women groups. For statistical significance, a p value of less than 0.05 was used. Results: Fifty pregnant patients were evaluated during the study. There were 17 (34.6%) confirmed cases of COVID-19 infection and 33 (66.6%) cases where the RT-PCR result was negative. Statistically, both IgG and IgM were significant (p 0.05). Participants averaged 33.06 years old (7.43). Significant statistical correlation between older age group and exposure to the virus, with the majority of cases occurring in the age range (35-49 years). There is no clear correlation between the mother's health and COVID-19 infection. Fatigue (90%), dyspnea (80%), cough (70%), headache (64%), sore throat (40%) and a loss of taste and smell (26%), were the next most prevalent symptoms after fever. Fever, dyspnea, and a loss of taste and smell were significantly correlated with the group that was exposed to the disease. C-reactive protein, E-selectin, and S. ferritin are all significantly correlated with COVID-19 infection exposure (p values 0.05). Most of the pregnant women in the study had normal levels of both platelets and white blood cells, with 90% and 60%, respectively, having normal Pit and WBC. Approximately 52% of the pregnant women in the study gave birth to premature babies, with a mean gestational age (GA) of 31 weeks + 2 days. A strong correlation between a maternal history of GDM and increased S. Ferritin and premature births exposed to COVID-19 was discovered. Significant correlation was established between premature vaginal delivery and exposure to COVID-19, with 16 instances (32% of total) compared to 10 cases (20% of total). Statistics also show that there was a considerable increase in the rate of preterm prolabor membrane rupture (PPROM) from the previous term, with 19 instances (38%). Occurrences of obstetric problems such as antepartum haemorrhage (APH) and severe postpartum haemorrhage (PPH) were documented, although there was no statistically significant link between them (p value > 0.05). However, the incidence of these side effects is greater in COVID-19 patients than in those who were not exposed to the virus. There were no maternal deaths observed, however the rate of stillbirths was significantly greater among individuals with COVID-19 compared to those who had not been exposed during pregnancy. Babies of mothers infected with COVID-19 are more likely to be admitted to the Neonatal Intensive Care Unit (NICLJ) for care than those of moms without the virus. Pregnant women with COVID-19 are at increased risk for premature delivery and preterm prelabor rupture of membranes, and the condition also affects NICU admissions. The aim of our study was to determine if COVID-19 infection is linked to preterm birth, premature membrane rupture, admission to the neonatal intensive care unit, stillbirth, placental abruption, or maternal mortality.