Covid-19 em parturiente e seus neonatos: estudo de caso controle em uma maternidade de referência na Amazônia brasileira

Abstract

The Covid­-19 pandemic and its rapid global spread had major health repercussions due to its high potential for transmissibility. Pregnant women at any gestational age and women in the puerperal period belong to the risk group. Objective: To know the clinical evolution of Covid­-19 in the parturient and her neonates. Methodology: An observational, retrospective, case­-control epidemiological study was carried out, comparing 48 parturients with Covid-­19 and their respective neonates (case group) and 98 healthy parturients and their respective neonates (control), hospitalized at Santa Casa de Misericórdia do For. The medical records of parturients diagnosed with Covid­-19, during the study period, and parturients without Covid­-19, both of any age, of all types of delivery, with or without alterations to the physical examination, admitted to the hospital in April were included. from 2020 to June 2021, in a total of 292 participants (parturients and neonates). Data were collected from medical records, from August 2021 to May 2022, and analyzed using the Bioestat 5.3 program. P<0.05 was considered statistically significant. Results: the mean age among parturients in the case group (n=48) and in the control group (n=98) was 27.7 and 28.5 years, respectively. Analytical statistics and Odds Ration (OR) calculations were statistically significant and higher in pregnant women with Covid-­19 for the following variables, respectively: cesarean delivery (p < 0.0001/OR= 6.1), preterm labor (p < 0.0001/ OR=20.2), length of stay longer than 48 hours (p<0.0001/OR=3.6), altered body temperature (p=0.0038/OR=7.5) and altered respiratory rate (p<0.0001/OR=9.6) were statistically significant and greater parturients with Covid­19 compared to parturients in the control group. The statistically significant repercussions on newborns of mothers with Covid­-19 were: lower percentage of breastfeeding (p < 0.0001/OR= 33.7), length of stay longer than 48 hours (p < 0.0015/ OR= 3.9) and referral the neonatal unit (p < 0.0015/OR= 24.3). The death outcome (fetal+neonatal) had 5 (10.4%) occurrences in the case group. Conclusion: the clinical evolution and outcomes are different between parturients positive for Covid­-19 and healthy parturients, with important repercussions on newborns.