THE LIKELIHOOD OF EXPERIENCING COMPLICATIONS DURING PREGNANCY AND THE EARLY NEONATAL PERIOD ASSOCIATED WITH CORONAVIRUS INFECTION, CONTRACTED AT VARIOUS GESTATIONAL STAGES AND MANAGED AT THE TIME OF DELIVERY

Objective. Evaluation of the probability of complications of pregnancy and early neonatal period in the event of coronavirus infection carried out in different gestational periods and cured at the time of delivery. Data sources. Medline and Pubmed databases. Full-text articles only. Results of our own research. Materials and Methods. The first phase of the study included 165 pregnant women who had a new coronavirus infection during pregnancy, admitted to an obstetric hospital between October 2021 and January 2023 for delivery. Based on inclusion and exclusion criteria, 113 women were selected to constitute the study sample, which was divided into 1, 2 and 3 study groups based on cluster analysis, which was conducted preliminarily on a small sample of 39 and later included in the total sample. Group 1 of the study included 25 women who became ill with COVID-19 at gestational age up to 16 weeks; Group 2 included 61 women who became ill with COVID-19 at gestational age from 17 to 34 weeks; and Group 3 included 27 women who became ill with COVID-19 after 34 weeks of gestation. The comparison group consisted of 65 pregnant women who did not suffer from diseases caused by the SARS-CoV-2 virus during pregnancy. Statistical analysis was performed using the IBM SPSS Statistics Version 25.0 software package (IBM Corporation, USA), taking into account the recommendations of the Statistical Analysis and Methods in the Published Literature (SAMPL) [25]. Results. In 1 screening examination, all pregnant women studied, including the comparison group, had a low risk of developing preeclampsia and retardation of fetal growth. Patients who had a new coronavirus infection before 34 weeks of gestation had an increased probability of developing preeclampsia (OR=5.71 [95% CI 2.04-15.95], p<0.001), low birth weight (OR=25.81 [95% CI 3.37-197.58], p<0.001), fetal growth retardation (OR=8.01 [95% CI 1.75-36, 65], p=0.005), preterm labor (OR=5.77 [95% CI 1.6-20.85], p=0.007), and emergency delivery (OR=6.35 [95% CI 2.29-17.62], p<0.001) compared to patients who did not become ill or had a new coronavirus infection at a later date. Newborns whose mothers had a new coronavirus infection before 34 weeks of gestation had a statistically significant increase in the probability of meconial aspiration (OR=6.9 [95% CI 1.01-58.54], p=0.03), pneumonia (OR=14.76 [95% CI 1.88-116.13], p<0.001), and the need for treatment in the neonatal intensive care unit (OR=29.4 [95% CI 3.86-224.13], p<0.001). Conclusions. Patients with a new coronavirus infection before 34 weeks of gestation are at highest risk of preeclampsia and placental insufficiency (fetal growth retardation and low birth weight), as well as emergency operative delivery (both cesarean section and vacuum extraction). Patients with mild or asymptomatic course also have a higher risk of these complications compared to pregnant women who have not had COVID-19. Newborns whose mothers had a new coronavirus infection before 16 weeks of gestation have a statistically significant increase in the risk of meconium aspiration, and before 34 weeks of non-coronavirus pneumonia, as well as the need for treatment in the neonatal intensive care unit.