Somatic Risk Factors for the Development of Preeclampsia in Pregnant Women with Previous COVID-19

Aim. To assess the contribution of somatic factors to the development of preeclampsia in pregnant women with previous coronavirus infection. Design. Retrospective cohort study. Materials and methods. The main group included 48 patients who gave birth at the Almazov National Medical Research Centre in 2022, with confirmed coronavirus infection during pregnancy at any gestational age, and with a subsequently established diagnosis of preeclampsia. Comparison Group No. 1 is a simple random sample of 70 patients who gave birth at the Almazov National Medical Research Centre in the same period, with a history of coronavirus infection without preeclampsia. Comparison Group No. 2 included 70 patients with preeclampsia who gave birth in 2019 (before the pandemic). A retrospective analysis of the pregnancy course and outcomes, anamnestic, laboratory and instrumental data was carried out. Results. Significant somatic risk factors for the development of preeclampsia after coronavirus infection include obesity, the frequency of which among patients in the main group was 47.9% (23/48) versus 20% (14/70) in comparison group No. 1 and 27.1% (19/70) in comparison group No. 2 (p = 0.005), as well as diabetes mellitus (10.4% (5/48) in the main group, 4.3% (3/70) in comparison group No. 2; there were no patients with diabetes mellitus in comparison group No. 1; p = 0.019). In addition, the somatic history of patients with preeclampsia and COVID-19 was characterized by a higher frequency of respiratory diseases comparing with other groups: 7 (14.6%) out of 48 patients in the main group, 2 (2.9%) women each in comparison groups No. 1 and No. 2 (p = 0.02). In the structure of somatic pathology in patients from the groups with preeclampsia (main group and comparison group No. 2), chronic arterial hypertension was also a significant risk factor, regardless of the fact of previous coronavirus infection. With regard to other pathologies of the cardiovascular system, rheumatic and gastrointestinal diseases, pathology of nervous and urinary systems, infectious and inflammatory diseases of non-coronavirus etiology, venous thromboembolic complications and blood diseases, significant differences between the groups were not established (p > 0.05). Conclusion. In patients with previous coronavirus infection, the most significant risk factors for preeclampsia were obesity, diabetes mellitus, and respiratory diseases. Large population studies are needed to develop the correct tactics for managing such patients from the high-risk group for gestational complications. Keywords: preeclampsia, COVID-19, coronavirus infection, arterial hypertension, obesity, diabetes mellitus, respiratory diseases.