Medical and Social Risk Factors of Perinatal Disorders in Women with COVID-19

The exact mechanisms and possibility of perinatal disorders in women after COVID-19 have not been definitively determined. In particular, the connection of such disorders with medical and social status is not known. The objective: to determine the medical and social risk factors for perinatal disorders in women who had COVID-19 during pregnancy. Materials and methods. The participants of the study were divided into two groups: the main group (MG) consisted of 200 women who were hospitalized with COVID-19 during pregnancy, the control group – 50 patients who did not have COVID-19 or other acute respiratory viral infections during pregnancy. The main group is divided into 2 subgroups: MG-1 – 50 women with adverse perinatal outcomes (perinatal mortality, fetal distress and/or fetal growth retardation, premature birth, fetal severe birth asphyxia), subgroup MG-2 – 150 patients with a physiological course of pregnancy. Indicators of social and economic status, harmful habits, lifestyle parameters, and stress were analyzed. The presence and level of anxiety and depression were determined using the Hospital Anxiety and Depression Scale (HADS). Results. Among the indicators of social and economic status with a negative impact on pregnancy outcomes were: living in the cities (44.0% in subgroup MG-1 vs 30.7% in subgroup MG-2, p < 0.05), higher education (44.0% vs 30.7%, p < 0.05), unregistered marriage (30.0% vs 16.7%, p < 0.05), income per family member less than 5,000 UAH/month (46.0% vs 22.7%, p < 0.05). When analyzing social and domestic characteristics, attention is drawn to the high frequency of alcohol consumption (10.0% vs 3.3%, p < 0.05), sedentary lifestyle (44.0% vs 26.0%, p < 0.05) and an increased stress level (70.0% vs 43.3%, p < 0.05), in particular at work (22.0% vs 11.3%, p < 0.05) and the combination of stress at home and at work (16.0% vs 7.3%, p < 0.05). The patients were characterized by the extremely high level of anxiety (90.0% vs 74.3%, p < 0.05), with a third of patients were diagnosed with clinically significant anxiety (30.0% vs 11.3%, p < 0.05), and higher depression level (28.0% vs 7.3%, p < 0.05). Conclusions. Perinatal disorders in patients who have had COVID-19 during pregnancy are associated with certain changes in medical and social status. Pregnancy management in these women requires analysis of medical and social factors, psychological assessment, timely application of psycho-emotional correction techniques to prevent negative perinatal consequences.