Clinical characteristics, outcomes, & mortality in pregnant women with COVID-19 in Maharashtra, India: Results from PregCovid registry

• Published in: Indian journal of medical research (New Delhi, India : 1994) India : 1994), 2021-05, Vol.153 (5), p.629-636
• Main Authors: Gajbhiye, Rahul, Mahajan, Niraj, Waghmare, Rakesh, Zala, Sarika, Chaaithanya, Itta, Kuppusamy, Periyasamy, Bhurke, Aishwarya, Pious, Merlin, Surve, Suchitra, Modi, Deepak, Mahale, Smita
• Format: Article
• Language: English
• Subjects: Care and treatment; Coronaviruses; COVID-19; Diagnosis; Epidemics; Female; Humans; India; India - epidemiology; Infant, Newborn; Maternal mortality; Original; Pandemics; Patient outcomes; Pregnancy; Pregnancy Complications, Infectious - epidemiology; Pregnancy Outcome - epidemiology; Pregnancy, Complications of; Pregnant Women; Registries; Risk factors; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Womens health
• ISSN: 0971-5916; 0975-9174
• DOI: 10.4103/ijmr.ijmr_1938_21

Background & objectives: The PregCovid registry was established to document the clinical presentations, pregnancy outcomes and mortality of pregnant and post-partum women with COVID-19. Methods: The PregCovid registry prospectively collects information in near-real time on pregnant and post-partum women with a laboratory-confirmed diagnosis of SARS-CoV-2 from 19 medical colleges across the State of Maharashtra, India. Data of 4203 pregnant women collected during the first wave of the COVID-19 pandemic (March 2020-January 2021) was analyzed. Results: There were 3213 live births, 77 miscarriages and 834 undelivered pregnancies. The proportion of pregnancy/foetal loss including stillbirths was six per cent. Five hundred and thirty-four women (13%) were symptomatic, of which 382 (72%) had mild, 112 (21%) had moderate, and 40 (7.5%) had severe disease. The most common complication was preterm delivery (528, 16.3%) and hypertensive disorders in pregnancy (328, 10.1%). A total of 158 (3.8%) pregnant and post-partum women required intensive care, of which 152 (96%) were due to COVID-19 related complications. The overall case fatality rate (CFR) in pregnant and post-partum women with COVID-19 was 0.8 per cent (34/4203). Higher CFR was observed in Pune (9/853, 1.1%), Marathwada (4/351, 1.1%) regions as compared to Vidarbha (9/1155, 0.8%), Mumbai Metropolitan (11/1684, 0.7%), and Khandesh (1/160, 0.6%) regions. Comorbidities of anaemia, tuberculosis and diabetes mellitus were associated with maternal deaths. Interpretation & conclusions: The study demonstrates the adverse outcomes including severe COVID-19 disease, pregnancy loss and maternal death in women with COVID-19 in Maharashtra, India.