A study of the socio demographic and obstetric factors in pregnant women with COVID-19 infection at a tertiary care hospital, Kollam, Kerala, India

Background: The first wave of the COVID-19 pandemic took the world to task. Pregnant women needed care without actually knowing if the treatment schedules outside of pregnancy could be extrapolated to the pregnant state. Obstetric protocols were adhered to as far as was feasible, yet world over there was an increase in cesarean section rates. The so-called alpha variant that we saw at the time appeared to infect pregnant women too with equal frequency but they fared well. The issues regarding infectivity and the use of personal protective equipment (PPE) assumed mammoth dimensions. The objectives of this paper were to explore the demographic data and the epidemiological risk factors and study the symptomatology, severity and course of COVID-19 in pregnancy.Methods: This was an observational study conducted on all the COVID-19 positive pregnant women admitted to the department of obstetrics and gynecology at the designated COVID hospital for the district - Government Medical College Kollam - for a period of 6 months from October 2020 to March 2021. These women were studied with respect to their socio demographic details and their Obstetric risk factors and performance. Data was collected and analyzed using statistical package for the social sciences (SPSS) software.Results: 377 antenatal COVID-19 positive women were admitted and analyzed during the study period. Nulliparous women (48.5%%) in the age group 20 to 30 years (74.28%) formed the major group. Third trimester and near date admissions were the majority (48.80%). Most women (79.31%) were asymptomatic. Most common symptoms were fever in 35% and flu like upper respiratory symptoms (20%). Breathlessness and lung involvement was seen in 2.91%. Contact tracing revealed a travel history or contact with infected persons at 15.64%. However, 84.8% had no contact history. All antenatal women were tested at admission and reverse transcriptase-polymerase chain reaction (RTPCR) was done in 73.21%. Rapid antigen and nucleic acid amplification test (NAAT) detected the rest. 46% had some co morbidity gestational diabetes mellitus (GDM), gestational hypertension, thyroid disease and anemia were the common co morbidities detected. The presence of GDM in 24.14% of the study population is noteworthy.Conclusions: Pregnancy being an immune compromised state, unpredictable outcomes are possible with COVID-19 infection. Asymptomatic patients too can experience complications. Frequent hospital and lab visits could be a source of infection. The growing incidence of GDM in the midst of the COVID-19 pandemic is a point for concern.