Publication:

Study of maternal and foetal outcome in COVID-19 anaemic patients during COVID pandemic in a tertiary centre

Background The haemoglobin concentration is one of the most critical indicators of the blood's oxygen-carrying ability. Due to the hypermetabolic condition produced by infection, anaemia in COVID-19 positive pregnant women might result in tissue hypoxia due to increased peripheral tissue oxygen demands. Complications such as multi-organ failure and acute respiratory distress syndrome can worsen the prognosis. Since hemoglobin is necessary for tissue oxygenation, anaemia may have a substantial impact on the prognosis of COVID-19 pneumonia, where tissue hypoxia develops as a result of disease pathogenesis. Aim of the current study was to study the effect of COVID-19 on pregnant women with anaemia in pregnancy, including symptoms and foetomaternal outcome in patients admitted to a tertiary care facility.

Methods Observational study done on pregnant females in labour and post-delivery patients who were diagnosed with COVID-19 infection using the SARS COV-2 nasopharyngeal reverse transcriptase polymerase chain reaction (RT-PCR) from 1st April 2020 to 30th June 2021. The required demographic, clinical details and haemoglobin levels were obtained, and selected participants were followed up until they were discharged.

Results In our study, out of 58 women, who had anaemia in pregnancy with COVID-19 infection delivering 59 neonates (1set of twins), 55.5% were in the age group of 25-35 years, 77% reached full term pregnancy and 67% were multigravida. 51.7 % patients were transferred from periphery hospitals. Delivery was by caesarean section in 61% and 39% delivered vaginally. 38.8% neonates delivered had birthweight of <2.5 kg out of which 20% had intrauterine growth restriction and 22.4 % were preterm. 3.4% stillbirth were reported. No maternal deaths were reported.

Conclusions From our study, maternal and neonatal outcome were unaffected by anaemia in COVID-19 pregnant women. Severely anaemic patients with comorbidities should be transferred to centres with appropriate neonatal intensive care facilities for delivery.