Impacto da síndrome respiratória aguda grave nos desfechos de parto prematuro e baixo peso ao nascer em gestantes no Ceará, Brasil, durante a pandemia de COVID-19

Abstract

In late 2019, in Wuhan, China, a viral disease caused by SARS-CoV-2 spread worldwide, leading the World Health Organization to declare the COVID-19 pandemic. COVID-19 is characterized by clinical manifestations ranging from asymptomatic infections to severe respiratory conditions. Two other members of this genus have previously caused outbreaks of human disease: severe acute respiratory syndrome (SARS), caused by SARS-CoV, and Middle East respiratory syndrome (MERS), caused by MERS-CoV. Studies have shown that pregnancy is a risk factor for adverse obstetric and neonatal outcomes from many respiratory viral infections, underscoring the importance of analyzing the impact of COVID-19 on maternal and fetal outcomes. This study analyzed the impact of severe acute respiratory syndrome (SARS) and COVID-19 on pregnant women in the state of Ceará between 2020 and 2022. Using data from notifications to the SARS hospitalization surveillance system (SINAN Influenza) and the Live Birth Information System (SINASC), we described the clinical and epidemiological characteristics of COVID-19 cases in the general population and among pregnant women. The study compared clinical and epidemiological data on children born to pregnant women with and without a history of SARS and assessed the severity of COVID-19 in mothers based on symptoms and pre-existing morbidities. We analyzed the impact of detrimental maternal-fetal outcomes such as low birth weight (<2,500 grams) and preterm birth (<37 weeks). The results revealed 2,434 cases of SARS in pregnant women, representing 2% of total notifications during the study period. Among these pregnant women, 72 died, corresponding to a fatality rate of 3%. The incidence of COVID-19 in pregnant women followed the trend of the epidemic waves, with a peak in 2021. Children born to mothers with a history of SARS during the COVID-19 epidemic were twice as likely to be born with low birth weight (OR = 2.239; 95% CI = 1.683–2.977) or prematurely (OR = 2.438; 95% CI = 1.920–3.096) compared to those born to mothers without a history of SARS.