COVID-19 and first trimester spontaneous abortion: a case-co
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The disease caused by the “severe acute respiratory syndrome coronavirus 2” (SARS-CoV-2) was named Coronavirus Disease 19 (COVID-19) and classified as a global public health emergency. The evidence related to the impact of COVID-19 on pregnancy is limited to the second and the third trimester of pregnancy, while data on the first trimester are scant. Many viral infections can be harmful to the fetus during the first trimester of pregnancy, and whether SARS-CoV-2 is one of them is still unknown.

With this study, researchers evaluated SARS-CoV-2 infection as a risk factor for early pregnancy loss in the first trimester of pregnancy. Furthermore, the COVID-19 course in the first trimester was assessed. Between February 22 and May 21, 2020, researchers conducted a case-control study, among first-trimester pregnant women, paired for last menstruation. The cumulative incidence of COVID-19 was compared between women with spontaneous abortion (case group, n=100) and those with ongoing pregnancy (control group, n=125). Current or past infection was determined by detection of SARS-CoV-2 from nasopharingeal swab and SARS-CoV-2 IgG/IgM antibodies in the blood samples. Patient demographics, COVID-19-related symptoms, and the main risk factors for abortion were collected.

Twenty-three of the 225 women (23/225) tested positive for COVID-19 infection. There was no difference in the cumulative incidence of COVID-19 between the cases (11/100) and the controls (12/125). Logistic regression analysis confirmed that COVID-19 was not an independent predictor of early pregnancy loss. COVID-19 related symptoms in the first trimester were fever, anosmia, ageusia, cough, arthralgia, and diarrhea; no pneumonia or Hospital admission due to COVID-19-related symptoms were recorded. No difference in the incidence of symptoms was noted between the two groups.

SARS-CoV-2 infection during the first trimester of pregnancy does not appear to predispose to early pregnancy loss; its cumulative incidence did not differ between women with spontaneous abortion and women with ongoing pregnancy. COVID-19 appears to have a favorable maternal course at the beginning of pregnancy, consistent with what has been observed during the second and the third trimester.

Source:https://www.ajog.org/article/S0002-9378(20)31177-7/fulltext?rss=yes
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