Reproductive and neonatal outcomes in women with unicornuate uterus: a population-based study

Objective: To investigate reproductive and neonatal outcomes in women with unicornuate uterus. Study design: Data from the Health Care Cost and Utilization Project-Nationwide Inpatient Sample database were extracted from 2010 through 2014 to create a delivery cohort using ICD-9 codes. Code 752.33 was used to identify cases with unicornuate uterus and reproductive outcomes were compared to pregnancies without unicornuate uterus. A multivariate logistic regression model was used to adjust for statistically significant variables (P-value<0.05). Results: Among 3,850,226 deliveries during the study period, 802 women had unicornuate uterus. Patient with unicornuate uterus were more likely to be older (P<0.001), have thyroid disease (P<0.001), previous Caesarean section (P<0.001), and to have had in-vitro fertilization (IVF) (P<0.001). The risk of gestational diabetes, pregnancy induced hypertension, gestational hypertension and preeclampsia were significantly greater in the unicornuate uterus group relative to controls, after controlling for baseline risk factors; aOR 1.32 [95% CI 1.03–1.71], aOR 1.46 [95% CI 1.16–1.85], aOR 1.16 [95% CI 1.22-2.28] and aOR 1.70 [95% CI 1.24-2.32], respectively. Also, the rates of preterm delivery, preterm premature rupture of membranes and caesarean section were higher in the unicornuate uterus group compared to controls after controlling for confounding factors, aOR 3.83 (95% CI 3.19–4.6), aOR 5.11 (95% CI 3.73–7.14) and aOR 11.38 (95% CI 9.16–14.14) respectively. At birth, 11.1% and 2.6% of neonates were small for gestational age in the unicornuate uterus and the control groups, respectively, aOR 4.90, (95% CI 3.87-6.21). Conclusion: Women with unicornuate uterus are at higher risk for pregnancy complications, preterm delivery and having small for gestation age neonates. Women with known unicornuate uterus may benefit from increased surveillance to prevent and/or decrease maternal and neonate morbidity and mortality.

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Pregnancy, delivery and neonatal outcomes among women living with Down syndrome. A matched cohort study, taken from a population database.

10.22541/au.164164894.45518412/v1 ◽

2022 ◽

Author(s):

Abdullah Alnoman ◽

Ahmad Badeghiesh ◽

Haitham Baghlaf ◽

Magdalena Peeva ◽

MH Dahan

Keyword(s):

Down Syndrome ◽

Pregnant Women ◽

Health Care Cost ◽

Neonatal Outcomes ◽

Premature Delivery ◽

Control Group ◽

P Value ◽

Nationwide Inpatient Sample Database ◽

Increased Risk ◽

Adverse Neonatal Outcomes

Objectives: Women with Down syndrome (DS) suffer from several health issues, however, their fecundity is not affected. Despite that, there are no studies in the literature to address pregnancy, delivery, or neonatal outcomes among women with DS. Design: We conducted a retrospective study using the Health Care Cost and Utilization Project-Nationwide Inpatient Sample Database over 11 years from 2004 to 2014. Methods: A delivery cohort was created using ICD-9 codes. ICD-9 code 758.0 was used to extract the cases of maternal DS. Pregnant women with DS (study group) were matched based on age and health insurance type to women without DS (control) at a ratio of 1:4. A multivariant logistic regression model was used to adjust for statistically significant variables (P-value < 0.5). Results: There were a total of 9,096,788 deliveries during the study period. Of those, 185 pregnant women were found to have DS. The matched control group was 740. Maternal pregnancy risks mostly did not differ between those with and without DS including pregnancy-induced PIH, gestational diabetes, preeclampsia, PPROM, chorioamnionitis, cesarean section, operative vaginal delivery, or blood transfusion (P >0.05, all). However, they were at extremely increased risk of delivering prematurely (aOR 3.86, 95% CI 1.25-11.93), and to have adverse neonatal outcomes such as small for gestational age (aOR 13.13, 95% CI 2.20-78.41), intrauterine fetal demise (aOR 20.97, 95% CI 1.86-237.02), and congenital anomalies (aOR 9.59, 95% CI 1.47-62.72). Conclusion: Women with DS should be counseled about their increased risk of premature delivery and adverse neonatal outcomes.

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Born Too Soon; Implications in a Tertiary Health Facility in Enugu State Nigeria

International Journal of Health Sciences and Research ◽

10.52403/ijhsr.20210630 ◽

2021 ◽

Vol 11 (6) ◽

pp. 190-196

Author(s):

Nwoga Hope Obiageli ◽

Ajuba Miriam Obinwanne ◽

Igweagu Chukwuma Paulinus

Keyword(s):

Caesarean Section ◽

Health Facility ◽

Preterm Delivery ◽

Tertiary Education ◽

Binary Logistic Regression ◽

Bivariate Analysis ◽

P Value ◽

Chi Square ◽

Chi Square Test ◽

Enugu State

Background: Preterm birth (PTB) is a complex complication of pregnancy with multiple etiologies. This results in long term medical burdens to the families and health care system at large. The objective of the study was to determine the socio-demographic and obstetric characteristics that affect preterm delivery. Methods: The study was a prospective cohort study conducted at the Obstetrics and Gynecology Department of a tertiary health facility in Nigeria. Data for the study were retrieved from the ante-natal and delivery card of the women that delivered at the unit within the time of data collection. Data was analyzed using SPSS version 25 and variables were presented as frequencies, percentages, means, and standard deviation. Bivariate analysis was done using chi-square test. The level of significance was set at p value ≤ 0.05. Binary logistic regression was used to determine factors that predicted preterm delivery. Results: Majority of them were married 746(96.9%), Igbos 763(99.1) and Christians 766(99.5%). Most of the women were civil servants 429(55.7%), while about 31.3% of them were unemployed 241(31.3%). Majority of the women 484(62.9%) had tertiary education. About 48% of them delivered through caesarean section while 53.9% booked within 14-28weeks gestation. Delivering through caesarean section and gestational age at booking predicted preterm delivery. Un-booked mothers have about 7times odds of having PTB when compared to those that booked at ≥28 week’s gestation. Conclusion: The prevalence of PTB is still high in Nigeria. Booking status of the mother and C/S delivery were found to be strongly associated with preterm delivery. Key words: Enugu State, Nigeria, Preterm delivery, Prevalence, Tertiary health facility.

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Maternal and fetal factors contributing to neonatal outcome in Al-Tibri Medical College and Hospital

Journal of Fatima Jinnah Medical University ◽

10.37018/qbhp7754 ◽

2021 ◽

Vol 15 (1) ◽

pp. 18-22

Author(s):

Erum Saboohi ◽

Nighat Seema ◽

Abdulah Hadi Hassan

Keyword(s):

Risk Factors ◽

Antenatal Care ◽

Preterm Delivery ◽

Neonatal Outcome ◽

Neonatal Outcomes ◽

P Value ◽

Medical College ◽

Adverse Neonatal Outcome ◽

Adverse Neonatal Outcomes ◽

Nicu Admission

Background: The study was done to identify the maternal and fetal factors contributing to neonatal outcome and to evaluate the correlation between risk factors and adverse neonatal outcome. Subjects and methods: This prospective observational study was conducted on 126 mothers and their neonates fulfilling the selection criteria at Al-Tibri Medical College and Hospital. A self-designed Performa was used to enter data of subjects. Sick neonates were referred to neonatal intensive care unit for admission and management. The results were analyzed by using SPSS version 22. A p-values <0.05 was considered as significant. Results: Out of 126 enrolled subjects, 81% mothers were multigravidas, 31% were unbooked, 13.5% had gestational comorbidities, 15% were drug addict, 2% were Hepatitis B positive. 22.2% underwent emergency LSCS while 31.7% delivered babies by elective LSCS. Regarding fetal factors contributing to sick babies, IUGR (20%), twin fetuses (15.4%), prematurity (47.7%) were significant. 65 were sick babies. Adverse neonatal outcomes observed were prematurity in 25.4%, IUGR in 11.1%, NICU admission in 33.3%, and neonatal death in 2%. Risk factors associated with adverse neonatal outcomes were positive maternal drug addiction (p-value = 0.028), preterm delivery (p-value<0.001), NICU admission (p-value<0.001) and low birth weight (p-value <0.001). Conclusion: Compromised maternal antenatal care has profound deleterious effect on fetus and neonate. Obstetricians, perinatologists and neonatologists need to work in concord to improve maternal antenatal care hence improving neonatal outcome. In our study adverse neonatal outcome was associated with unbooked cases, delivery by EmLSCS, addicted mother, preterm delivery, LBW and neonates requiring NICU admission.

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O-164 Associations between hypothyroidism and adverse obstetric and neonatal outcomes: a population study of 9.1 million births

Human Reproduction ◽

10.1093/humrep/deab127.032 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

R Hizkiyahu ◽

A Badeghiesh ◽

H Baghlaf ◽

M H Dahan

Keyword(s):

Caesarean Section ◽

Preterm Delivery ◽

Healthcare Cost ◽

Nationwide Inpatient Sample ◽

Post Partum ◽

Neonatal Outcomes ◽

Hypertensive Disorders Of Pregnancy ◽

Neonatal Complications ◽

Post Partum Hemorrhage ◽

Hypertensive Disorders

Abstract Study question Does hypothyroidism confer an independent risk for adverse delivery and neonatal outcomes, based on analysis of the Healthcare Cost and Utilization Project-Nationwide Inpatient Sample database? Summary answer After controlling for confounders, women with hypothyroidism are at an increased risk of hypertensive disorders of pregnancy, preterm delivery, placental abruption, hemorrhage and caesarean section. What is known already Surprisingly, studies in the literature on maternal and neonatal complications of hypothyroidism in pregnancy are relatively small. The largest study to date included 184,611 pregnancies overall, with 7140 with hypothyroidism. Maternal hypothyroidism has been associated with multiple adverse pregnancy outcomes. These findings have not been confirmed in a large population database study. Study design, size, duration This is a retrospective study utilizing data from the Healthcare Cost and Utilization Project-Nationwide Inpatient Sample (HCUP-NIS). A cohort of all deliveries between 2004 and 2014 inclusively was created. Within this group, all deliveries to women with hypothyroidism formed the study group (n = 185,073), and the remaining deliveries were categorized as non- hypothyroidism births and comprised the reference group (n = 8,911,715). The main outcome measures were pregnancy and perinatal complications. Patients were included once per pregnancy. Participants/materials, setting, methods The HCUP-NIS is the largest inpatient sample database in the USA. It provides information relating to seven million inpatient stays per year, includes ∼20% of hospital admissions, and represents over 96% of the American population. Multivariate logistic regression analysis, controlling for confounding effects, was conducted to explore associations between hypothyroidism and delivery and neonatal outcomes. According to Tri-Council Policy statement (2018), IRB approval was not required, given data was anonymous and publicly available. Main results and the role of chance Women with hypothyroidism were more likely to be older than 25 years, Caucasian, have higher household incomes, private insurance and deliver in an urban teaching hospital, as compared with the non-hypothyroidism obstetrical population (p < 0.0001, all cases). After adjustment for all statistically significant confounders, women with hypothyroidism were more likely to suffer from gestational diabetes mellitus (aOR 1.43, 95%CI 1.38-1.47), hypertensive disorders of pregnancy: gestational hypertension (aOR 1.17, 95%CI 1.11-1.22) and preeclampsia (aOR 1.21, 95%CI 1.16-1.27) (all P < 0.001)). They were more likely to experience PPROM (aOR 1.19, 95%CI 1.09-1.29) and preterm delivery (aOR 1.12 95%CI 1.08-1.17), and deliver by caesarean section (aOR 1.21, 95% CI 1.18-1.24 (all P < 0.001)). Women with hypothyroidism more often developed chorioamnionitis (aOR 1.09, 95%CI 1.01-1.17, P = 0.019), maternal infections (aOR 1.08, 95% CI 1.01-1.16, P = 0.017), post-partum hemorrhage (aOR 1.07, 95%CI 1.01-1.13, P = 0.012), disseminated intravascular coagulation (aOR 1.20, 95%CI 1.00-1.43, P = 0.047), require blood transfusions (aOR 1.12, 95%CI 1.03-1.22, P = 0.009), and hysterectomy (aOR 1.42, 95% CI 1.13-1.80, P = 0.012) compared to the control group. [HB1] As for neonatal outcomes, small for gestational age and congenital anomalies were more likely to occur in the offspring of women with hypothyroidism (aOR 1.20, 95% CI 1.14-1.27 and aOR 1.34, 95% CI 1.22–1.48, both P < 0.001). Limitations, reasons for caution This is a retrospective analysis utilizing an administrative database that relies on data coding accuracy and consistency. Wider implications of the findings Women with hypothyroidism were more likely to experience pregnancy, delivery and neonatal complications. We found an association between hypothyroidism and; hypertensive disorders, post-partum hemorrhage, transfusions, infections, preterm deliveries and hysterectomy, among other problems. This data from a population sized database confirmed the findings of the smaller studies in the literature. Trial registration number not applicable

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First versus second stage caesarean section: a comparison of maternal and neonatal outcomes

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20173467 ◽

2017 ◽

Vol 6 (8) ◽

pp. 3477

Author(s):

Sushma Sinha ◽

Surya Malik ◽

Mala Dixit

Keyword(s):

Retrospective Study ◽

Caesarean Section ◽

Caesarean Delivery ◽

Neonatal Morbidity ◽

Neonatal Outcomes ◽

P Value ◽

Neonatal Complications ◽

Second Stage ◽

Number Of Patients ◽

One Year

Background: A retrospective study was done to compare the maternal and neonatal complications of caesarean delivery performed in the second stage compared with the first stage of labor.Methods: This is a one year retrospective study done in a 100-bedded hospital, govt of NCT OF Delhi, New Delhi from 1st November 2015 to 31st October 2016. Total number of deliveries in this one year duration were 1785, including both normal and caesarean deliveries. Total number of patients who underwent caesarean delivery in the first stage of labor were 159, and in 2nd stage of labor were 15 during this time period. These were designated into two groups, group 1 and group 2. These two groups were then compared in terms of maternal demographics, labor characteristics, maternal outcomes and neonatal outcomes. Numerical variables were compared between groups by calculating P-value for each variable. P-value <0.05 was considered statistically significant.Results: Caesarean deliveries performed in the second stage were associated with increased maternal morbidity in terms of blood loss, unintended extensions, blood transfusions, prolonged hospital stay, febrile morbidity. Similarly, Neonatal morbidity was much higher in the patient who underwent LSCS in 2nd stage of labor compared to 1st stage. There was increase in neonatal complications, for e. g. –5 minute Apgar <7, NICU admissions >24 hrs, neonatal septicaemia, (P-value <0.05).Conclusions: In conclusion, present study suggests that women undergoing caesarean section in the second stage of labor have increased maternal and fetal morbidity. Therefore, selection of birthing method should be made very carefully and meticulously to decrease maternal and neonatal morbidity.

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P–571 Preimplantation Genetic Testing for Aneuploidies (PGT-A) and pregnancy outcome

Human Reproduction ◽

10.1093/humrep/deab130.570 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

D Markova ◽

R A Zaabi ◽

N D Munck ◽

I Elkhatib ◽

H Fatemi ◽

...

Keyword(s):

Birth Weight ◽

Caesarean Section ◽

Preterm Delivery ◽

Pregnancy Complications ◽

Neonatal Outcomes ◽

Fetal Abnormalities ◽

Endometrial Preparation ◽

Group A ◽

The Mean ◽

Singleton Pregnancies

Abstract Study question Frozen embryo transfer (FET) of euploid blastocysts in hormone replacement therapy (HRT) or natural cycle (NC): are there differences in obstetric, fetal and neonatal outcomes? Summary answer Pregnancy complications, neonatal outcomes and fetal abnormalities are not increased after FET with PGT-A in singleton pregnancies. What is known already Since its introduction, PGT has been widely used in ART centers for preventing chromosomal and monogenic diseases. Despite its increased use, there are scarce and conflicting data about adverse pregnancy, fetal and neonatal outcomes. In one published study, the risk of preeclampsia and placenta previa was increased when PGT pregnancies were compared with non-PGT, while the incidence of gestational diabetes mellitus (GDM), preterm delivery, fetal defects and NICU (Neonatal Intensive Care Unit) admission were similar. According to other data, the rate of caesarean section in PGT pregnancies was high - around 80% in singletons. Study design, size, duration An observational, retrospective study was conducted between March 2015 and November 2019 in patients with singleton pregnancies after ART with PGT-A/FET/HRT and NC. A total number of 353 patients from two fertility centers (ART Fertility Clinics Dubai and Abu Dhabi, UAE), were included. They were divided into two groups according to the endometrial preparation for FET: group A: HRT (n = 225) and group B: NC (n = 128). Participants/materials, setting, methods Patients with primary / secondary infertility and at least one transferable euploid blastocyst after trophectoderm biopsy, achieving an ongoing singleton pregnancy after FET were included. Endometrial preparation for FET was either performed in a NC or an HRT cycle. For this study, the following pregnancy outcomes were recorded: GDM, preeclampsia and hypertension, obstetric cholestasis, placental abnormalities, mode of delivery, preterm delivery, gestational age at delivery, birth weight, fetal abnormalities and admission to NICU. Main results and the role of chance There were no statistically significant differences in maternal and demographic characteristics of the studied groups. The mean maternal age was 34.05(20–45) and 34.26(23–47) years for group A and B respectively. The mean BMI was 28.31kg/m² (17.93–43.76) versus 27.93 (17.32–43.18). The ratio of nulliparous versus multiparous patients was 1:1 for both groups. Majority of the patients in both groups were of Arab ethnicity. The number of patients recorded as smokers was low and comparable in the groups. The mean gestational age at the time of delivery was comparable: 37.64 gestational weeks (24–41) versus 37.76 (26–41). The Caesarean section rate was around 50% for both groups. The rate of preterm delivery was comparable in both groups (16.9% and 18.8% for group A and B respectively). There was no detectable difference in the distribution of the birth weight in both groups with a median weight of 3000 grams of which 13.6% were low birth weight. In the studied groups, 30.5% had pregnancy complications with no observed statistically significant differences when the groups were compared. There was no increased incidence of fetal abnormalities. Admission to NICU was comparable and was related to prematurity. Limitations, reasons for caution The limitations of the study are the retrospective design and the small number of participants. Wider implications of the findings: In patients with FET of an euploid embryo after PGT-A, the type of FET treatment preparation (HRT or NC) has no significant effect on pregnancy complications, birth weight and fetal abnormalities. The findings of the present study could be used to improve prenatal counselling for women undergoing ART with PGT-A. Trial registration number Not applicable

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PENGGUNAAN SELAPUT AMNION SEGAR PADA INSISI LUKA OPERASI SEKSIO SESAREA

JOURNAL OBGIN EMAS ◽

10.25077/aoj.1.2.47-55.2017 ◽

2019 ◽

Vol 1 (2) ◽

pp. 47-55

Author(s):

Syahredi Syaiful Adnani ◽

Hafni Bachtiar

Keyword(s):

Wound Healing ◽

Caesarean Section ◽

Amniotic Membrane ◽

Healing Time ◽

Cost Of Care ◽

Control Group ◽

P Value ◽

Control Groups ◽

And Control ◽

Wound Healing Time

In the last few decades, the incidence of caesarean section is increasing in the world, especially in Indonesia. One of the way to treat tissue scar is through biologic and synthetic dressing where nowadays, amnion has been used as biologic dressing frequently. This study was conducted to determine the effect of the use of fresh amniotic membrane on wound incision Caesarean section compared with Caesarean section incision wound covered using regular gauze bandages and fixated with plaster in RS. Dr. Reksodiwiryo Padang. The design of this study is an experimen-tal study with Post test design with control group design. Sampling was done using a formula consecutive sampling two different test samples obtained an average of 72 people for each group. The analysis used include univariate and bivariate analyzes. The average wound healing time the difference was statistically significant (p value <0.05) in the treatment and control groups. There was highly significant difference in the proportion of local infection on day 3 between the treatment and control groups (p value <0.05). There were very significant differences in the proportion of local allergic reactions at day 3, and 5 between the treatment and control group (p <0.05). There are significant differences in terms of the cost of care per day between treatment and control groups (p <0.05). From this study, the average wound healing time has a very significant difference.Keywords: Fresh Amniotic Membrane, Wound Cesarean Section, Wound Healing

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A comparative evaluation of post placental intrauterine contraceptive device (IUCD) insertion between normal delivery and caesarean section

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20183802 ◽

2018 ◽

Vol 7 (9) ◽

pp. 3826

Author(s):

Sharmistha Sarkar ◽

Dhruba Prasad Paul ◽

Jayanta Ray

Keyword(s):

Caesarean Section ◽

Vaginal Delivery ◽

Comparative Evaluation ◽

P Value ◽

Contraceptive Device ◽

Government Medical College ◽

Expulsion Rate ◽

Medical College ◽

Significant Difference ◽

Post Placental

Background: Adverse maternal and perinatal outcomes are related to pregnancies spaced too closely together. Objective of present study was to compare the expulsion rate and complications between post placental IUCD insertion between caesarean section and vaginal delivery.Methods: This study was a prospective comparative study conducted in the department of Obstetrics and Gynecology, at Agartala Government Medical College over 1.5 Years (January 2016-June2017) All cases at term pregnancy delivering by caesarean section and vaginal delivery were divided into two different groups. Sample size of 105 in each group. Subjects recruited from-obstetrics OPD and casualty of Agartala Government Medical College (AGMC) and GB Pant Hospital expulsion rate and complications. Comparative evaluation of Expulsion rate and complications following post placental IUCD insertion between caesarean section and vaginal delivery at the end of six months, one year and one and half year.Results: There was no significant difference in either complications between the two groups (P value-.913) or outcomes (p value-.035). Expulsion rate 18.2% following vaginal delivery compared to those with intracaesarean insertion i.e 3.8%.Conclusions: The complications associated with postplacental Intrauterine device insertion is insignificant, still the awareness, acceptance and continuation are very low. Therefore Information, education Communication activity by the field workers must be enhanced to overcome this knowledge gap.

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Competency of health workers in detecting and managing gestational hypertension, pre-eclampsia, severe pre-eclampsia and eclampsia during antenatal check-ups in primary care health facilities in Bangladesh: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-046638 ◽

2021 ◽

Vol 11 (7) ◽

pp. e046638

Author(s):

Sk Masum Billah ◽

Abdullah Nurus Salam Khan ◽

S M Rokonuzzaman ◽

Nafisa Lira Huq ◽

Marufa Aziz Khan ◽

...

Keyword(s):

Primary Care ◽

Health Workers ◽

Gestational Hypertension ◽

Cross Sectional Study ◽

P Value ◽

Sectional Study ◽

Hypertensive Disorders Of Pregnancy ◽

Cross Sectional ◽

Hypertensive Disorders ◽

Care Facilities

Study objectiveTo evaluate the competency of trained health workers in detecting and managing hypertensive disorders of pregnancy during routine antenatal check-ups (ANCs) at primary care facilities in Bangladesh.Study design and settingsCross-sectional study; conducted in 26 primary care facilities.Outcome measuresAccurate diagnosis of the hypertensive disorders of pregnancy.MethodIn total 1560 ANC consultations provided by primary health workers, known as Family Welfare Visitors (FWVs), were observed using a structured checklist between October 2017 and February 2018. All consultations were reassessed by study physicians for validation.ResultOf the ‘true’ cases of gestational hypertension (n=32), pre-eclampsia (n=29) and severe pre-eclampsia (n=16), only 3%, 7% and 25%, respectively, were correctly diagnosed by FWVs. Per cent agreement for the diagnosed cases of any hypertensive disorders of pregnancy was 9% and kappa statistics was 0.50 (p value 0.0125). For identification of any hypertensive disorders by FWVs, sensitivity and positive predictive values were 14% and 50%, respectively. There was a moderate positive correlation between the blood pressure measurements taken by FWVs and study physicians. Only 27% of those who had ‘some protein’ in urine were correctly identified by FWVs. Women diagnosed with any of the hypertensive disorders of pregnancy by FWVs were more likely to be counselled on at least one danger sign of pre-eclampsia (severe headache, blurring of vision and upper abdominal pain) than those without any such diagnosis (41% vs 19%, p value 0.008). All four cases of severe pre-eclampsia diagnosed by FWVs were given a loading dose of intramuscular magnesium sulphate and three among them were referred to a higher facility.ConclusionThe FWVs should be appropriately trained on risk assessment of pregnant women with particular emphasis on accurately assessing the diagnostic criteria of hypertensive disorders of pregnancy and its management.

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Liver Impairment and Hematological Changes in Patients with Chronic Hepatitis C and COVID-19: A Retrospective Study after One Year of Pandemic

Medicina ◽

10.3390/medicina57060597 ◽

2021 ◽

Vol 57 (6) ◽

pp. 597

Author(s):

Bianca Cerbu ◽

Stelian Pantea ◽

Felix Bratosin ◽

Iulia Vidican ◽

Mirela Turaiche ◽

...

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Clinical Outcomes ◽

Chronic Hepatitis C ◽

Hcv Infection ◽

Multivariate Logistic Regression Model ◽

P Value ◽

Liver Impairment ◽

All Cause Mortality ◽

Chronic Hcv

Background and Objectives: The COVID-19 pandemic is an ongoing public health emergency. Patients with chronic diseases are at greater risk for complications and poor outcomes. The objective of this study was to investigate the liver function abnormalities and clinical outcomes in patients with COVID-19 and chronic hepatitis C. Materials and Methods: This retrospective, single-center study was conducted on a cohort of 126 patients with a history of hepatitis C, confirmed with COVID-19 between 01 April 2020 and 30 December 2020. Several clinical outcomes were compared between patients with active and non-active HCV infection, and the risks of liver impairment and all-cause mortality in active HCV patients were analyzed using a multivariate logistic regression model. Results: Among 1057 patients under follow-up for chronic HCV infection, 126 (11.9%) were confirmed with COVID-19; of these, 95 (75.4%) were under treatment or achieved SVR, while in the other 31 (24.6%), we found active HCV replication. There was a significantly higher proportion of severe COVID-19 cases in the active HCV group as compared to the non-active HCV group (32.2 vs. 7.3%, p < 0.001). Multivariate analysis showed that age, sex, alanine aminotransferase, C-reactive protein, procalcitonin, and HCV viral load were significant independent risk factors for liver impairment and all-cause mortality. The length of stay in hospital and intensive care unit for COVID-19 was significantly higher in patients with active HCV infection (p-value < 0.001), and a higher proportion of these patients required mechanical ventilation. Conclusions: Active HCV infection is an independent risk factor for all-cause mortality in COVID-19 patients.

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