Date of Award

12-4-2022

Degree Type

Thesis

Degree Name

MS in Epidemiology & Biostatistics

First Advisor

DR. SARAH SALEEM

Second Advisor

SYED IQBAL AZAM

Third Advisor

DR SALEEM JESSANI

Department

Community Health Sciences

Abstract

INTRODUCTION: Covid-19 is a newly identified viral infection globally and has affected the human population severely. Pregnancy is a vulnerable period and pregnant women who suffer from viral infections during pregnancy are at higher risks of developing adverse pregnancy outcomes including miscarriages. Pregnancy loss before 24 weeks of gestation is termed as miscarriage. Literature regarding the association of SARS-CoV-2 (severe acute respiratory syndrome-Coronavirus-2) and miscarriage is in its infancy and there is a case-to-case variation. There is a lack of evidence to define whether SARS-CoV-2 exposure is associated with miscarriages We hypothesized that the rates of miscarriages are twice or more among women who are exposed to Covid-19 during pregnancy as compared to those who are not.
METHODS: This hospital-based, multicenter, retrospective study is a supplementary study in a larger international prospective cohort study investigating maternal, pregnancy and neonatal outcomes for women and neonates infected with SARS-CoV-2 being carried out in six countries funded by World Health Organization”. Data from six sites across Pakistan including two private and four public hospitals was extracted for this study. All women who reported a pregnancy, had a verified outcome and exposure status were included in the analysis.
RESULTS: Out of 278 covid exposed women , total 177 (61.6%) participants were recruited from public hospitals and 110 (38.3%) from private hospitals while out of 33 unexposed, 12 (36.3%) were recruited from public hospitals and 21 (63.6%) from private hospitals. Mean (Standard deviation) age of mothers enrolled in the exposed group was 28.3 (SD 5.5) years and in the unexposed group was 28.6 (SD 6.0) years. Patients who suffered a miscarriage in the exposed group were 4.5%(13/287) and 6.1% (2/33) in the unexposed group (p value=0.69). Exposure to Covid-19 was not associated with miscarriages and the difference was not statistically significant (OR 1.41 95% CI 0.30,6.66)(p value=0.66). However, age of the patient [OR 1.14 95%CI 1.02, 1.29 (p-value =0.02)] and gestational age at enrollment [OR 0.76, 95% CI 0.67, 0.85(p-value< 0.001)] showed statistically significant association with miscarriages.
CONCLUSION: We conclude from this study that the exposure to SARS-Cov-2 as assessed by antibody status and rapid antigen/RT-PCR tests does not affect the miscarriage rate and our hypothesis that miscarriage rate is twice or more among Covid-19 exposed women could not be proved, thus we failed to reject our null hypothesis. Inclusion of larger sample from ongoing parent study might help to elaborate these findings.

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Last Page

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