TY - JOUR
T1 - Characterization of COVID-19 infected pregnant women with ICU admission and the risk of preterm
T2 - A cluster analysis
AU - Sarria-Santamera, Antonio
AU - Kapashova, Nurly
AU - Sarsenov, Radmir
AU - Mukhtarova, Kymbat
AU - Sipenova, Aigerim
AU - Terzic, Milan
AU - Bapayeva, Gauri
AU - Sarbalina, Asselzhan
AU - Zhumambayeva, Saule
AU - Nadyrov, Kamalzhan
AU - Tazhibayeva, Karina
AU - Jaxalykova, Kulyash K.
AU - Myrzabekova, Aigul
AU - Khamidullina, Zaituna
N1 - Publisher Copyright:
© 2024 The Author(s)
PY - 2024/12
Y1 - 2024/12
N2 - Background: The unique physiological changes during pregnancy present challenges in understanding the full scope and effects of COVID-19 on pregnant women, adding complexity to their medical management. Given the significant changes in the immune, circulatory, respiratory, and hormonal systems during the progression of the pregnancy, and the specific factors with higher risk of COVID-19, like metabolic, vascular, and endothelial factors, typically also associated with maternal and neonatal unfavorable outcomes, the full understanding of how COVID-19 affects pregnant women is not clarified yet. Methods: In this study, anonymous data from medical records of pregnant women with lab-confirmed COVID‐19 in Astana, Kazakhstan from May 1, 2021, to July 14, 2021, were collected retrospectively. A multivariate regression model was built to identify factors associated with the risk of ICU admission. Cluster analysis was performed to identify distinct groups among women admitted to the ICU based on their blood parameters, coagulation profiles, and oxygenation saturation levels. Results: 10.7 % of pregnant women were admitted to ICU. Among them, 4.36 % were in the 2nd trimester and 13.58 % in the 3rd trimester. No women in the 1st trimester were admitted to ICU. A multivariate regression model demonstrates that gestational diabetes, leukocytes, CRP, and saturation were the factors significantly associated with a higher risk of ICU admission. Three clusters of pregnant women were segmented, and preterm birth was frequent in clusters 1 (serious systemic conditions affecting multiple organs) and 3 (women with hypertension and preeclampsia), whereas cluster 2 represents women who can also be characterized as suffering from infections with a possible autoimmune component. Neutrophil to lymphocyte ratio was frequent in clusters 1 and 3. Conclusion: In this study, multivariable analysis identified factors with a risk of ICU admission, and clustering analysis helped to identify groups of COVID-19-infected pregnant women admitted to ICU with similar risk profiles. Differences in clusters can help to explain discrepancies in COVID-19 outcomes and suggest biochemical and molecular mechanisms involved in COVID-19 and outline a more personalized approach to understanding, diagnosing, and treating women.
AB - Background: The unique physiological changes during pregnancy present challenges in understanding the full scope and effects of COVID-19 on pregnant women, adding complexity to their medical management. Given the significant changes in the immune, circulatory, respiratory, and hormonal systems during the progression of the pregnancy, and the specific factors with higher risk of COVID-19, like metabolic, vascular, and endothelial factors, typically also associated with maternal and neonatal unfavorable outcomes, the full understanding of how COVID-19 affects pregnant women is not clarified yet. Methods: In this study, anonymous data from medical records of pregnant women with lab-confirmed COVID‐19 in Astana, Kazakhstan from May 1, 2021, to July 14, 2021, were collected retrospectively. A multivariate regression model was built to identify factors associated with the risk of ICU admission. Cluster analysis was performed to identify distinct groups among women admitted to the ICU based on their blood parameters, coagulation profiles, and oxygenation saturation levels. Results: 10.7 % of pregnant women were admitted to ICU. Among them, 4.36 % were in the 2nd trimester and 13.58 % in the 3rd trimester. No women in the 1st trimester were admitted to ICU. A multivariate regression model demonstrates that gestational diabetes, leukocytes, CRP, and saturation were the factors significantly associated with a higher risk of ICU admission. Three clusters of pregnant women were segmented, and preterm birth was frequent in clusters 1 (serious systemic conditions affecting multiple organs) and 3 (women with hypertension and preeclampsia), whereas cluster 2 represents women who can also be characterized as suffering from infections with a possible autoimmune component. Neutrophil to lymphocyte ratio was frequent in clusters 1 and 3. Conclusion: In this study, multivariable analysis identified factors with a risk of ICU admission, and clustering analysis helped to identify groups of COVID-19-infected pregnant women admitted to ICU with similar risk profiles. Differences in clusters can help to explain discrepancies in COVID-19 outcomes and suggest biochemical and molecular mechanisms involved in COVID-19 and outline a more personalized approach to understanding, diagnosing, and treating women.
KW - Cluster analysis
KW - COVID-19
KW - ICU admission
KW - Pregnant women
KW - Preterm birth
UR - http://www.scopus.com/inward/record.url?scp=85208687758&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85208687758&partnerID=8YFLogxK
U2 - 10.1016/j.jiph.2024.102572
DO - 10.1016/j.jiph.2024.102572
M3 - Article
AN - SCOPUS:85208687758
SN - 1876-0341
VL - 17
JO - Journal of Infection and Public Health
JF - Journal of Infection and Public Health
IS - 12
M1 - 102572
ER -
