Impacto de la infección por COVID-19 en gestantes adultas ingresadas en la Unidad de Alto Riesgo Obstétrico del Hospital Teodoro Maldonado Carbo de Guayaquil Ecuador, entre diciembre de 2020 y diciembre de 2022.

Abstract

Introduction: COVID-19 infection represented a major challenge for obstetric care during the pandemic, particularly in pregnant women with comorbidities. Several studies have reported an increase in maternal and perinatal complications associated with this infection, highlighting the need to evaluate its impact in high-complexity local settings. Objective: To evaluate the impact of COVID-19 infection in adult pregnant women admitted to the High-Risk Obstetrics Unit of the Teodoro Maldonado Carbo Hospital between December 2020 and December 2022. Materials and Methods: Observational, retrospective, and cross-sectional study based on the review of 122 medical records of hospitalized pregnant women. Patients were classified into two groups according to COVID-19 diagnosis (confirmed by PCR or antigen test). Sociodemographic, clinical, respiratory, and obstetric variables were collected. Descriptive and inferential analyses were performed using absolute frequencies, percentages, central tendency measures, and Chi-square test, with statistical significance set at p<0.05. Results: Out of the total patients, 86 (70.5%) were COVID-19 positive and 36 (29.5%) negative. The average age was 31 years (SD ±5.45), and the mean gestational age was 36.8 weeks (SD ±3.18). Obesity (39.5% vs 19.4%; p=0.0432) and preeclampsia (29.1% vs 2.8%; p=0.0053) were significantly more frequent in the positive group. A higher proportion of upper respiratory symptoms (36.0% vs 2.8%; p=0.0003) and maternal complications such as pregnancy termination (47.7% vs 13.9%; p=0.0009) and invasive mechanical ventilation (14.0% vs 0%; p=0.0427) were observed in COVID-19 positive patients. Among perinatal complications, preterm birth (37.2% vs 8.3%; p=0.0027) and fetal distress (50.0% vs 13.9%; p=0.0004) were significantly more frequent in the infected group. Conclusion: COVID-19 infection in pregnant women was associated with a significant increase in maternal and perinatal complications. The early identification of comorbidities and timely multidisciplinary management in specialized units is essential to reduce risks in this vulnerable population.