COVID-19 impact in early pregnancy losses: A retrospective study

Abstract
Background: Severe acute lung disease, known as coronavirus disease 2019 [COVID-19] had multifaced impacts on human lives especially in pregnant women. However, no clear-cut consensus have been made on the effect of COVID 19 on pregnancy and fetal effects due to limited data. Aim: To study pregnant women presenting to our department with missed miscarriages or early fetal demise in the COVID pandemic time for a period of 2 years (April 2020 to March 2022) and to assess the risk of early pregnancy loss due to COVID 19 infection if any. Materials and Methods: A Retrospective comparative study was carried out among pregnant women attending the department of Obstetrics & Gynaecology for MTP at SVS Medical College, Mahabubnagar in view of miscarriages both embryonic and anembryonic and early fetal demise till 20weeks Gestational age in the period April2020 to March 2021 and a control group of pregnant ladies who presented for MTPs before 20 weeks for miscarriages and early IUFDs till 20 weeks gestational age in the period of April 2019 to march 2020 were taken. Results: A total of 232 women were registered during pre-pandemic period and 180 women were registered during pandemic period for the study. The two groups were similar in demographic characteristics including the mean maternal age in both the groups which were 22+/-2 and 23+/-2yrs. Parity affected in both the study groups i.e, precovid which were 38.2% in primigravida and 61.7% in multigravida and the pregnancy loss during covid-there were 44.6% in primigravida and 55.3% in multigravida, showing no significant difference in pregnancy loss during and before covid. The percentages of missed miscarriages, early IUFDS less than 20 weeks Gestational age, MTPs done for various congenital anomalies also showed only marginal changes in both the groups. Conclusion: In our study, we did not find any significant difference between the early fetal demise, missed miscarriages, MTPs done for congenital anomalies during the pre-covid and COVID periods. Though some studies support early pregnancy loss due to COVID infection, because of our small sample size, we could not find attribute the marginal changes in the study group i.e, during COVID pandemic due to small sample size and also many studies reporting no significant difference, large multicentric studies are needed to evaluate any association between the COVID-19 SARS virus infection and its effect on fetal demise, any miscarriages or congenital anomalies.