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PLoS One . Clinical characteristic and outcomes of pregnant women with COVID-19: The PROUDEST prospective cohort study

tetano

Editor, Senior Moderator
PLoS One


. 2025 Jul 3;20(7):e0327174.
doi: 10.1371/journal.pone.0327174. eCollection 2025. Clinical characteristic and outcomes of pregnant women with COVID-19: The PROUDEST prospective cohort study

Lizandra Paravidine Sasaki[SUP] 1 2 [/SUP], Geraldo Magela Fernandes[SUP] 1 [/SUP], Ângelo Pereira da Silva[SUP] 2 [/SUP], Yacara Ribeiro Pereira[SUP] 2 3 [/SUP], Aleida Oliveira de Carvalho[SUP] 2 [/SUP], Felipe Motta[SUP] 1 [/SUP], David Alves de Araújo Junior[SUP] 1 [/SUP], Maria Eduarda Canellas de Castro[SUP] 1 [/SUP], Gabriela Profírio Jardim-Santos[SUP] 1 [/SUP], Heidi Luise Schulte[SUP] 1 [/SUP], Clara Correia de Siracusa[SUP] 4 [/SUP], Isadora Pastrana Rabelo[SUP] 5 [/SUP], Pedro Sadi Monteiro[SUP] 3 [/SUP], Fabiola Cristina Ribeiro Zucchi[SUP] 4 [/SUP], Agenor de Castro Moreira Dos Santos Junior[SUP] 5 [/SUP], Ismael Artur Costa-Rocha[SUP] 6 [/SUP], Jordana Grazziela Alves Coelho-Dos-Reis[SUP] 7 [/SUP], Patricia Shu Kurizky[SUP] 1 [/SUP], Rosana Tristão[SUP] 4 [/SUP], Dayde Lane Mendonça Da Silva[SUP] 2 [/SUP], Otávio de Toledo Nóbrega[SUP] 1 [/SUP], Alexandre Anderson de Sousa Munhoz Soares[SUP] 1 [/SUP], Cleandro Pires de Albuquerque[SUP] 1 2 [/SUP], Ciro Martins Gomes[SUP] 1 2 4 8 [/SUP], Laila Salmen Espindola[SUP] 1 [/SUP], Olindo Assis Martins-Filho[SUP] 6 [/SUP], Alberto Moreno Zaconeta[SUP] 4 [/SUP], Licia Maria Henrique da Mota[SUP] 1 2 7 [/SUP]



Affiliations
Abstract

The present study intended to characterize the clinical features and outcomes of SARS-CoV-2 infection at distinct pregnancy trimesters. A total of 260 pregnant women with SARS-CoV-2 infection at any pregnancy trimester were enrolled in a prospective follow-up study. Clinical features were recorded between the SARS-CoV-2 infection diagnosis towards delivery and postpartum period. ANOVA and Chi-square/Fisher tests, Bi- and multivariate analyses were performed to verify the effect of predictors on disease outcome, adjusted for the pregestational variables. Data demonstrated that anosmia (64.6%), nasal congestion/discharge (61.5%), headache (60.8%), ageusia (58.5%) and myalgia (58.5%) were the most common symptoms observed amongst pregnant women with non-severe COVID-19. Fever (44.6%) and dyspnea (36.5%) were associated with higher disease severity. Gestational diabetes mellitus (35.8%), systemic arterial hypertension (18.1%), preterm delivery (11.5%) and superimposed preeclampsia (6.2%) were reported as adverse pregnancy outcomes amongst pregnant women with COVID-19. Parturients with acute COVID-19 and pregnant women infected at the 3rd trimester presented more severe or critical outcomes as compared to those infected at 2nd and 1st trimesters. Preterm labor (Odds Ratio = 3.64), acute fetal distress (Prevalence Ratio = 2.40) and Apgar 1st minute score ≤ 7 (Prevalence Ratio = 2.56) were adverse outcomes reported in parturients with acute COVID-19 and those with severe or critical outcomes. Together these findings demonstrated that SARS-CoV-2 infection during pregnancy was associated with relevant maternal and neonatal adverse outcomes. The understanding of the clinical and obstetric outcomes of COVID-19 during pregnancy can provide insights to establish the most suitable approach for clinical management of pregnant women.


 
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