Pregnant women with mild COVID-19 followed in community setting by telemedicine, and factors associated with unfavorable outcome

PLoS One. 2023 Aug 3;18(8):e0288845. doi: 10.1371/journal.pone.0288845. eCollection 2023.

Abstract

Objectives: Few is known on pregnant women with mild COVID-19 managed in a community setting with a telemedicine solution, including their outcomes. The objective of this study is to evaluate the adverse fetal outcomes and hospitalization rates of pregnant COVID-19 outpatients who were monitored with the Covidom© telemedicine solution.

Methods: A nested study was conducted on pregnant outpatients with confirmed COVID-19, who were managed with Covidom© between March and November 2020. The patients were required to complete a standard medical questionnaire on co-morbidities and symptoms at inclusion, and were then monitored daily for 30 days after symptom onset. Adverse fetal outcome was defined as a composite of preterm birth, low birthweight, or stillbirth, and was collected retrospectively through phone contact with a standardized questionnaire.

Results: The study included 714 pregnant women, with a median age of 32.0 [29.0-35.0] and a median BMI of 23.8 [21.3-27.0]. The main comorbidities observed were smoking (53%), hypertension (19%). The most common symptoms were asthenia (45.6%), cough (40.3%) and headache (25.7%), as well as anosmia (28.4%) and agueusia (32.3%). Adverse fetal outcomes occurred in 64 (9%) cases, including 38 (5%) preterm births, 33 (5%) low birthweights, and 6 (1%) stillbirths. Hospitalization occurred in 102 (14%) cases and was associated with adverse fetal outcomes (OR 2.4, 95% CI 1.3-4.4).

Conclusions: Our study suggests that adverse fetal outcomes are rare in pregnant women with mild COVID-19 who are monitored at home with telemedicine. However, hospitalization for COVID-19 and pregnancy-induced hypertension are associated with a higher risk of adverse fetal outcome.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • COVID-19* / epidemiology
  • Female
  • Humans
  • Infant, Newborn
  • Pregnancy
  • Pregnancy Outcome / epidemiology
  • Pregnant Women
  • Premature Birth* / epidemiology
  • Retrospective Studies
  • Stillbirth / epidemiology
  • Telemedicine*

Grants and funding

This study received a funding by the Programme Hospitalier de Recherche Clinique 2020 of the French Ministry of Health, by a research fund by APHP-Fondation de France. The Covidom platform received a funding from EIT Health specific Covid-19 fund. The funders play no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.