Comparison of third-trimester indices in pregnant women with and without COVID-19 infection: A cross-sectional study
DOI:
https://doi.org/10.59692/jogeca.v37i2.368Keywords:
COVID 19 infection, pregnant women, third trimester, blood profileAbstract
Background: The third trimester represents a critical window in pregnancy when these hematologic changes could have the greatest impact. Therefore, understanding how coronavirus disease 2019 (COVID-19) infection influences blood profiles during this period is vital for clinical management and risk stratification. In Kenya, while national guidelines recommend laboratory evaluation, including complete blood count, c-reactive protein (CRP), lactate dehydrogenase (LDH), and coagulation profiles for pregnant women with suspected or confirmed COVID-19, there is a paucity of local data documenting these hematologic trends.
Objective: To investigate hematologic profile differences between pregnant women in the third trimester with and without COVID-19 infection.
Methods: A cross-sectional comparative study was employed to compare hematological parameters in pregnant women with and without
COVID-19 between May 1st and August 31st, 2021. We recruited 60 eligible patients from the Nairobi hospital using purposive sampling. We assessed the complete blood count, coagulation profile, lactate dehydrogenase, and C-reactive protein.
Results: Pregnant women with COVID-19 had significantly higher levels of neutrophils, prothrombin time, CRP, and LDH compared to those without, with respective AORs of 9.50 (p<0.01), 11.52 (p=0.001), and 3.06 (p=0.078). No significant differences were observed in white blood cells, basophils, and international normalized ratio after adjusting for age, parity, COVID-19 vaccination, and fetus number.
Conclusion: This study reported significant associations between neutrophil count, prothrombin time, CRP, LDH levels, and COVID-19 infection status in pregnant women. These indices may aid in distinguishing healthy pregnant women from those with COVID-19 infection.
Keywords: COVID-19 infection, pregnant women, third trimester, blood profile
References
Wilkinson M, Johnstone ED, Simcox LE, Myers JE. The impact of COVID-19 on pregnancy outcomes in a diverse cohort in England. Sci Rep. 2022;12(1):1–10.
Allotey J, Stallings E, Bonet M, Yap M, Chatterjee S, Kew T, et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ. 2020;370:m3320.
Kourtis AP, Read JS, Jamieson DJ. Pregnancy and infection. N Engl J Med. 2014;370(23):2211–8.
Shanes ED, Mithal LB, Otero S, Azad HA, Miller ES, Goldstein JA. Placental pathology in COVID-19. MedRxiv. 2023 Jul;5(7):10098.
Covali R, Socolov D, Socolov R, Brinzeu S, Grigoriu C, Gorduza EV, et al. Complete blood count peculiarities in pregnant SARS-CoV-2-infected patients at term: a cohort study. Diagnostics (Basel). 2021;12(1):70.
Vakili S, Savardashtaki A, Jamalnia S, Sadeghi M, Zarei SA, Mohamadkhani A, et al. Laboratory findings of COVID-19 infection are conflicting in different age groups and pregnant women: a literature review. Arch Med Res. 2020;51(7):603–7.
Kim JH, Shrestha N, Girshin M. Unexpected severe thrombocytopenia in the COVID-19 positive parturient. Anesth Analg. 2020;131(2):e116–7.
Zhang C, Chu H, Pei YV, Zhang J. Laboratory effects of COVID-19 infection in pregnant women and their newborns: a systematic review and meta-analysis. Front Glob Womens Health. 2021;2:684294.
Duffy CR, Hart JM, Modest AM, Powers E, Dizon AM, Dotters-Katz SK, et al. Lymphopenia and SARS-CoV-2 infection among hospitalized obstetric patients. Obstet Gynecol. 2020;136(2):229–31.
Zein JG, Strauss R, Attaway AH, Alqarzaee AA, Alshak MN, Sosnay PR, et al. Eosinophilia is associated with improved COVID-19 outcomes in inhaled corticosteroid-treated patients. J Allergy Clin Immunol Pract. 2022;10(3):742–50.e14.
Chen G, Liao Q, Ai J, Yang B, Bai H, Chen J, et al. Immune response to COVID-19 during pregnancy. Front Immunol. 2021;12:675476.
Hapshy V, Aziz D, Kahar P, Khanna D, Johnson KE, Parmar MS. COVID-19 and pregnancy: risk, symptoms, diagnosis, and treatment. SN Compr Clin Med. 2021;3(7):1477–83.
Servante J, Swallow G, Thornton JG, Huda T, Matata C, Bonet M, et al. Haemostatic and thrombo-embolic complications in pregnant women with COVID-19: a systematic review and critical analysis. BMC Pregnancy Childbirth. 2021;21(1):108.
Lombardi A, Duiella S, Piani LL, Bozzi G, Rescigno C, Ceriotti F, et al. Inflammatory biomarkers in pregnant women with COVID-19: a retrospective cohort study. Sci Rep. 2021;11(1):13350.
Sun G, Zhang Y, Liao Q, Cheng Y. Blood test results of pregnant COVID-19 patients: an updated case-control study. Front Cell Infect Microbiol. 2020;10:560899.
Bhowmik KK, Barek MA, Aziz MA, Islam MS. A systematic review and meta-analysis of abnormalities in hematological and biochemical markers among Bangladeshi COVID-19 cases. Health Sci Rep. 2022;5(4):e728.
Pinto V, Ranatunga K, Perera A, Abeyagunawardena M, Karunathilake D, Wijayaratne D, et al. Interim guidelines on management of COVID-19 ICU patients. Ministry of Health, Sri Lanka. 2020. Available from: https://anaesthesia.lk/wp-content/uploads/2020/05/GUIDELINES-ON-MANAGEMENT-OF-COVID-19-ICU-PATIENT-college-Copy.pdf
Lippi G, Plebani M, Henry BM. Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: a meta-analysis. Clin Chim Acta. 2020;506:145–8.
Lippi G, Plebani M, Michael B. Thrombocytopenia in severe COVID-19 cases. Clin Chim Acta. 2020;506:145–8.
Liu J, Liu Y, Xiang P, Pu L, Xiong H, Li C, et al. Neutrophil-to-lymphocyte ratio predicts critical illness in patients with 2019 coronavirus disease in the early stage. J Transl Med. 2020;18(1):206.
Liu H, Liu F, Li J, Zhang T, Wang D, Lan W. Clinical and CT imaging features of COVID-19 pneumonia: focus on pregnant women and children. J Infect. 2020;80(5):e7–e13.
Li N, Han L, Peng M, Lv Y, Ouyang Y, Liu K, et al. Maternal and neonatal outcomes of pregnant women with COVID-19 pneumonia: a case-control study. Clin Infect Dis. 2020;71(16):2035–41.
Juan J, Gil MM, Rong Z, Zhang Y, Yang H, Poon LC. Effect of COVID-19 on maternal, perinatal and neonatal outcome: systematic review. Ultrasound Obstet Gynecol. 2020;56(1):15–27.
Pereira A, Cruz-Melguizo S, Adrien M, Fuentes L, Marin E, Perez-Medina T. Clinical course of coronavirus disease-2019 in pregnancy. Acta Obstet Gynecol Scand. 2020;99(7):839–47.
Connors JM, Levy JH. COVID-19 and its implications for thrombosis and anticoagulation. Blood. 2020;135(23):2033–40.
Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020;18(4):844–7.
Al-Saadi EAKD, Abdulnabi MA. Hematological changes associated with COVID-19 infection. J Clin Lab Anal. 2022;36(1):e24064.
Downloads
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2025 DANIEL OKETCH, Dr. Diana Ondieki, Prof. Ogutu O, Dr. James Amenge, Pamela Mandela, Kennedy Oduor
This work is licensed under a Creative Commons Attribution 4.0 International License.
