ABSTRACT
Objective: To evaluate both short and mid-term effects of maternal COVID-19 on cardiac functions of fetuses and children.
Methods: The present case-control study was conducted on 36 pregnant women who had COVID-19 infection in the second trimester of pregnancy and 30 pregnant women as healthy controls. Fetal, neonatal and infant cardiac functions were compared between the groups. Assessment of fetal cardiac functions were performed in the last trimester of the pregnancy at least 6 weeks after the recovery of infection. The first postnatal echo was performed within the first two weeks and the follow-up (second) echo was performed in the 6-8 weeks of life.
Results: The demografic data were similar between groups. Interventricular septum and left ventricular posterior wall end-diastolic dimensions were significantly higher in the study group in both fetal, neonatal and infant periods. Impaired diastolic functions of right and left ventricles were detected and myocardial performance indexes with tissue doppler imaging of both lateral walls and septum were significantly higher than controls at all periods.
Conclusion: Maternal COVID-19 seems to have a global impact on cardiac functions of babies in the short and mid-term periods after maternal recovery.
KEY WORDS: maternal COVID-19, cardiac function, miyocardial performance index, fetal, infant, echocardiography.
INTRODUCTION :
Pregnant women with COVID-19 are at greater risk for pregnancy complications like preterm delivery and fetal distress. Their newborns are more likely to be admitted to the neonatal ICU [1,4]. SARS-CoV-2 related excessive inflammation, coagulation disorders and hypoxemia may cause placental insufficiency leading to adverse perinatal outcomes and fetal mortality [5].
COVID-19 infection in neonates and children showed mild symptoms and better outcomes compared to adults. But cardiovascular involvement of the SARS-CoV-2 virus and multisystem inflammatory syndrome in neonates and children (MIS-N, MIS-C) seems to be crucial and life-threatening [6,7]. Although, there are some studies in the literature evaluating the effect of COVID-19 on fetal and neonatal cardiac functions, the evidence of long-term cardiovascular outcome of COVID-19 infection and/or MIS-N is scant [8,9]. We aimed to investigate the short and mid-term influence of maternal mild to moderate COVID-19 infection on cardiac functions of fetus, neonate and infant.