METHOD: A retrospective observational study amongst AMA mothers was done in Universiti Kebangsaan Malaysia Medical Centre, a Malaysian teaching hospital. The data over a period of three years (January 2013 - December 2016) obtained from the Maternal Foetal Medicine clinic registry was analysed. AMA mothers with singleton pregnancy presenting for foetal structural anomaly scan was included. They were later subdivided into 2 groups (35-39 years and ≥ 40 years). The logistic regression analysis was used to analyse the association of the chromosomal anomalies and the age groups.
RESULTS: In all 486 patients were recruited and 84 patients were identified with foetal anomaly (17.3%). There was no significant difference in the prevalence of foetal anomalies or significant association with a specific structural foetal anomaly identified (p>0.05). However, the number of followups for these patients are significantly higher (p<0.001).
CONCLUSION: The prevalence of structural foetal anomalies identified in detailed ultrasonography was low in AMA mothers. Hence, referral criteria for detailed anomaly ultrasonography need to be re-looked.
METHODS: This was a retrospective study conducted in HCTM from January 2021 to January 2022. All pregnant women admitted for COVID-19 infections were recruited. The patients' records were traced. Adverse maternal and neonatal outcomes were documented and analysed.
RESULTS: There were 172 pregnant women recruited into this study. We excluded twenty-four patients with incomplete data and nine women who delivered elsewhere. The final 139 patients were available for data analysis. The majority of women were in their third trimester of pregnancy (87.8%); however, only 5.0% and 7.2% were in the first and second trimesters, respectively. The study population had a median BMI of 29.1 kg/m2 and almost half of them had never received a COVID-19 vaccination. A sub-analysis of data concerning adverse maternal and foetal outcomes comparing early vs. severe stages of COVID-19 infection showed that severe-stage disease increased the risk of preterm birth (54.5% vs. 15.4%, p < 0.001) and preterm birth before 34 weeks (31.9% vs. 2.6%, p < 0.001) significantly. The severe-stage disease also increased NICU admission (40.9% vs. 15.4%, p = 0.017) with lower birth weight (2995 g vs. 2770 g, p = 0.017). The unvaccinated mothers had an increased risk of preterm birth before 34 weeks and this was statistically significant (11.6% vs. 2.9%, p = 0.048).
CONCLUSIONS: Adverse pregnancy outcomes such as ICU admission or patient death could occur; however, the clinical course of COVID-19 in most women was not severe and the infection did not significantly influence the pregnancy. The risk of preterm birth before 34 weeks was higher in a more severe-stage disease and unvaccinated mother. The findings from this study can guide and enhance antenatal counselling of women with COVID-19 infection, although they should be interpreted with caution in view of the very small number of included cases of patients in the first and second trimesters.