Obstetric complications and perinatal outcomes in patients with chickenpox

Objective. The aim of the research was to study of the obstetric complications and perinatal outcomes in patients with chickenpox.

Materials and methods. A retrospective analysis of 47 case histories of patients who had chickenpox within 3 weeks before labor and women who became ill within 48 hours postpartumn, was carried out. The average age of the patients was 28.38 ± 4.96 years. The clinical features of the course of chickenpox in the perinatal period, the structure of obstetric complications, features of the course of labor and outcomes for newborns were established. Statistical data processing was carried out with the IBM SPSS Statistics 27.0 program and the online calculator https://www.medcalc.org/calc/odds_ratio.php.

Results. In the study group, multiparous patients predominated – 30/47 (63.83%). At the time of birth, most of the patients were in the period of early convalescence – 20/47, 13/47 in the period of rashes, 12/47 in the period of late convalescence, 2/47 in the incubation period for chickenpox. There was a statistically significant decrease in Apgar scores at 1 minute of life in newborns (p = 0.04) in the group of women in labor with active viremia (48 hours before the onset of maternal illness – day 5 of rash (n = 15) compared with the group of women in labor in the period of late convalescence. In the study, complications such as premature rupture of the foetal membrane and subinvolution of the uterus were more frequent than in the general population, and were 13/47 (27.7%) and 5/47 (10.6%), respectively. The most frequent complication during pregnancy was preeclampsia (13/47 of patients). The incidence of congenital varicella in newborns was 3/47 (6.4 per cent), mortality rate among newborns with congenital varicella was 33.33 per cent. We found evidence of a significant association between preeclampsia and congenital varicella (OR = 23, 95% CI: 1.1-482.12, p < 0,05). Preeclampsia patients also had an extended rash period (p = 0.009).

Conclusion. The number of complications of pregnancy, labor and the post-partum period is high among patients with chickenpox. Preeclampsia is a risk factor for neonatal varicella and lingering varicella in the mother.

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