tetano
Editor, Senior Moderator
Am J Obstet Gynecol. 2020 Apr 23. pii: S0002-9378(20)30462-2. doi: 10.1016/j.ajog.2020.04.014. [Epub ahead of print]
Coronavirus disease 2019 (COVID-19) in pregnant women: A report based on 116 cases.
Yan J[SUP]1[/SUP], Guo J[SUP]2[/SUP], Fan C[SUP]3[/SUP], Juan J[SUP]1[/SUP], Yu X[SUP]2[/SUP], Li J[SUP]2[/SUP], Feng L[SUP]4[/SUP], Li C[SUP]3[/SUP], Chen H[SUP]2[/SUP], Qiao Y[SUP]2[/SUP], Lei D[SUP]3[/SUP], Wang C[SUP]1[/SUP], Xiong G[SUP]5[/SUP], Xiao F[SUP]6[/SUP], He W[SUP]7[/SUP], Pang Q[SUP]8[/SUP], Hu X[SUP]9[/SUP], Wang S[SUP]10[/SUP], Chen D[SUP]11[/SUP], Zhang Y[SUP]12[/SUP], Poon LC[SUP]13[/SUP], Yang H[SUP]14[/SUP].
Author information
Abstract
BACKGROUND:
The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a global public health emergency. Data on the effect of COVID-19 in pregnancy are limited to small case series.
OBJECTIVES:
To evaluate the clinical characteristics and outcomes in pregnancy and the vertical transmission potential of SARS-CoV-2 infection.
STUDY DESIGH:
Clinical records were retrospectively reviewed for 116 pregnant women with COVID-19 pneumonia from 25 hospitals in China between January 20 and March 24, 2020. Evidence of vertical transmission was assessed by testing for SARS-CoV-2 in amniotic fluid, cord blood, and neonatal pharyngeal swab samples.
RESULTS:
The median gestational age on admission was 38[SUP]+0[/SUP] (IQR 36[SUP]+0[/SUP]-39[SUP]+1[/SUP]) weeks. The most common symptoms were fever (50.9%, 59/116) and cough (28.4%, 33/116); 23.3% (27/116) patients presented without symptoms. Abnormal radiologic findings were found in 96.3% (104/108) of cases. There were eight cases (6.9%, 8/116) of severe pneumonia but no maternal deaths. One of eight patients (1/8) that presented in the first- and early-second-trimester had a missed spontaneous abortion. Twenty-one of 99 patients (21.2%, 21/99) that had delivered had preterm birth, including six with preterm premature ruptured of membranes. The rate of spontaneous preterm birth before 37 weeks was 6.1% (6/99). There was one case of severe neonatal asphyxia that resulted in neonatal death. Eighty-six of the 100 neonates that had testing for SARS-CoV-2 had negative results, of these ten neonates had paired amniotic fluid and cord blood samples that were tested negative for SARS-CoV-2.
CONCLUSIONS:
SARS-CoV-2 infection during pregnancy is not associated with an increased risk of spontaneous abortion and spontaneous preterm birth. There is no evidence of vertical transmission of SARS-CoV-2 infection when the infection manifests during the third-trimester of pregnancy.
Copyright ? 2020 Elsevier Inc. All rights reserved.
KEYWORDS:
Ascending infection; COVID-19; Coronavirus; PTB; SARS-CoV-2; coronavirus disease 2019; pandemic; pneumonia; pregnancy; pregnancy outcomes; pregnant women; preterm birth; severe acute respiratory syndrome coronavirus 2; spontaneous PTB; spontaneous abortion; spontaneous preterm birth; vertical transmission
PMID:32335053DOI:10.1016/j.ajog.2020.04.014
Coronavirus disease 2019 (COVID-19) in pregnant women: A report based on 116 cases.
Yan J[SUP]1[/SUP], Guo J[SUP]2[/SUP], Fan C[SUP]3[/SUP], Juan J[SUP]1[/SUP], Yu X[SUP]2[/SUP], Li J[SUP]2[/SUP], Feng L[SUP]4[/SUP], Li C[SUP]3[/SUP], Chen H[SUP]2[/SUP], Qiao Y[SUP]2[/SUP], Lei D[SUP]3[/SUP], Wang C[SUP]1[/SUP], Xiong G[SUP]5[/SUP], Xiao F[SUP]6[/SUP], He W[SUP]7[/SUP], Pang Q[SUP]8[/SUP], Hu X[SUP]9[/SUP], Wang S[SUP]10[/SUP], Chen D[SUP]11[/SUP], Zhang Y[SUP]12[/SUP], Poon LC[SUP]13[/SUP], Yang H[SUP]14[/SUP].
Author information
Abstract
BACKGROUND:
The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a global public health emergency. Data on the effect of COVID-19 in pregnancy are limited to small case series.
OBJECTIVES:
To evaluate the clinical characteristics and outcomes in pregnancy and the vertical transmission potential of SARS-CoV-2 infection.
STUDY DESIGH:
Clinical records were retrospectively reviewed for 116 pregnant women with COVID-19 pneumonia from 25 hospitals in China between January 20 and March 24, 2020. Evidence of vertical transmission was assessed by testing for SARS-CoV-2 in amniotic fluid, cord blood, and neonatal pharyngeal swab samples.
RESULTS:
The median gestational age on admission was 38[SUP]+0[/SUP] (IQR 36[SUP]+0[/SUP]-39[SUP]+1[/SUP]) weeks. The most common symptoms were fever (50.9%, 59/116) and cough (28.4%, 33/116); 23.3% (27/116) patients presented without symptoms. Abnormal radiologic findings were found in 96.3% (104/108) of cases. There were eight cases (6.9%, 8/116) of severe pneumonia but no maternal deaths. One of eight patients (1/8) that presented in the first- and early-second-trimester had a missed spontaneous abortion. Twenty-one of 99 patients (21.2%, 21/99) that had delivered had preterm birth, including six with preterm premature ruptured of membranes. The rate of spontaneous preterm birth before 37 weeks was 6.1% (6/99). There was one case of severe neonatal asphyxia that resulted in neonatal death. Eighty-six of the 100 neonates that had testing for SARS-CoV-2 had negative results, of these ten neonates had paired amniotic fluid and cord blood samples that were tested negative for SARS-CoV-2.
CONCLUSIONS:
SARS-CoV-2 infection during pregnancy is not associated with an increased risk of spontaneous abortion and spontaneous preterm birth. There is no evidence of vertical transmission of SARS-CoV-2 infection when the infection manifests during the third-trimester of pregnancy.
Copyright ? 2020 Elsevier Inc. All rights reserved.
KEYWORDS:
Ascending infection; COVID-19; Coronavirus; PTB; SARS-CoV-2; coronavirus disease 2019; pandemic; pneumonia; pregnancy; pregnancy outcomes; pregnant women; preterm birth; severe acute respiratory syndrome coronavirus 2; spontaneous PTB; spontaneous abortion; spontaneous preterm birth; vertical transmission
PMID:32335053DOI:10.1016/j.ajog.2020.04.014