tetano
Editor, Senior Moderator
BMJ
. 2020 Jun 8;369:m2107.
doi: 10.1136/bmj.m2107.
Characteristics and Outcomes of Pregnant Women Admitted to Hospital With Confirmed SARS-CoV-2 Infection in UK: National Population Based Cohort Study
Marian Knight[SUP] 1 [/SUP], Kathryn Bunch[SUP] 2 [/SUP], Nicola Vousden[SUP] 3 [/SUP], Edward Morris[SUP] 4 [/SUP], Nigel Simpson[SUP] 5 [/SUP], Chris Gale[SUP] 6 [/SUP], Patrick O'Brien[SUP] 7 [/SUP], Maria Quigley[SUP] 2 [/SUP], Peter Brocklehurst[SUP] 8 [/SUP], Jennifer J Kurinczuk[SUP] 2 [/SUP], UK Obstetric Surveillance System SARS-CoV-2 Infection in Pregnancy Collaborative Group
Affiliations
Abstract
Objectives: To describe a national cohort of pregnant women admitted to hospital with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the UK, identify factors associated with infection, and describe outcomes, including transmission of infection, for mothers and infants.
Design: Prospective national population based cohort study using the UK Obstetric Surveillance System (UKOSS).
Setting: All 194 obstetric units in the UK.
Participants: 427 pregnant women admitted to hospital with confirmed SARS-CoV-2 infection between 1 March 2020 and 14 April 2020.
Main outcome measures: Incidence of maternal hospital admission and infant infection. Rates of maternal death, level 3 critical care unit admission, fetal loss, caesarean birth, preterm birth, stillbirth, early neonatal death, and neonatal unit admission.
Results: The estimated incidence of admission to hospital with confirmed SARS-CoV-2 infection in pregnancy was 4.9 (95% confidence interval 4.5 to 5.4) per 1000 maternities. 233 (56%) pregnant women admitted to hospital with SARS-CoV-2 infection in pregnancy were from black or other ethnic minority groups, 281 (69%) were overweight or obese, 175 (41%) were aged 35 or over, and 145 (34%) had pre-existing comorbidities. 266 (62%) women gave birth or had a pregnancy loss; 196 (73%) gave birth at term. Forty one (10%) women admitted to hospital needed respiratory support, and five (1%) women died. Twelve (5%) of 265 infants tested positive for SARS-CoV-2 RNA, six of them within the first 12 hours after birth.
Conclusions: Most pregnant women admitted to hospital with SARS-CoV-2 infection were in the late second or third trimester, supporting guidance for continued social distancing measures in later pregnancy. Most had good outcomes, and transmission of SARS-CoV-2 to infants was uncommon. The high proportion of women from black or minority ethnic groups admitted with infection needs urgent investigation and explanation.
Study registration: ISRCTN 40092247.
. 2020 Jun 8;369:m2107.
doi: 10.1136/bmj.m2107.
Characteristics and Outcomes of Pregnant Women Admitted to Hospital With Confirmed SARS-CoV-2 Infection in UK: National Population Based Cohort Study
Marian Knight[SUP] 1 [/SUP], Kathryn Bunch[SUP] 2 [/SUP], Nicola Vousden[SUP] 3 [/SUP], Edward Morris[SUP] 4 [/SUP], Nigel Simpson[SUP] 5 [/SUP], Chris Gale[SUP] 6 [/SUP], Patrick O'Brien[SUP] 7 [/SUP], Maria Quigley[SUP] 2 [/SUP], Peter Brocklehurst[SUP] 8 [/SUP], Jennifer J Kurinczuk[SUP] 2 [/SUP], UK Obstetric Surveillance System SARS-CoV-2 Infection in Pregnancy Collaborative Group
Affiliations
- PMID: 32513659
- DOI: 10.1136/bmj.m2107
Abstract
Objectives: To describe a national cohort of pregnant women admitted to hospital with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the UK, identify factors associated with infection, and describe outcomes, including transmission of infection, for mothers and infants.
Design: Prospective national population based cohort study using the UK Obstetric Surveillance System (UKOSS).
Setting: All 194 obstetric units in the UK.
Participants: 427 pregnant women admitted to hospital with confirmed SARS-CoV-2 infection between 1 March 2020 and 14 April 2020.
Main outcome measures: Incidence of maternal hospital admission and infant infection. Rates of maternal death, level 3 critical care unit admission, fetal loss, caesarean birth, preterm birth, stillbirth, early neonatal death, and neonatal unit admission.
Results: The estimated incidence of admission to hospital with confirmed SARS-CoV-2 infection in pregnancy was 4.9 (95% confidence interval 4.5 to 5.4) per 1000 maternities. 233 (56%) pregnant women admitted to hospital with SARS-CoV-2 infection in pregnancy were from black or other ethnic minority groups, 281 (69%) were overweight or obese, 175 (41%) were aged 35 or over, and 145 (34%) had pre-existing comorbidities. 266 (62%) women gave birth or had a pregnancy loss; 196 (73%) gave birth at term. Forty one (10%) women admitted to hospital needed respiratory support, and five (1%) women died. Twelve (5%) of 265 infants tested positive for SARS-CoV-2 RNA, six of them within the first 12 hours after birth.
Conclusions: Most pregnant women admitted to hospital with SARS-CoV-2 infection were in the late second or third trimester, supporting guidance for continued social distancing measures in later pregnancy. Most had good outcomes, and transmission of SARS-CoV-2 to infants was uncommon. The high proportion of women from black or minority ethnic groups admitted with infection needs urgent investigation and explanation.
Study registration: ISRCTN 40092247.