tetano
Editor, Senior Moderator
PLoS One
. 2022 Mar 11;17(3):e0264901.
doi: 10.1371/journal.pone.0264901. eCollection 2022.
SARS-CoV-2 infection in pregnant women assisted in a high-risk maternity hospital in Brazil: Clinical aspects and obstetric outcomes
Carolina Loyola Prest Ferrugini[SUP] 1 [/SUP], Neide Aparecida Tosato Boldrini[SUP] 2 [/SUP], Franco Luis Salume Costa[SUP] 1 [/SUP], Michelle Anne de Oliveira Batista Salgueiro[SUP] 3 [/SUP], Pamella Dunga de Paula Coelho[SUP] 4 [/SUP], Angelica Espinosa Miranda[SUP] 1 [/SUP]
Affiliations
Abstract
Background: The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the possible development of serious illness, and the possibility of severe obstetric outcomes highlight the importance of addressing SARS-CoV-2 infection in obstetric management.
Methods and findings: A cross-sectional study of pregnant women assisted in a high-risk maternity hospital in Brazil in 2020. All patients admitted for delivery or miscarriage care were tested for SARS-CoV-2 using polymerase chain reaction (PCR) and for immunoglobulin (I)gM, and/or IgG by immunochromatography. Clinical aspects and obstetric outcomes were analyzed. A total of 265 pregnant women were included in the study. There were 38 (14.4%) PCR positive cases during pregnancy, 12 (31.6%) on admission screening, and 71(27.2%) patients were IgM- and/or IgG-positive. Among the participants, 86 (32.4%) had at least one positive test during pregnancy. SARS-CoV-2 positive patients had greater contact with known positive patients (p = 0.005). The most frequently reported symptoms were runny nose, cough, loss of smell and taste, headache, and fever. There was also a 35% rate of asymptomatic infections and a 4.6% rate of severe or critical infections. Patients exposed or infected with SARS-CoV-2 had a higher incidence of preterm delivery, cesarean section, need for resuscitation in the delivery room, Apgar score <7 at 5 min, admission to the neonatal intensive care unit, and jaundice. Newborns with at least one positive test had a significantly greater need for phototherapy after delivery (p = 0.05). The results showed a high rate of positive tests among newborns (37.5%), which seems to be compatible with both neonatal and perinatal infection.
Conclusions: It is important to further investigate SARS-CoV-2 infection during pregnancy, including the clinical course and the possibility of adverse outcomes with impact on maternal and fetal health, regardless of the development of symptoms.
. 2022 Mar 11;17(3):e0264901.
doi: 10.1371/journal.pone.0264901. eCollection 2022.
SARS-CoV-2 infection in pregnant women assisted in a high-risk maternity hospital in Brazil: Clinical aspects and obstetric outcomes
Carolina Loyola Prest Ferrugini[SUP] 1 [/SUP], Neide Aparecida Tosato Boldrini[SUP] 2 [/SUP], Franco Luis Salume Costa[SUP] 1 [/SUP], Michelle Anne de Oliveira Batista Salgueiro[SUP] 3 [/SUP], Pamella Dunga de Paula Coelho[SUP] 4 [/SUP], Angelica Espinosa Miranda[SUP] 1 [/SUP]
Affiliations
- PMID: 35275942
- PMCID: PMC8916667
- DOI: 10.1371/journal.pone.0264901
Abstract
Background: The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the possible development of serious illness, and the possibility of severe obstetric outcomes highlight the importance of addressing SARS-CoV-2 infection in obstetric management.
Methods and findings: A cross-sectional study of pregnant women assisted in a high-risk maternity hospital in Brazil in 2020. All patients admitted for delivery or miscarriage care were tested for SARS-CoV-2 using polymerase chain reaction (PCR) and for immunoglobulin (I)gM, and/or IgG by immunochromatography. Clinical aspects and obstetric outcomes were analyzed. A total of 265 pregnant women were included in the study. There were 38 (14.4%) PCR positive cases during pregnancy, 12 (31.6%) on admission screening, and 71(27.2%) patients were IgM- and/or IgG-positive. Among the participants, 86 (32.4%) had at least one positive test during pregnancy. SARS-CoV-2 positive patients had greater contact with known positive patients (p = 0.005). The most frequently reported symptoms were runny nose, cough, loss of smell and taste, headache, and fever. There was also a 35% rate of asymptomatic infections and a 4.6% rate of severe or critical infections. Patients exposed or infected with SARS-CoV-2 had a higher incidence of preterm delivery, cesarean section, need for resuscitation in the delivery room, Apgar score <7 at 5 min, admission to the neonatal intensive care unit, and jaundice. Newborns with at least one positive test had a significantly greater need for phototherapy after delivery (p = 0.05). The results showed a high rate of positive tests among newborns (37.5%), which seems to be compatible with both neonatal and perinatal infection.
Conclusions: It is important to further investigate SARS-CoV-2 infection during pregnancy, including the clinical course and the possibility of adverse outcomes with impact on maternal and fetal health, regardless of the development of symptoms.