Maternal COVID-19 infection, clinical characteristics, pregnancy, and neonatal outcome: A prospective cohort study

Eur J Obstet Gynecol Reprod Biol. 2020 Sep:252:559-562. doi: 10.1016/j.ejogrb.2020.07.008. Epub 2020 Jul 15.

Abstract

Objective: To study the effect of COVID-19 on pregnancy and neonatal outcomes.

Study design: Prospective cohort study in a large tertiary maternity unit within a university hospital with an average annual birth of over 10,000 births. We prospectively collected and analysed data for a cohort of 23 pregnant patients including singleton and multiple pregnancies tested positive for COVID-19 between February 2020 and April 2020 inclusive to assess the effect of COVID-19 on pregnancy, and neonatal outcomes.

Results: Twenty-three pregnant patients tested positive for COVID-19, delivering 20 babies including a set of twins, with four ongoing pregnancies at the time of manuscript submission. 16/23 (70 %) whom tested positive were patients from Asian (Indian sub-continent) background. The severity of the symptoms ranged from mild in 13/23 (65.2 %) of the patients, moderate in 2/23 (8.7 %), and severe in 8/23 (34.8 %). Four out of total 23 COVID-19 pregnant patients (17.4 %) developed severe adult respiratory distress syndrome complications requiring ICU support, one of whom led to maternal death 1/23 (4.3 %). 11/23 (48 %) of the patients had pre-existing co-morbidities, with morbid obesity 5/23 (21.7 %) and diabetes 4/23 (17.4 %) being the more commonly represented. Of the 23 pregnant patients 19 were in their third trimester of pregnancy and delivered; 7/19 (36.8 %) had preterm birth, 3/19 (15.8 %) developed adult respiratory distress syndrome before delivery, and 2/19 (10.5 %) had pre-eclampsia. 16/19 (84 %) of patients delivered by C-section. Out of the 20 new-borns, 18 were singletons with a set of twin.

Conclusion: COVID-19 is associated with high prevalence of preterm birth, preeclampsia, and caesarean section compared to non-COVID pregnancies. COVID-19 infection was not found in the newborns and none developed severe neonatal complications.

Keywords: COVID-19; Coronavirus; Maternal morbidity/mortality; Neonatal morbidity/mortality; Pandemic; Pregnancy.

MeSH terms

  • Adult
  • Betacoronavirus*
  • COVID-19
  • Cesarean Section / statistics & numerical data
  • Coronavirus Infections / complications*
  • Coronavirus Infections / virology
  • Female
  • Humans
  • Infant, Newborn
  • Pandemics
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / virology
  • Pre-Eclampsia / epidemiology
  • Pre-Eclampsia / virology
  • Pregnancy
  • Pregnancy Complications, Infectious / virology*
  • Pregnancy Outcome / epidemiology*
  • Premature Birth / epidemiology
  • Premature Birth / virology
  • Prospective Studies
  • SARS-CoV-2