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COVID-19 and Women’s Health

118 Pregnant Women with COVID-19: Treatments and Outcomes

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BACKGROUND AND PURPOSE:

  • Chen et al. (NEJM, 2020) report on the clinical characteristics and outcomes of pregnant women with COVID-19 in Wuhan, China

METHODS:

  • Case series (December 8, 2019, to March 20, 2020)
  • Participants
    • Pregnant women
  • COVID-19 diagnosis based on
    • Lab confirmation using RT-PCR test or suggestive CT findings
  • Degree of severity
    • Severe: Respiratory rate ≥ 30 breaths/min | PaO2/FIO2 <300 mmHg | SpO2 ≤93% on room air at rest
    • Critical: Occurrence of severe respiratory distress | Respiratory failure requiring mechanical ventilation | Shock and organ failure

RESULTS:

  • 118 pregnant patients with COVID-19 were identified
    • Positive RT-PCR test: 71%
    • Suggestive findings on CT of the chest: 29%
    • Median age 31 years (IQR 28 to 34) | 52% nulliparous
    • 64% were infected with SARS-CoV-2 in their third trimester
  • Presenting symptoms
    • Fever: 75%
    • Cough: 73%
  • Lab and chest CT characteristics
    • Lymphopenia: 44%
    • Infiltrates in both lungs on chest CT: 79%
  • Disease severity
    • Mild disease: 92%
    • Severe disease: 8% | Developed after delivery in 6 of 9 women
    • Critical disease: 1 patient | Developed after delivery
  • Disease outcomes
    • Discharged: 94% (including all women with severe or critical disease)
    • Deaths: 0%
  • Pregnancy outcomes
    • There were 3 spontaneous abortions, 2 ectopic pregnancies, and 4 induced abortions (all due to patients’ concerns about COVID-19)
    • Deliveries during study period: 58%
      • Cesarean section: 93% | 61% performed due to COVID-19 concerns
      • Premature: 21% | 8 were induced (7 of these due to COVID-19 concerns)
    • No babies had neonatal asphyxia
  • Newborn outcomes
    • SARS-CoV-2: Testing was done on 8 neonatal throat swabs and 3 breast milk samples | All tests reported negative

CONCLUSION:

  • Risk of severe COVID-19 in this population of pregnant women (8%) appears favorable to risk in the general population (15.7%) in mainland China
  • The authors conclude that, unlike influenza, pregnant patients with COVID-19 do not appear to be at a higher risk of severe disease

Learn More – Primary Sources:

Clinical Characteristics of Pregnant Women with Covid-19 in Wuhan, China

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Related ObG Topics:

Coronavirus and Pregnancy: CDC Guidance and Professional Recommendations
43 Pregnant Women with COVID-19: Clinical Course and Outcomes
COVID-19 Case Series: Pregnancy and Infant Outcomes
COVID-19 in Newborns: What are the Clinical Features and Outcomes?
Vertical Transmission in Pregnancies with Confirmed COVID-19

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