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

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