BACKGROUND AND PURPOSE:

• Kayem et al. (Journal of Gynecology Obstetrics and Human Reproduction, 2020) describe the course of COVID-19 in French pregnant women

METHODS:

• Case series (between March 1 and April 14, 2020)
• Setting
  • 33 French maternity units
• Participants
  • Pregnant women with confirmed COVID-19 (RT-PCR nasal sample or chest CT)
• Data collection
  • Patient demographic data, baseline comorbidities, and pregnancy outcomes
• Primary outcome
  • COVID-19: Requiring oxygen
  • Critical COVID-19: Invasive mechanical ventilation or ECMO

RESULTS:

• Temporal trends
  • Active cases increased exponentially in March
  • Lockdown began March 17
  • April 1-14: Number of cases fell
  • On April 14^th, there were 617 pregnant women with COVID-19
• COVID-19 clinical outcomes (April 14)
  • Required oxygen therapy: 15.1% of cases (95% CI, 12.3 to 18.1; 93 patients)
  • Critical COVID-19: 5.7% of total cases (95% CI, 4.0 to 7.8; 35 cases)
  • Mortality: 0.2% of cases (95% CI, 0 to 0.9; 1 patient with critical disease)
• Risk factors for serious disease
  • Age >35 years
  • Obesity
  • Preexisting diabetes
  • Previous preeclampsia
  • Gestational hypertension
  • Preeclampsia
• 181 Women Delivered | Cesarean 48.1% | Cesarean for COVID-19 24.9%
  • Fetal loss (14 to 21 weeks): 2.8% (5/181 deliveries)
  • Intrauterine intrapartum fetal death: 1.3% (7/181)
• Rates of preterm birth
  • <37 weeks
    • Non-severe cases: 10.6% (13 of 123 patients)
    • Oxygen-requiring cases: 48.3% (14 of 29 patients)
    • Critical cases: 79.3% (23 of 29 patients)
  • Before 32 weeks’
    • Non-severe cases: 2.4% (3 of 123 patients)
    • Oxygen-requiring cases: 13.8% (4 of 29 patients)
    • Critical cases: 48.3% (14 of 29 patients)
  • One neonate in the critical group died from prematurity
    • 0.5% (95% CI, 0.01 to 2.9)
• Neonatal infection
  • 2 neonates (1.1%) were positive for SARS-CoV-2

CONCLUSIONS:

• Risk factors for serious COVID-19 while pregnant are similar to risk factors for severe disease within the general population
  • Advanced age
  • Obesity
  • Hypertension and preeclampsia
  • Diabetes
• Rates of preterm birth increased with worsening disease severity

Learn More – Primary Sources:

A snapshot of the Covid-19 pandemic among pregnant women in France

Related ObG Topics:

118 Pregnant Women with COVID-19: Treatments and Outcomes

COVID-19 Case Series: Pregnancy and Infant Outcomes

CDC Reports on Pregnancy and COVID-19 Outcomes

The UKOSS COVID-19 Pregnancy Registry: Update on 427 Patients Admitted to Hospital