BACKGROUND AND PURPOSE:

• Zlatkin et al. (BMC Pregnancy Childbirth, 2022) determined maternal, obstetrical, and perinatal outcomes of women who gave birth while infected with SARS-CoV-2

METHODS:

• Case-control study
  • April 2020 to February 2021
  • Tertiary care center
• Population
  • Patients diagnosed with COVID-19 during pregnancy
• Exposures
  • Active SARS-CoV-2 infection during delivery
  • Recovery from infection at least 10 days before labor and delivery
• Study design
  • All pregnant women are routinely screened upon admission
  • Patients with active SARS-CoV-2 infection give birth in a positively pressured delivery room | Each patient is supervised by a dedicated midwife
  • Antepartum and/or postpartum COVID-19 treatment for hospitalized patients: Prophylactic LMWH alone if symptomatic | Combined with dexamethasone 6 mg daily for 10 days or until discharge for patients with severe disease 
• Primary outcome
  • Mode of delivery
• Secondary outcomes
  • Maternal infection characteristics such as disease severity
  • Perinatal complications

RESULTS:

• Infected at time of delivery: 84 participants | Recovered: 92 participants
• There was no statistically significant between-group difference in
  • Mean gestational age at delivery (P=0.71)
    • Infected: 39 weeks
    • Recovered: 39 weeks
  • Overall rate of cesarean delivery (P=0.35)
    • Infected: 26.2%
    • Recovered: 17.4%
  • Rate of non-elective cesarean delivery (P=0.48)
    • Infected: 10.71%
    • Recovered: 4.34%
• Disease severity in the active-infection group
  • Severe diseases: 2.4% | 5 women
  • Critical disease: 3.6% | 3 women admitted to ICU, requiring cesarean delivery to facilitate care
  • There were no severe or critical disease cases in the recovered group
• There were no differences between the groups for adverse perinatal outcomes

CONCLUSION:

• Overall, delivery with an active SARS-CoV-2 infection appears to be as safe as delivery is in those who have recovered from a SARS-CoV-2 infection
• Most women admitted with active infection were asymptomatic
• Among the active infection group, the authors found that there was

… a trend toward higher rates of severe and critical COVID-19 disease, ICU admission, mechanical ventilation, preterm delivery, and emergent caesarean deliveries mostly related to COVID-19 severity

Learn More – Primary Sources:

Obstetric and perinatal outcomes in parturients with active SARS-CoV-2 infection during labor and delivery: a retrospective cohort study

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