Objective: To describe risk factors and outcomes of pregnant women infected with SARS-CoV-2 admitted to South African healthcare facilities. Methods:A population-based cohort study was conducted utilizing an amended International Obstetric Surveillance System protocol. Data on pregnant women with SARS-CoV-2 infection, hospitalized between April 14, 2020, and November 24, 2020, were analyzed.Results: A total of 36 hospitals submitted data on 673 infected hospitalized pregnant women; 217 (32.2%) were admitted for COVID-19 illness and 456 for other indications. There were 39 deaths with a case fatality rate of 6.3%: 32 (14.7%) deaths occurred in women admitted for COVID-19 illness compared to 7 (1.8%) in women admitted for other indications. Of the women, 106 (15.9%) required critical care.Maternal tuberculosis, but not HIV co-infection or other co-morbidities, was associated with admission for COVID-19 illness. Rates of cesarean delivery did not differ significantly between women admitted for COVID-19 and those admitted for other indications. There were 179 (35.4%) preterm births, 25 (4.7%) stillbirths, 12 (2.3%) neonatal deaths, and 162 (30.8%) neonatal admissions. Neonatal outcomes did not differ significantly from those of infected women admitted for other indications. Conclusion:The maternal mortality rate was high among women admitted with SARS-CoV-2 infection and higher in women admitted primarily for COVID-19 illness with tuberculosis being the only co-morbidity associated with admission.

No abstract

Early-onset fetal growth restriction (FGR) and pre-eclampsia is a major cause of perinatal morbidity and mortality. The 2014-2016 South African triennial perinatal mortality audit showed that in the category of neonates above 500 g that died, 14.9% were due to hypertensive disease in pregnancy and 2.3% were due to FGR. 1 Incorrect management of hypertensive disease attributed to 4% of all-cause perinatal mortality. 1 Earlier data (20131 Earlier data ( -2015 showed the leading cause of stillbirths between 28 and 32 weeks of pregnancy was hypertensive disorders and antepartum hemorrhage, with FGR accounting for 7%.

No abstract