Initial review of pregnancy and neonatal outcomes of pregnant women with COVID-19 infection

Abstract

ObjectivesData regarding the pathogenesis and clinical manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continue to emerge, however, there’s limited data in regard to maternal and neonatal outcomes. Therefore, we conducted a retrospective analysis of all pregnant women who tested positive for SARS-CoV-2 within Nuvance Health system.Study designData were abstracted from the medical records of each patient and descriptive analysis was performed. Variables included demographics, COVID testing results, symptoms, management, labor course, neonatal information, and complications.ResultsTotal of 40 patients were identified. Average age was 29.6 years old, 35% were Hispanic, and approximately one in three patients had comorbidities. Of the patients who had repeated testing, the average number of days between first positive test and negative test was 36.8 days (+/− 19.9 days). Three out of four women reported symptoms. Of the 40 pregnant women who were positive for SARS-CoV-2, 25 of them delivered. About 84% of the women delivered after 37 weeks. Twelve percent of the women delivered under 33 and 6/7 weeks. Most patients had vaginal deliveries (68%) and the remaining had cesarean deliveries. Neonatal outcomes included: mean 1 and 5 min Apgar scores of 8 and 8.8, respectively and the mean birth weight was 3212 g. Twenty neonates were tested for SARS-CoV-2 and were all found to be negative.ConclusionOverall, with routine prenatal care and preventive measures, pregnant patients and neonates in our study had good outcomes. At this time, there appears to be no evidence of vertical transmission.

COVID-19 y embarazo: repercusiones maternas y neonatales. Una revisión de la literatura

“…Las condiciones asociadas al embarazo más frecuentes fueron la preeclampsia, descrita en 5 artículos (13,15,16,19,20), con frecuencias del 0,6 % ( 16) hasta el 23,3 % (19) de casos; no obstante, cuando la condición de la paciente fue crítica, se encontró hasta en un 40,4 % (19) de los casos. La hemorragia posparto fue descrita en 5 artículos (12,15,16,18,19), con frecuencias del 1,3 % ( 16) hasta el 25 % (18) de los casos. El aborto espontáneo se reportó en 5 artículos (12,13,19,21,22), con frecuencias del 1 % (19) hasta el 14,2 % (13) de los casos.…”

“…Se identificaron inicialmente 2618 artículos y se añadió luego el filtro de estudios observacionales, que resultó en 49 artículos. De estos se leyeron títulos y resúmenes y, finalmente, se incluyeron 15 artículos (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25), que responden a la pregunta de investigación.…”

SARS-CoV-2 and the role of vertical transmission from infected pregnant women to their fetuses: systematic review.

“…We included 34 primary studies that were not case reports. The primary studies included eight case series (Chaudhary S 2020, Liu W 2020, Masmejan S 2020, Olivini N 2020, Pereira A 2020, Pissarra S 2020, Zhang P 2020, 21 cohort studies (either prospective or retrospective) (Anand P 2020, Ayed A 2020 , Bachani S 2020, Barbero P 2020, Gale C 2020, Fenizia B 2020, He Z 2020, Hu X 2020, Luo Q 2020, Khan MA 2020, Nayak AH 2020, Ogamba I 2020, Oncel MY 2020, Maraschini A 2020, Popofsky S 2020, Smithgall MC 2020,Tang F 2020, Vinuela MC 2020, Vouga M 2020,Yang R 2020, 2 retrospective observational studies , Moreno SC 2020. and one quality improvement project (Cojocaru L 2020), one longitudinal surveillance study (Woodworth KR 2020), and one multi-centre retrospective chart review (Marin Gabriel MA 2020.…”

“…The studies included symptomatic and asymptomatic women; however there did not seem to be a specific correlation between symptom status of the mothers and the likelihood of a positive test in the babies, with some studies reporting on women who had symptoms of COVID-19 either immediately prior to or during hospitalisation, some with severe symptoms, where none of the babies tested positive within 24h of birth (e.g. Liu W 2020, Luo Q 2020, Masmejan S 2020, Moreno SC 2020, Ogamba I 2020, Popofsky S 2020 (See Table 1a). Similarly, the mode of delivery (vaginal birth, caesarean section, emergency caesarean section) did not seem to be correlated to positivity rate amongst neonates; across the included cohort and case series studies, for the 6188 cases where mode of delivery was reported, 3939 were by vaginal delivery, 2122 by caesarean section, and 127 reported as emergency caesarean (Table 1b).…”

“…Of the included studies, 25 studies reported assessment of the placenta, of these 18 were case studies (Alamar I 2020, Birindwa EK 2020, Ferraiolo A 2020, Grimminck K 2020, Kulkarni R 2020, Hsu AL 2020, Lv Y 2020, Palalioglu RM 2020, Pulinx B 2020, Rebello CM 2020, Shende P 2020, Sisman J 2020, Stonoga E 2020, Tang J 2020, Von Kohorn I 2020, Zaigham M 2020, 2 were retrospective case series (Liu W 2020, Masmejan S 2020, 3 were cohort studies (Fenizia B 2020, Ogamba I 2020, Oncel MY 2020 and 2 were a cohort and a case series specifically studying placental samples (Smithgall MC 2020, Zhang P 2020) (Supplementary file Table 4. Findings of studies reporting placenta analysis).…”