Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre, descriptive study

Abstract

Background In December, 2019, coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China. The number of affected pregnant women is increasing, but scarce information is available about the clinical features of COVID-19 in pregnancy. This study aimed to clarify the clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19. MethodsIn this retrospective, single-centre study, we included all pregnant women with COVID-19 who were admitted to Tongji Hospital in Wuhan, China. Clinical features, treatments, and maternal and fetal outcomes were assessed.Findings Seven patients, admitted to Tongji Hospital from Jan 1, to Feb 8, 2020, were included in our study. The mean age of the patients was 32 years (range 29-34 years) and the mean gestational age was 39 weeks plus 1 day (range 37 weeks to 41 weeks plus 2 days). Clinical manifestations were fever (six [86%] patients), cough (one [14%] patient), shortness of breath (one [14%] patient), and diarrhoea (one [14%] patient). All the patients had caesarean section within 3 days of clinical presentation with an average gestational age of 39 weeks plus 2 days. The final date of followup wasFeb 12, 2020. The outcomes of the pregnant women and neonates were good. Three neonates were tested for SARS-CoV-2 and one neonate was infected with SARS-CoV-2 36 h after birth.Interpretation The maternal, fetal, and neonatal outcomes of patients who were infected in late pregnancy appeared very good, and these outcomes were achieved with intensive, active management that might be the best practice in the absence of more robust data. The clinical characteristics of these patients with COVID-19 during pregnancy were similar to those of non-pregnant adults with COVID-19 that have been reported in the literature.

Clinical Manifestations of Children with COVID-19: a Systematic Review

“…Clinical outcomes of death, discharged or still hospitalized were described for 371 cases in 32 studies. 3,5,[21][22][23][24][25][26][27][28][29]31,11,[33][34][35][36][37][38][39][40][41][42]12,44,45,13,14,[16][17][18]20 Of these, 62 cases were still hospitalized when studies were submitted, 308 were discharged and 1 died.…”

“…Of 293 potentially relevant articles identified by the search strategy, 38 met the inclusion criteria. A total of 1117 descriptions of pediatric cases 3,5,18-27,10,28-37,11,38-40,12-17 and 7 neonate cases [41][42][43][44][45] of COVID-19 were obtained, being that 643 were males 478 were females, and 3 were not disclosed. The flow diagram (Figure 1) summarizes the steps followed to identify the studies meeting the inclusion criteria.…”

Knowledge and practice of preventive measures against COVID-19 infection among pregnant women in a low-resource African setting

“…Although, case reports from advanced countries about the outcome of coronavirus disease in pregnancy appear to be good 8 and and these outcomes were achieved with intensive, active management that might be absent in most developing countries due to poor healthcare system prevalent in resource-constrained settings. Therefore, pregnant women require special attention in relation to prevention, diagnosis, and management.…”

“…6,7 However, there is little information on Covid-19 infection during pregnancy. [7][8][9] There are limited case series reporting the impact on women affected by coronaviruses (CoV) during pregnancy. 1,2,6 In women affected by other coronavirus infections such as .…”

Effects of COVID-19 infection during pregnancy and neonatal prognosis: what is the evidence?

“…All the studies adopting a descriptive cross-sectional design (42%) [16,17,18,19,20] were conducted in China and addressed 40 (33.6%) pregnant women infected with COVID-19, predominantly in the third trimester of pregnancy (95%), presenting at least one prior comorbidity (60%). Fever at admission (58%) and postpartum (28%), cough (20%), and dyspnea (13%) were the primary clinical findings.…”