Coronavirus disease 2019 in pregnancy was associated with maternal morbidity and preterm birth

Abstract

BACKGROUND: Despite the mainly reassuring outcomes for pregnant women with coronavirus disease 2019 reported by previous case series with small sample sizes, some recent reports of severe maternal morbidity requiring intubation and of maternal deaths show the need for additional data about the impact of coronavirus disease 2019 on pregnancy outcomes. OBJECTIVE: This study aimed to report the maternal characteristics and clinical outcomes of pregnant women with coronavirus disease 2019. STUDY DESIGN: This retrospective, single-center study includes all consecutive pregnant women with confirmed (laboratory-confirmed) or suspected (according to the Chinese management guideline [version 7.0]) coronavirus disease 2019, regardless of gestational age at diagnosis, admitted to the Strasbourg University Hospital (France) from March 1, 2020, to April 3, 2020. Maternal characteristics, laboratory and imaging findings, and maternal and neonatal outcomes were extracted from medical records. RESULTS: The study includes 54 pregnant women with confirmed (n¼38) and suspected (n¼16) coronavirus disease 2019. Of these, 32 had an ongoing pregnancy, 1 had a miscarriage, and 21 had live births: 12 vaginal and 9 cesarean deliveries. Among the women who gave birth, preterm deliveries were medically indicated for their coronavirus disease 2019erelated condition for 5 of 21 women (23.8%): 3 (14.3%) before 32 weeks' gestation and 2 (9.5%) before 28 weeks' gestation. Oxygen support was required for 13 of 54 women (24.1%), including high-flow oxygen (n¼2), noninvasive (n¼1) and invasive (n¼3) mechanical ventilation, and extracorporeal membrane oxygenation (n¼1). Of these, 3, aged 35 years or older with positive test result for severe acute respiratory syndrome coronavirus 2 using reverse transcription polymerase chain reaction, had respiratory failure requiring indicated delivery before 29 weeks' gestation. All 3 women were overweight or obese, and 2 had an additional comorbidity. CONCLUSION: Coronavirus disease 2019 in pregnancy was associated with maternal morbidity and preterm birth. Its association with other well-known risk factors for severe maternal morbidity in pregnant women with no infection, including maternal age above 35 years, overweight, and obesity, suggests further studies are required to determine whether these risk factors are also associated with poorer maternal outcome in these women.

Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis

“…Eight studies (95 247 women) compared pregnant populations with non-pregnant populations,2526272829303132 and four studies (2230 women) compared pregnant women with covid-19 versus pregnant women without covid-19 33343536. Forty cohort studies reported on clinical manifestations (13 018 pregnant, 85 084 non-pregnant women),25262728293031323536373839404142434445464748495051525354555657585960616263646566 45 studies reported on covid-19 related maternal outcomes (14 094 pregnant, 85 169 non-pregnant women),2526272829303132353637383940414243454647484950515354555657585961626364656667…”

Maternal and neonatal characteristics and outcomes among COVID-19 infected women: An updated systematic review and meta-analysis

“…In addition, 2 studies were excluded due to duplicity of data reporting. Out of 27 studies [ [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] ], 16 studies were from China (14 were from Hubei province and 2 from Guangzhou) and 4 studies was from USA [ [44] , [45] , [46] , [47] ], 2 from France [ 48 , 49 ], 2 from Italy [ 50 , 51 ], 1 from UK [ 52 ], 1 from Spain [ 53 ], and 1 from Iran [ 54 ]. Of 27 studies, 4 studies (n = 233) also included a control group [ [38] , [39] , [40] , [41] ].…”

Clinical manifestations and perinatal outcomes of pregnant women with COVID-19: a systematic review and meta-analysis

“…Thereafter, 169 articles were excluded for the following reasons: reviews and expert opinions (n = 55); case reports with less than 10 cases (n = 52); irrelevant studies (n = 17); studies without confirmation of COVID-19 by polymerase chain reaction (PCR) tests (n = 9); studies only including the infants born to mothers without confirmed COVID-19 (n = 7); and overlapping studies (n = 29). Hence, eleven studies on 9032 pregnant women with COVID-19 and 338 neonates were ultimately included for meta-analysis [17][18][19][20][21][22][23][24][25][26][27] . The main characteristics of the included studies are listed in Table 1.…”