Maternal and perinatal outcomes of pregnant women with SARS‐CoV‐2 infection

Abstract

Objectives To evaluate maternal and perinatal outcomes of pregnant women affected by SARS‐COV‐2. Methods This was a multinational retrospective cohort study including women with laboratory‐confirmed SARS‐COV‐2 from 73 centers from 22 different countries in Europe, United States, South America, Asia and Australia from February 1, 2020 to April 30, 2020. Confirmed SARS‐COV‐2 infection was defined as a positive result on real‐time reverse‐transcriptase‐polymerase‐chain‐reaction (RT‐PCR) assay of nasal and pharyngeal swab specimens. The primary outcome was a composite measure of maternal mortality and morbidity including admission to intensive care unit (ICU), use of mechanical ventilation, or death. Results 388 singleton pregnancies tested positive to SARS‐COV‐2 at RT‐PCR nasal and pharyngeal swab were included in the study. The primary outcome was observed in 47/388 women (12.1%). 43/388 women (11.1%) were admitted to ICU, 36/388 (9.3%) required mechanical ventilation, and 3/388 women deceased (0.8%). Of the 388 women included in the study, 122 (31.4%) were still pregnant at the time of the study. Among the other 266 women, 6 had spontaneous first‐trimester abortion, 3 had elective termination of pregnancy, 6 had stillbirth, and 251 delivered a live‐born infant. The rate of preterm birth less than 37 weeks of gestation was 26.3% (70/266). Of the 251 live‐born infants, 69/251 (27.5%) were admitted to NICU, with 5 neonatal deaths (2.0%). The overall rate of perinatal death was 4.1% (11/266). Only one infant (1/251, 0.4%) born from a mother tested positive during the third trimester, was found positive to SARS‐COV‐2 at RT‐PCR. Conclusions SARS‐COV‐2 in pregnant women is associated with 0.8% rate of maternal mortality, but 11.1% rate of admission to ICU. The risk of vertical transmission seems to be negligible.