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Coronavirus disease 2019 in pregnant women: a report based on 116 cases.
Am J Obstet Gynecol. 2020 07; 223(1):111.e1-111.e14.AJ

Abstract

BACKGROUND

The coronavirus disease 2019, caused by severe acute respiratory syndrome coronavirus 2, is a global public health emergency. Data on the effect of coronavirus disease 2019 in pregnancy are limited to small case series.

OBJECTIVE

To evaluate the clinical characteristics and outcomes in pregnancy and the vertical transmission potential of severe acute respiratory syndrome coronavirus 2 infection.

STUDY DESIGN

Clinical records were retrospectively reviewed for 116 pregnant women with coronavirus disease 2019 pneumonia from 25 hospitals in China between January 20, 2020, and March 24, 2020. Evidence of vertical transmission was assessed by testing for severe acute respiratory syndrome coronavirus 2 in amniotic fluid, cord blood, and neonatal pharyngeal swab samples.

RESULTS

The median gestational age on admission was 38+0 (interquartile range, 36+0-39+1) weeks. The most common symptoms were fever (50.9%, 59/116) and cough (28.4%, 33/116); 23.3% (27/116) patients presented without symptoms. Abnormal radiologic findings were found in 96.3% (104/108) of cases. Of the 116 cases, there were 8 cases (6.9%) of severe pneumonia but no maternal deaths. One of 8 patients who presented in the first trimester and early second trimester had a missed spontaneous abortion. Of 99 patients, 21 (21.2%) who delivered had preterm birth, including 6 with preterm premature rupture of membranes. The rate of spontaneous preterm birth before 37 weeks' gestation was 6.1% (6/99). One case of severe neonatal asphyxia resulted in neonatal death. Furthermore, 86 of the 100 neonates tested for severe acute respiratory syndrome coronavirus 2 had negative results; of these, paired amniotic fluid and cord blood samples from 10 neonates used to test for severe acute respiratory syndrome coronavirus 2 had negative results.

CONCLUSION

Severe acute respiratory syndrome coronavirus 2 infection during pregnancy is not associated with an increased risk of spontaneous abortion and spontaneous preterm birth. There is no evidence of vertical transmission of severe acute respiratory syndrome coronavirus 2 infection when the infection manifests during the third trimester of pregnancy.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China.Department of Obstetrics and Gynecology, Zhongnan Hospital of Wuhan University, Wuhan, China, Clinical Medicine Research Center of Prenatal Diagnosis and Birth Health in Hubei Province, Wuhan, China.Department of Obstetrics, Renmin Hospital of Wuhan University, Wuhan, China.Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China.Department of Obstetrics and Gynecology, Zhongnan Hospital of Wuhan University, Wuhan, China, Clinical Medicine Research Center of Prenatal Diagnosis and Birth Health in Hubei Province, Wuhan, China.Department of Obstetrics and Gynecology, Zhongnan Hospital of Wuhan University, Wuhan, China, Clinical Medicine Research Center of Prenatal Diagnosis and Birth Health in Hubei Province, Wuhan, China.Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology.Department of Obstetrics, Renmin Hospital of Wuhan University, Wuhan, China.Department of Obstetrics and Gynecology, Zhongnan Hospital of Wuhan University, Wuhan, China, Clinical Medicine Research Center of Prenatal Diagnosis and Birth Health in Hubei Province, Wuhan, China.Department of Obstetrics and Gynecology, Zhongnan Hospital of Wuhan University, Wuhan, China, Clinical Medicine Research Center of Prenatal Diagnosis and Birth Health in Hubei Province, Wuhan, China.Department of Obstetrics, Renmin Hospital of Wuhan University, Wuhan, China.Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China.Department of Obstetrics and Gynecology, The Central Hospital of Wuhan, Wuhan, China.Department of Obstetrics and Gynecology, The Central Hospital of Suizhou, Suizhou, China.Department of Obstetrics and Gynecology, Yichang Central People's Hospital, Yichang, China.Department of Obstetrics and Gynecology, Beijing You'An Hospital, Beijing, China.Department of Obstetrics and Gynecology, The People's Hospital of Hanchuan, Hanchuan, Hubei Province, China.Department of Nutrition and Food Hygiene, School of Public Health, Wuhan University, Wuhan, China.Department of Obstetrics and Gynecology, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.Department of Obstetrics and Gynecology, Zhongnan Hospital of Wuhan University, Wuhan, China, Clinical Medicine Research Center of Prenatal Diagnosis and Birth Health in Hubei Province, Wuhan, China.Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China. Electronic address: yanghuixia@bjmu.edu.cn.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Video-Audio Media

Language

eng

PubMed ID

32335053

Citation

Yan, Jie, et al. "Coronavirus Disease 2019 in Pregnant Women: a Report Based On 116 Cases." American Journal of Obstetrics and Gynecology, vol. 223, no. 1, 2020, pp. 111.e1-111.e14.
Yan J, Guo J, Fan C, et al. Coronavirus disease 2019 in pregnant women: a report based on 116 cases. Am J Obstet Gynecol. 2020;223(1):111.e1-111.e14.
Yan, J., Guo, J., Fan, C., Juan, J., Yu, X., Li, J., Feng, L., Li, C., Chen, H., Qiao, Y., Lei, D., Wang, C., Xiong, G., Xiao, F., He, W., Pang, Q., Hu, X., Wang, S., Chen, D., ... Yang, H. (2020). Coronavirus disease 2019 in pregnant women: a report based on 116 cases. American Journal of Obstetrics and Gynecology, 223(1), e1-e14. https://doi.org/10.1016/j.ajog.2020.04.014
Yan J, et al. Coronavirus Disease 2019 in Pregnant Women: a Report Based On 116 Cases. Am J Obstet Gynecol. 2020;223(1):111.e1-111.e14. PubMed PMID: 32335053.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Coronavirus disease 2019 in pregnant women: a report based on 116 cases. AU - Yan,Jie, AU - Guo,Juanjuan, AU - Fan,Cuifang, AU - Juan,Juan, AU - Yu,Xuechen, AU - Li,Jiafu, AU - Feng,Ling, AU - Li,Chunyan, AU - Chen,Huijun, AU - Qiao,Yuan, AU - Lei,Di, AU - Wang,Chen, AU - Xiong,Guoping, AU - Xiao,Fengyi, AU - He,Wencong, AU - Pang,Qiumei, AU - Hu,Xiaoling, AU - Wang,Suqing, AU - Chen,Dunjin, AU - Zhang,Yuanzhen, AU - Poon,Liona C, AU - Yang,Huixia, Y1 - 2020/04/23/ PY - 2020/04/09/received PY - 2020/04/15/revised PY - 2020/04/17/accepted PY - 2020/4/27/pubmed PY - 2020/7/11/medline PY - 2020/4/27/entrez KW - COVID-19 KW - PTB KW - SARS-CoV-2 KW - ascending infection KW - coronavirus KW - coronavirus disease 2019 KW - pandemic KW - pneumonia KW - pregnancy KW - pregnancy outcomes KW - pregnant women KW - preterm birth KW - severe acute respiratory syndrome coronavirus 2 KW - spontaneous PTB KW - spontaneous abortion KW - spontaneous preterm birth KW - vertical transmission SP - 111.e1 EP - 111.e14 JF - American journal of obstetrics and gynecology JO - Am. J. Obstet. Gynecol. VL - 223 IS - 1 N2 - BACKGROUND: The coronavirus disease 2019, caused by severe acute respiratory syndrome coronavirus 2, is a global public health emergency. Data on the effect of coronavirus disease 2019 in pregnancy are limited to small case series. OBJECTIVE: To evaluate the clinical characteristics and outcomes in pregnancy and the vertical transmission potential of severe acute respiratory syndrome coronavirus 2 infection. STUDY DESIGN: Clinical records were retrospectively reviewed for 116 pregnant women with coronavirus disease 2019 pneumonia from 25 hospitals in China between January 20, 2020, and March 24, 2020. Evidence of vertical transmission was assessed by testing for severe acute respiratory syndrome coronavirus 2 in amniotic fluid, cord blood, and neonatal pharyngeal swab samples. RESULTS: The median gestational age on admission was 38+0 (interquartile range, 36+0-39+1) weeks. The most common symptoms were fever (50.9%, 59/116) and cough (28.4%, 33/116); 23.3% (27/116) patients presented without symptoms. Abnormal radiologic findings were found in 96.3% (104/108) of cases. Of the 116 cases, there were 8 cases (6.9%) of severe pneumonia but no maternal deaths. One of 8 patients who presented in the first trimester and early second trimester had a missed spontaneous abortion. Of 99 patients, 21 (21.2%) who delivered had preterm birth, including 6 with preterm premature rupture of membranes. The rate of spontaneous preterm birth before 37 weeks' gestation was 6.1% (6/99). One case of severe neonatal asphyxia resulted in neonatal death. Furthermore, 86 of the 100 neonates tested for severe acute respiratory syndrome coronavirus 2 had negative results; of these, paired amniotic fluid and cord blood samples from 10 neonates used to test for severe acute respiratory syndrome coronavirus 2 had negative results. CONCLUSION: Severe acute respiratory syndrome coronavirus 2 infection during pregnancy is not associated with an increased risk of spontaneous abortion and spontaneous preterm birth. There is no evidence of vertical transmission of severe acute respiratory syndrome coronavirus 2 infection when the infection manifests during the third trimester of pregnancy. SN - 1097-6868 UR - https://www.unboundmedicine.com/medline/citation/32335053/Coronavirus_disease_2019_in_pregnant_women:_a_report_based_on_116_cases_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9378(20)30462-2 DB - PRIME DP - Unbound Medicine ER -