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Neonatal outcome in 29 pregnant women with COVID-19: A retrospective study in Wuhan, China.
PLoS Med. 2020 07; 17(7):e1003195.PM

Abstract

BACKGROUND

As of June 1, 2020, coronavirus disease 2019 (COVID-19) has caused more than 6,000,000 infected persons and 360,000 deaths globally. Previous studies revealed pregnant women with COVID-19 had similar clinical manifestations to nonpregnant women. However, little is known about the outcome of neonates born to infected women.

METHODS AND FINDINGS

In this retrospective study, we studied 29 pregnant women with COVID-19 infection delivered in 2 designated general hospitals in Wuhan, China between January 30 and March 10, 2020, and 30 neonates (1 set of twins). Maternal demographic characteristics, delivery course, symptoms, and laboratory tests from hospital records were extracted. Neonates were hospitalized if they had symptoms (5 cases) or their guardians agreed to a hospitalized quarantine (13 cases), whereas symptom-free neonates also could be discharged after birth and followed up through telephone (12 cases). For hospitalized neonates, laboratory test results and chest X-ray or computed tomography (CT) were extracted from hospital records. The presence of antibody of SARS-CoV-2 was assessed in the serum of 4 neonates. Among 29 pregnant COVID-19-infected women (13 confirmed and 16 clinical diagnosed), the majority had higher education (56.6%), half were employed (51.7%), and their mean age was 29 years. Fourteen women experienced mild symptoms including fever (8), cough (9), shortness of breath (3), diarrhea (2), vomiting (1), and 15 were symptom-free. Eleven of 29 women had pregnancy complications, and 27 elected to have a cesarean section delivery. Of 30 neonates, 18 were admitted to Wuhan Children's Hospital for quarantine and care, whereas the other 12 neonates discharged after birth without any symptoms and had normal follow-up. Five hospitalized neonates were diagnosed as COVID-19 infection (2 confirmed and 3 suspected). In addition, 12 of 13 other hospitalized neonates presented with radiological features for pneumonia through X-ray or CT screening, 1 with occasional cough and the others without associated symptoms. SARS-CoV-2 specific serum immunoglobulin M (IgM) and immunoglobulin G (IgG) were measured in 4 neonates and 2 were positive. The limited sample size limited statistical comparison between groups.

CONCLUSIONS

In this study, we observed COVID-19 or radiological features of pneumonia in some, but not all, neonates born to women with COVID-19 infection. These findings suggest that intrauterine or intrapartum transmission is possible and warrants clinical caution and further investigation.

TRIAL REGISTRATION

Chinese Clinical Trial Registry, ChiCTR2000031954 (Maternal and Perinatal Outcomes of Women with coronavirus disease 2019 (COVID-19): a multicenter retrospective cohort study).

Authors+Show Affiliations

International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.Renmin Hospital, Wuhan University, Wuhan, China. Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia.Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia.Bloomberg Faculty of Nursing, University of Toronto, Ontario, Canada.The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Renmin Hospital, Wuhan University, Wuhan, China.Renmin Hospital, Wuhan University, Wuhan, China.International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Pub Type(s)

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

Language

eng

PubMed ID

32722722

Citation

Wu, Yan-Ting, et al. "Neonatal Outcome in 29 Pregnant Women With COVID-19: a Retrospective Study in Wuhan, China." PLoS Medicine, vol. 17, no. 7, 2020, pp. e1003195.
Wu YT, Liu J, Xu JJ, et al. Neonatal outcome in 29 pregnant women with COVID-19: A retrospective study in Wuhan, China. PLoS Med. 2020;17(7):e1003195.
Wu, Y. T., Liu, J., Xu, J. J., Chen, Y. F., Yang, W., Chen, Y., Li, C., Wang, Y., Liu, H., Zhang, C., Jiang, L., Qian, Z. X., Kawai, A., Mol, B. W., Dennis, C. L., Xiong, G. P., Cheng, B. H., Yang, J., & Huang, H. F. (2020). Neonatal outcome in 29 pregnant women with COVID-19: A retrospective study in Wuhan, China. PLoS Medicine, 17(7), e1003195. https://doi.org/10.1371/journal.pmed.1003195
Wu YT, et al. Neonatal Outcome in 29 Pregnant Women With COVID-19: a Retrospective Study in Wuhan, China. PLoS Med. 2020;17(7):e1003195. PubMed PMID: 32722722.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neonatal outcome in 29 pregnant women with COVID-19: A retrospective study in Wuhan, China. AU - Wu,Yan-Ting, AU - Liu,Jun, AU - Xu,Jing-Jing, AU - Chen,Yan-Fen, AU - Yang,Wen, AU - Chen,Yang, AU - Li,Cheng, AU - Wang,Yu, AU - Liu,Han, AU - Zhang,Chen, AU - Jiang,Ling, AU - Qian,Zhao-Xia, AU - Kawai,Andrew, AU - Mol,Ben Willem, AU - Dennis,Cindy-Lee, AU - Xiong,Guo-Ping, AU - Cheng,Bi-Heng, AU - Yang,Jing, AU - Huang,He-Feng, Y1 - 2020/07/28/ PY - 2020/04/02/received PY - 2020/06/24/accepted PY - 2020/7/30/entrez PY - 2020/7/30/pubmed PY - 2020/8/7/medline SP - e1003195 EP - e1003195 JF - PLoS medicine JO - PLoS Med VL - 17 IS - 7 N2 - BACKGROUND: As of June 1, 2020, coronavirus disease 2019 (COVID-19) has caused more than 6,000,000 infected persons and 360,000 deaths globally. Previous studies revealed pregnant women with COVID-19 had similar clinical manifestations to nonpregnant women. However, little is known about the outcome of neonates born to infected women. METHODS AND FINDINGS: In this retrospective study, we studied 29 pregnant women with COVID-19 infection delivered in 2 designated general hospitals in Wuhan, China between January 30 and March 10, 2020, and 30 neonates (1 set of twins). Maternal demographic characteristics, delivery course, symptoms, and laboratory tests from hospital records were extracted. Neonates were hospitalized if they had symptoms (5 cases) or their guardians agreed to a hospitalized quarantine (13 cases), whereas symptom-free neonates also could be discharged after birth and followed up through telephone (12 cases). For hospitalized neonates, laboratory test results and chest X-ray or computed tomography (CT) were extracted from hospital records. The presence of antibody of SARS-CoV-2 was assessed in the serum of 4 neonates. Among 29 pregnant COVID-19-infected women (13 confirmed and 16 clinical diagnosed), the majority had higher education (56.6%), half were employed (51.7%), and their mean age was 29 years. Fourteen women experienced mild symptoms including fever (8), cough (9), shortness of breath (3), diarrhea (2), vomiting (1), and 15 were symptom-free. Eleven of 29 women had pregnancy complications, and 27 elected to have a cesarean section delivery. Of 30 neonates, 18 were admitted to Wuhan Children's Hospital for quarantine and care, whereas the other 12 neonates discharged after birth without any symptoms and had normal follow-up. Five hospitalized neonates were diagnosed as COVID-19 infection (2 confirmed and 3 suspected). In addition, 12 of 13 other hospitalized neonates presented with radiological features for pneumonia through X-ray or CT screening, 1 with occasional cough and the others without associated symptoms. SARS-CoV-2 specific serum immunoglobulin M (IgM) and immunoglobulin G (IgG) were measured in 4 neonates and 2 were positive. The limited sample size limited statistical comparison between groups. CONCLUSIONS: In this study, we observed COVID-19 or radiological features of pneumonia in some, but not all, neonates born to women with COVID-19 infection. These findings suggest that intrauterine or intrapartum transmission is possible and warrants clinical caution and further investigation. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR2000031954 (Maternal and Perinatal Outcomes of Women with coronavirus disease 2019 (COVID-19): a multicenter retrospective cohort study). SN - 1549-1676 UR - https://www.unboundmedicine.com/medline/citation/32722722/Neonatal_outcome_in_29_pregnant_women_with_COVID_19:_A_retrospective_study_in_Wuhan_China_ L2 - https://dx.plos.org/10.1371/journal.pmed.1003195 DB - PRIME DP - Unbound Medicine ER -