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Characteristics and short-term obstetric outcomes in a case series of 67 women test-positive for SARS-CoV-2 in Stockholm, Sweden.
Acta Obstet Gynecol Scand. 2020 12; 99(12):1626-1631.AO

Abstract

INTRODUCTION

The Stockholm region was the first area in Sweden to be hit by the pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The national guidelines on the care of women with a positive test for SARS-CoV-2 (detection with polymerase chain reaction [PCR]) recommend individualized antenatal care, mode of delivery based on obstetric considerations, and no routine separation of the mother and the newborn. Breastfeeding is encouraged, and although there is no specific recommendation regarding wearing a face mask to prevent viral transmission to the newborn while nursing, instructions are given to keep high hygiene standards. All studies based on cases tested on hospital admission will capture more women with pregnancy complications than in the general population. Our aim was to describe the clinical characteristics of SARS-CoV-2-positive women and their neonates, and to report short-term maternal and neonatal outcomes.

MATERIAL AND METHODS

A retrospective case series with data from medical records including all test-positive women (n = 67) who gave birth to 68 neonates from 19 March to 26 April 2020 in Stockholm, Sweden. Means, proportions and percentages were calculated for clinical characteristics and outcomes.

RESULTS

The mean age was 32 years, 40% were nulliparous and 61% were overweight or obese. Further, 15% had diabetes and 21% a hypertensive disease. Seventy percent of the women had a vaginal birth. Preterm delivery occurred in 19% of the women. The preterm deliveries were mostly medically indicated, including two women who were delivered preterm due to severe coronavirus disease 19 (COVID-19), corresponding to 15% of the preterm births. Four women (6%) were admitted to the intensive care unit postpartum but there were no maternal deaths. There were two perinatal deaths (one stillbirth and one neonatal death). Three neonates were PCR-positive for SARS-CoV-2 after birth.

CONCLUSIONS

In this case series of 67 women testing positive for SARS-CoV-2 with clinical presentations ranging from asymptomatic to manifest COVID-19 disease, few women presented with severe COVID-19 illness. The majority had a vaginal birth at term with a healthy neonate that was negative for SARS-CoV-2.

Authors+Show Affiliations

BB Stockholm, Danderyd Hospital, Stockholm, Sweden. Department of Medicine Solna, Clinical Epidemiology division, Karolinska Institutet, Stockholm, Sweden.Department of Obstetrics and Gynecology, Södersjukhuset Hospital, Stockholm, Sweden. Department of Clinical Science and Education, Södersjukhuset Hospital, Karolinska Institutet, Stockholm, Sweden.Department of Obstetrics and Gynecology, Danderyd Hospital, Stockholm, Sweden. Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.Department of Obstetrics and Gynecology, Södersjukhuset Hospital, Stockholm, Sweden. Department for Clinical Intervention, Technology and Intervention, Karolinska Institutet, Stockholm, Sweden.BB Stockholm, Danderyd Hospital, Stockholm, Sweden. Department of Medicine, Center for Pharmacoepidemiology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.Department of Women's Health, Karolinska University Hospital, Stockholm, Sweden.Department of Women's and Children's Health, Södertälje Hospital, Stockholm, Sweden.Department of Women's Health, Karolinska University Hospital, Stockholm, Sweden. Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.Department of Obstetrics and Gynecology, Södersjukhuset Hospital, Stockholm, Sweden. Department of Clinical Science and Education, Södersjukhuset Hospital, Karolinska Institutet, Stockholm, Sweden.Department for Clinical Intervention, Technology and Intervention, Karolinska Institutet, Stockholm, Sweden. Department of Women's Health, Karolinska University Hospital, Stockholm, Sweden.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32981033

Citation

Remaeus, Katarina, et al. "Characteristics and Short-term Obstetric Outcomes in a Case Series of 67 Women Test-positive for SARS-CoV-2 in Stockholm, Sweden." Acta Obstetricia Et Gynecologica Scandinavica, vol. 99, no. 12, 2020, pp. 1626-1631.
Remaeus K, Savchenko J, Brismar Wendel S, et al. Characteristics and short-term obstetric outcomes in a case series of 67 women test-positive for SARS-CoV-2 in Stockholm, Sweden. Acta Obstet Gynecol Scand. 2020;99(12):1626-1631.
Remaeus, K., Savchenko, J., Brismar Wendel, S., Brusell Gidlöf, S., Graner, S., Jones, E., Molin, J., Saltvedt, S., Wallström, T., & Pettersson, K. (2020). Characteristics and short-term obstetric outcomes in a case series of 67 women test-positive for SARS-CoV-2 in Stockholm, Sweden. Acta Obstetricia Et Gynecologica Scandinavica, 99(12), 1626-1631. https://doi.org/10.1111/aogs.14006
Remaeus K, et al. Characteristics and Short-term Obstetric Outcomes in a Case Series of 67 Women Test-positive for SARS-CoV-2 in Stockholm, Sweden. Acta Obstet Gynecol Scand. 2020;99(12):1626-1631. PubMed PMID: 32981033.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characteristics and short-term obstetric outcomes in a case series of 67 women test-positive for SARS-CoV-2 in Stockholm, Sweden. AU - Remaeus,Katarina, AU - Savchenko,Julia, AU - Brismar Wendel,Sophia, AU - Brusell Gidlöf,Sebastian, AU - Graner,Sophie, AU - Jones,Elin, AU - Molin,Johanna, AU - Saltvedt,Sissel, AU - Wallström,Tove, AU - Pettersson,Karin, Y1 - 2020/11/05/ PY - 2020/06/18/received PY - 2020/09/14/revised PY - 2020/09/22/accepted PY - 2020/9/28/pubmed PY - 2020/9/28/medline PY - 2020/9/27/entrez KW - COVID-19 KW - SARS-CoV-2 KW - delivery outcomes KW - pregnancy outcomes KW - preterm birth SP - 1626 EP - 1631 JF - Acta obstetricia et gynecologica Scandinavica JO - Acta Obstet Gynecol Scand VL - 99 IS - 12 N2 - INTRODUCTION: The Stockholm region was the first area in Sweden to be hit by the pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The national guidelines on the care of women with a positive test for SARS-CoV-2 (detection with polymerase chain reaction [PCR]) recommend individualized antenatal care, mode of delivery based on obstetric considerations, and no routine separation of the mother and the newborn. Breastfeeding is encouraged, and although there is no specific recommendation regarding wearing a face mask to prevent viral transmission to the newborn while nursing, instructions are given to keep high hygiene standards. All studies based on cases tested on hospital admission will capture more women with pregnancy complications than in the general population. Our aim was to describe the clinical characteristics of SARS-CoV-2-positive women and their neonates, and to report short-term maternal and neonatal outcomes. MATERIAL AND METHODS: A retrospective case series with data from medical records including all test-positive women (n = 67) who gave birth to 68 neonates from 19 March to 26 April 2020 in Stockholm, Sweden. Means, proportions and percentages were calculated for clinical characteristics and outcomes. RESULTS: The mean age was 32 years, 40% were nulliparous and 61% were overweight or obese. Further, 15% had diabetes and 21% a hypertensive disease. Seventy percent of the women had a vaginal birth. Preterm delivery occurred in 19% of the women. The preterm deliveries were mostly medically indicated, including two women who were delivered preterm due to severe coronavirus disease 19 (COVID-19), corresponding to 15% of the preterm births. Four women (6%) were admitted to the intensive care unit postpartum but there were no maternal deaths. There were two perinatal deaths (one stillbirth and one neonatal death). Three neonates were PCR-positive for SARS-CoV-2 after birth. CONCLUSIONS: In this case series of 67 women testing positive for SARS-CoV-2 with clinical presentations ranging from asymptomatic to manifest COVID-19 disease, few women presented with severe COVID-19 illness. The majority had a vaginal birth at term with a healthy neonate that was negative for SARS-CoV-2. SN - 1600-0412 UR - https://www.unboundmedicine.com/medline/citation/32981033/Characteristics_and_short_term_obstetric_outcomes_in_a_case_series_of_67_women_test_positive_for_SARS_CoV_2_in_Stockholm_Sweden_ L2 - https://doi.org/10.1111/aogs.14006 DB - PRIME DP - Unbound Medicine ER -