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Pregnant women with COVID-19 and risk of adverse birth outcomes and maternal-fetal vertical transmission: a population-based cohort study in Wuhan, China.
BMC Med. 2020 10 19; 18(1):330.BM

Abstract

BACKGROUND

The coronavirus disease 2019 (COVID-19) outbreak is evolving rapidly worldwide. However, little is known about the association between pregnant women with COVID-19 and the risk of adverse birth outcomes.

METHOD

We conducted a retrospective cohort study based on the Maternal and Child Health Information System (MCHIMS) of Wuhan, China. All pregnant women with singleton live birth recorded by the system between January 13 and March 18, 2020, were included. The adverse birth outcomes were preterm birth, low birth weight, neonatal asphyxia, premature rupture of membrane (PROM), and cesarean section delivery. Multivariate logistic regression was used to evaluate the associations between maternal COVID-19 diagnosis and adverse birth outcomes.

RESULTS

Out of 11,078 pregnant women, 65 were confirmed with coronavirus disease 2019 (COVID-19). No deaths occurred from these confirmed cases or their newborns. Compared to pregnant women without COVID-19, pregnant women with a confirmed COVID-19 diagnosis had an increased risk of preterm birth (OR 3.34, 95% CI 1.60-7.00) and cesarean section (OR 3.63, 95% CI 1.95-6.76). There was no statistical difference in low birth weight, neonatal asphyxia, and PROM between the mothers with and without COVID-19. Among these newborns that were born to mothers with confirmed COVID-19, none was tested severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive or had abnormal CT results. Only one had diarrhea and three had a fever.

CONCLUSIONS

This population-based cohort study suggests that COVID-19 during the later pregnancy is associated with an increased risk of adverse birth outcomes, including iatrogenic preterm birth and cesarean section delivery. Our data provide little evidence for maternal-fetal vertical transmission of SARS-CoV-2. It is important to monitor the long-term health effects of SARS-CoV-2 infection on pregnant women and their children.

Authors+Show Affiliations

Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, 100 Xianggang Road, Wuhan, 430030, China.Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, 100 Xianggang Road, Wuhan, 430030, China.School of Public Health, Brown University, Providence, RI, 02903, USA.Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, 3545 Lafayette Ave., St. Louis, MO, 63104, USA.Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, 100 Xianggang Road, Wuhan, 430030, China.School of Public Health, Brown University, Providence, RI, 02903, USA.Krannert School of Management, Purdue University, 475 Stadium Mall Drive, West Lafayette, IN, 47906-2050, USA.Department of Pediatrics, Peking University First Hospital, 8 Xishiku Street, Beijing, 100034, China.Rollins School of Public Health, Emory University, 1518 Clifton Rd, NE, Atlanta, GA, 30322, USA.Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, 100 Xianggang Road, Wuhan, 430030, China.Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, 100 Xianggang Road, Wuhan, 430030, China.Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, 100 Xianggang Road, Wuhan, 430030, China.Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, 100 Xianggang Road, Wuhan, 430030, China.Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science &Technology, 13 Hangkong Road, Wuhan, 430030, China. wangyoujie@mails.tjmu.edu.cn.Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, 100 Xianggang Road, Wuhan, 430030, China. april1972@163.com.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

33070775

Citation

Yang, Rong, et al. "Pregnant Women With COVID-19 and Risk of Adverse Birth Outcomes and Maternal-fetal Vertical Transmission: a Population-based Cohort Study in Wuhan, China." BMC Medicine, vol. 18, no. 1, 2020, p. 330.
Yang R, Mei H, Zheng T, et al. Pregnant women with COVID-19 and risk of adverse birth outcomes and maternal-fetal vertical transmission: a population-based cohort study in Wuhan, China. BMC Med. 2020;18(1):330.
Yang, R., Mei, H., Zheng, T., Fu, Q., Zhang, Y., Buka, S., Yao, X., Tang, Z., Zhang, X., Qiu, L., Zhang, Y., Zhou, J., Cao, J., Wang, Y., & Zhou, A. (2020). Pregnant women with COVID-19 and risk of adverse birth outcomes and maternal-fetal vertical transmission: a population-based cohort study in Wuhan, China. BMC Medicine, 18(1), 330. https://doi.org/10.1186/s12916-020-01798-1
Yang R, et al. Pregnant Women With COVID-19 and Risk of Adverse Birth Outcomes and Maternal-fetal Vertical Transmission: a Population-based Cohort Study in Wuhan, China. BMC Med. 2020 10 19;18(1):330. PubMed PMID: 33070775.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pregnant women with COVID-19 and risk of adverse birth outcomes and maternal-fetal vertical transmission: a population-based cohort study in Wuhan, China. AU - Yang,Rong, AU - Mei,Hui, AU - Zheng,Tongzhang, AU - Fu,Qiang, AU - Zhang,Yiming, AU - Buka,Stephen, AU - Yao,Xinan, AU - Tang,Zezhong, AU - Zhang,Xichi, AU - Qiu,Lin, AU - Zhang,Yaqi, AU - Zhou,Jieqiong, AU - Cao,Jiangxia, AU - Wang,Youjie, AU - Zhou,Aifen, Y1 - 2020/10/19/ PY - 2020/05/14/received PY - 2020/09/25/accepted PY - 2020/10/19/entrez PY - 2020/10/20/pubmed PY - 2020/10/29/medline KW - Birth outcome KW - COVID-19 KW - Maternal-fetal vertical transmission SP - 330 EP - 330 JF - BMC medicine JO - BMC Med VL - 18 IS - 1 N2 - BACKGROUND: The coronavirus disease 2019 (COVID-19) outbreak is evolving rapidly worldwide. However, little is known about the association between pregnant women with COVID-19 and the risk of adverse birth outcomes. METHOD: We conducted a retrospective cohort study based on the Maternal and Child Health Information System (MCHIMS) of Wuhan, China. All pregnant women with singleton live birth recorded by the system between January 13 and March 18, 2020, were included. The adverse birth outcomes were preterm birth, low birth weight, neonatal asphyxia, premature rupture of membrane (PROM), and cesarean section delivery. Multivariate logistic regression was used to evaluate the associations between maternal COVID-19 diagnosis and adverse birth outcomes. RESULTS: Out of 11,078 pregnant women, 65 were confirmed with coronavirus disease 2019 (COVID-19). No deaths occurred from these confirmed cases or their newborns. Compared to pregnant women without COVID-19, pregnant women with a confirmed COVID-19 diagnosis had an increased risk of preterm birth (OR 3.34, 95% CI 1.60-7.00) and cesarean section (OR 3.63, 95% CI 1.95-6.76). There was no statistical difference in low birth weight, neonatal asphyxia, and PROM between the mothers with and without COVID-19. Among these newborns that were born to mothers with confirmed COVID-19, none was tested severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive or had abnormal CT results. Only one had diarrhea and three had a fever. CONCLUSIONS: This population-based cohort study suggests that COVID-19 during the later pregnancy is associated with an increased risk of adverse birth outcomes, including iatrogenic preterm birth and cesarean section delivery. Our data provide little evidence for maternal-fetal vertical transmission of SARS-CoV-2. It is important to monitor the long-term health effects of SARS-CoV-2 infection on pregnant women and their children. SN - 1741-7015 UR - https://www.unboundmedicine.com/medline/citation/33070775/Pregnant_women_with_COVID_19_and_risk_of_adverse_birth_outcomes_and_maternal_fetal_vertical_transmission:_a_population_based_cohort_study_in_Wuhan_China_ L2 - https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-020-01798-1 DB - PRIME DP - Unbound Medicine ER -