Tags

Type your tag names separated by a space and hit enter

Maternal, fetal and neonatal outcomes of large series of SARS-CoV-2 positive pregnancies in peripartum period: A single-center prospective comparative study.
Eur J Obstet Gynecol Reprod Biol. 2021 Feb; 257:11-18.EJ

Abstract

OBJECTIVE

To describe the proportions of asymptomatic, mild and severe diseases in infected pregnant women admitted for delivery. To compare maternal, fetal and neonatal outcomes of SARS-CoV-2 infected pregnant women with those of non-infected patients.

STUDY DESIGN

Through an universal PCR testing for SARS-COV-2 at admission (not symptoms-based), this prospective cohort study enrolled all pregnant women admitted for delivery between 16th of June and the 16th of August 2020 in the West French Guiana Hospital Center.

RESULTS

507 pregnant women were included during the study period, of which 137 (27 %) were infected with SARS-COV-2. On admission, only 34/137 (24.8 %) of these patients presented with clinical symptoms. Among asymptomatic women, 16 /103 (15 %) became symptomatic after diagnosis. Throughout the delivery hospitalization and follow-up, 87/137 (63.5 %) remained always asymptomatic, 45/137 (32.8 %) developed a mild COVID-19 and 5/137 (3.6 %) developed a severe infection. SARS-CoV-2 infected patients were more likely to have post-partum hemorrhage >500 mL (14.2 % vs 7.2 %, RR 2.0 [95 %CI 1.1-3.4]), to be transfused (5.5 % vs 1.1 %, RR 4.9 [1.5-16.6]), and to be hospitalized in ICU (3.6 % vs 0.8 %, RR 4.5 [95 %CI 1.1-18.6] than uninfected ones. Intra-uterine fetal demises were more common in infected mothers compared to controls (5.1 % vs 1.1 %, RR 4.7 [95 % CI 1.4-45.9). Among 108 neonates from infected mothers tested at birth, none tested positive (0/108). When tested between 25 and 42 h after delivery, 4/29 (13.7 %) were positive for SARS-CoV-2 RT-PCR on nasopharyngeal swabs and remained asymptomatic.

CONCLUSION

Pregnant women admitted for delivery and diagnosed with a SARS-COV-2 infection through an universal screening were symptomatic in only a quarter of cases. Their risks of post-partum hemorrhage, transfusion and admission to ICU were higher than those of uninfected patients. They also presented a higher risk of intra-uterine fetal demise. There were no other differences in maternal, obstetrical or neonatal outcomes.

Authors+Show Affiliations

Department of Obstetrics and Gynaecology, West French Guiana Hospital Center, Saint-Laurent-du-Maroni, French Guiana. Electronic address: hcininajeh@gmail.com.Department of Obstetrics and Gynaecology, West French Guiana Hospital Center, Saint-Laurent-du-Maroni, French Guiana.Assistance Publique-Hôpitaux de Paris, Service de Gynécologie-Obstétrique, Hôpital Louis Mourier, Colombes, France. Université de Paris. Inserm IAME-U1137, Paris, France. Groupe de Recherche sur les Infections pendant la grossesse (GRIG).Department of Biology, West French Guiana Hospital Center, Saint-Laurent-du-Maroni, French Guiana.Department of Obstetrics and Gynaecology, West French Guiana Hospital Center, Saint-Laurent-du-Maroni, French Guiana.Department of Obstetrics and Gynaecology, West French Guiana Hospital Center, Saint-Laurent-du-Maroni, French Guiana.Department of Obstetrics and Gynaecology, West French Guiana Hospital Center, Saint-Laurent-du-Maroni, French Guiana.Materno-Fetal and Obstetrics Research Unit, Department "Woman-Mother-Child", Lausanne University Hospital, Lausanne, Switzerland.

Pub Type(s)

Comparative Study
Journal Article
Observational Study

Language

eng

PubMed ID

33310656

Citation

Hcini, Najeh, et al. "Maternal, Fetal and Neonatal Outcomes of Large Series of SARS-CoV-2 Positive Pregnancies in Peripartum Period: a Single-center Prospective Comparative Study." European Journal of Obstetrics, Gynecology, and Reproductive Biology, vol. 257, 2021, pp. 11-18.
Hcini N, Maamri F, Picone O, et al. Maternal, fetal and neonatal outcomes of large series of SARS-CoV-2 positive pregnancies in peripartum period: A single-center prospective comparative study. Eur J Obstet Gynecol Reprod Biol. 2021;257:11-18.
Hcini, N., Maamri, F., Picone, O., Carod, J. F., Lambert, V., Mathieu, M., Carles, G., & Pomar, L. (2021). Maternal, fetal and neonatal outcomes of large series of SARS-CoV-2 positive pregnancies in peripartum period: A single-center prospective comparative study. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 257, 11-18. https://doi.org/10.1016/j.ejogrb.2020.11.068
Hcini N, et al. Maternal, Fetal and Neonatal Outcomes of Large Series of SARS-CoV-2 Positive Pregnancies in Peripartum Period: a Single-center Prospective Comparative Study. Eur J Obstet Gynecol Reprod Biol. 2021;257:11-18. PubMed PMID: 33310656.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Maternal, fetal and neonatal outcomes of large series of SARS-CoV-2 positive pregnancies in peripartum period: A single-center prospective comparative study. AU - Hcini,Najeh, AU - Maamri,Fatma, AU - Picone,Olivier, AU - Carod,Jean-Francois, AU - Lambert,Véronique, AU - Mathieu,Meredith, AU - Carles,Gabriel, AU - Pomar,Léo, Y1 - 2020/12/01/ PY - 2020/09/18/received PY - 2020/11/16/revised PY - 2020/11/30/accepted PY - 2020/12/15/pubmed PY - 2021/1/28/medline PY - 2020/12/14/entrez KW - Maternal outcomes KW - Neonatal outcomes KW - Pregnancy KW - SARS-CoV-2 infection KW - Stillbirth SP - 11 EP - 18 JF - European journal of obstetrics, gynecology, and reproductive biology JO - Eur J Obstet Gynecol Reprod Biol VL - 257 N2 - OBJECTIVE: To describe the proportions of asymptomatic, mild and severe diseases in infected pregnant women admitted for delivery. To compare maternal, fetal and neonatal outcomes of SARS-CoV-2 infected pregnant women with those of non-infected patients. STUDY DESIGN: Through an universal PCR testing for SARS-COV-2 at admission (not symptoms-based), this prospective cohort study enrolled all pregnant women admitted for delivery between 16th of June and the 16th of August 2020 in the West French Guiana Hospital Center. RESULTS: 507 pregnant women were included during the study period, of which 137 (27 %) were infected with SARS-COV-2. On admission, only 34/137 (24.8 %) of these patients presented with clinical symptoms. Among asymptomatic women, 16 /103 (15 %) became symptomatic after diagnosis. Throughout the delivery hospitalization and follow-up, 87/137 (63.5 %) remained always asymptomatic, 45/137 (32.8 %) developed a mild COVID-19 and 5/137 (3.6 %) developed a severe infection. SARS-CoV-2 infected patients were more likely to have post-partum hemorrhage >500 mL (14.2 % vs 7.2 %, RR 2.0 [95 %CI 1.1-3.4]), to be transfused (5.5 % vs 1.1 %, RR 4.9 [1.5-16.6]), and to be hospitalized in ICU (3.6 % vs 0.8 %, RR 4.5 [95 %CI 1.1-18.6] than uninfected ones. Intra-uterine fetal demises were more common in infected mothers compared to controls (5.1 % vs 1.1 %, RR 4.7 [95 % CI 1.4-45.9). Among 108 neonates from infected mothers tested at birth, none tested positive (0/108). When tested between 25 and 42 h after delivery, 4/29 (13.7 %) were positive for SARS-CoV-2 RT-PCR on nasopharyngeal swabs and remained asymptomatic. CONCLUSION: Pregnant women admitted for delivery and diagnosed with a SARS-COV-2 infection through an universal screening were symptomatic in only a quarter of cases. Their risks of post-partum hemorrhage, transfusion and admission to ICU were higher than those of uninfected patients. They also presented a higher risk of intra-uterine fetal demise. There were no other differences in maternal, obstetrical or neonatal outcomes. SN - 1872-7654 UR - https://www.unboundmedicine.com/medline/citation/33310656/Maternal_fetal_and_neonatal_outcomes_of_large_series_of_SARS_CoV_2_positive_pregnancies_in_peripartum_period:_A_single_center_prospective_comparative_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0301-2115(20)30781-8 DB - PRIME DP - Unbound Medicine ER -