COVID-19 in pregnancy, management and outcomes among pregnant women and neonates — results from tertiary care center in Wroclaw
Abstract
Objectives: A novel coronavirus — SARS CoV-2 — outbreak has, for sure, been the greatest medical challenge in recent years. The maternal and neonatal consequences of the infection are still largely unknown. Material and methods: This prospective study aims to describe the perinatal care and outcomes of SARS-CoV-2 positive pregnant women and their newborn infants during the third wave of the pandemic, in a large tertiary university center in Wroclaw/Poland from 15 February to 1 May 2021. Results: The paper describes a group of 83 women with confirmed SARS-CoV-2 infection during delivery, as well as their newborn infants (n = 84). The course of COVID-19 disease in pregnant patients was mostly asymptomatic (56%) but 31% women manifested mild to moderate symptoms and 14% had severe infection. The median gestational age at the delivery was 38 weeks. On average, 16.7% of mothers were separated from their newborns at birth, 83.3% practiced skin-to-skin, and roomed in with their babies, and 84.5% of the infants received any mother’s milk. Preterm infants were more often borne by mothers with symptomatic course of COVID-19 infection. Need for neonatal treatment was only due to prematurity. Neonates with acquired infection (after 14th day of life) had to be treated symptomatically with fever and loose stools, only 28.5% had symptoms of respiratory failure. Conclusions: Despite the confirmed SARS-CoV-2 infection, the majority of mother- infant dyads were in a good health condition. The data on perinatal care reported in the paper could be helpful contribution supporting childbirth physiology protection during the COVID-19 pandemic.
Keywords: COVID-19perinatal careSARS-CoV-2neonatepregnancy outcomes
References
- Mark EG, McAleese S, Golden WC, et al. Coronavirus Disease 2019 in Pregnancy and Outcomes Among Pregnant Women and Neonates: A Literature Review. Pediatr Infect Dis J. 2021; 40(5): 473–478.
- Wang S, Guo L, Chen L, et al. A Case Report of Neonatal 2019 Coronavirus Disease in China. Clin Infect Dis. 2020; 71(15): 853–857.
- Chen D, Yang H, Cao Y, et al. Expert consensus for managing pregnant women and neonates born to mothers with suspected or confirmed novel coronavirus (COVID-19) infection. Int J Gynaecol Obstet. 2020; 149(2): 130–136.
- Royal College of Obstetricians and Gynaecologists (RCOG). The Grants Register 2021. 2020: 713–721.
- Bohren MA, Berger BO, Munthe-Kaas H, et al. Perceptions and experiences of labour companionship: a qualitative evidence synthesis. Cochrane Database Syst Rev. 2019; 3: CD012449.
- Williams J, Namazova-Baranova L, Weber M, et al. The Importance of Continuing Breastfeeding during Coronavirus Disease-2019: In Support of the World Health Organization Statement on Breastfeeding during the Pandemic. The Journal of Pediatrics. 2020; 223: 234–236.
- Vassilopoulou E, Feketea G, Koumbi L, et al. Breastfeeding and COVID-19: From Nutrition to Immunity. Frontiers in Immunology. 2021; 12.
- Rekomendowana ścieżka postępowania dla kobiet w ciąży COVID-19. https://www.ptgin.pl/rekomendowana-sciezka-postepowania-dla-kobiet-w-ciazy-covid-19.
- Zalecenia Polskiego Towarzystwa Neonatologicznego Krajowego Nadzoru w dziedzinie neonatologii. (2020) Postępowanie z noworodkiem przy podejrzeniu/potwierdzeniu zakażenia SARS-CoV-2 u matki oraz z rozpoznaniem zakażenia SARS-CoV-2. http://www.neonatologia.edu.pl/index.php?option=com_content&view=article&id=215:postepowanie-z-noworodkiem-przy-podejrzeniu-potwierdzeniu-zakazenia-sars-cov-2-u-matki-oraz-z-rozpoznaniem-zakazenia-sars-cov-2&catid=8&Itemid=103.
- Reale SC, Lumbreras-Marquez MI, King CH, et al. Patient characteristics associated with SARS-CoV-2 infection in parturients admitted for labour and delivery in Massachusetts during the spring 2020 surge: A prospective cohort study. Paediatr Perinat Epidemiol. 2021; 35(1): 24–33.
- Allotey J, Stallings E, Bonet M, et al. for PregCOV-19 Living Systematic Review Consortium. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ. 2020; 370: m3320.
- Public Health England. COVID-19: investigation and initial clinical management of possible cases 2020. https://www.gov.uk/government/publications/wuhan-novel-coronavirus-initialinvestigation-of-possible-cases/investigation-and-initial-clinical-management-of-possible-casesof-wuhan-novel-coronavirus-wn-cov-infection.
- Vouga M, Favre G, Perez OM, et al. Maternal and Obstetrical Outcomes in a Cohort of Pregnant Women Tested for SARS-CoV-2: Interim Results of the COVI-Preg International Registry. SSRN Electronic Journal. .
- Zimmermann P, Curtis N, Zimmermann P, et al. Coronavirus Infections in Children Including COVID-19: An Overview of the Epidemiology, Clinical Features, Diagnosis, Treatment and Prevention Options in Children. Pediatr Infect Dis J. 2020; 39(5): 355–368.
- Donati S, Corsi E, Salvatore MA, et al. Childbirth Care among SARS-CoV-2 Positive Women in Italy. Int J Environ Res Public Health. 2021; 18(8).
- Cardona-Pérez J, Villegas-Mota I, Helguera-Repetto A, et al. Prevalence, clinical features, and outcomes of SARS-CoV-2 infection in pregnant women with or without mild/moderate symptoms: Results from universal screening in a tertiary care center in Mexico City, Mexico. PLOS ONE. 2021; 16(4): e0249584.
- Ciapponi A, Bardach A, Comandé D, et al. COVID-19 and pregnancy: An umbrella review of clinical presentation, vertical transmission, and maternal and perinatal outcomes. PLoS One. 2021; 16(6): e0253974.
- Jering KS, Claggett BL, Cunningham JW, et al. Clinical Characteristics and Outcomes of Hospitalized Women Giving Birth With and Without COVID-19. JAMA Intern Med. 2021; 181(5): 714–717.
- Lokken E, Huebner E, Taylor G, et al. Disease severity, pregnancy outcomes, and maternal deaths among pregnant patients with severe acute respiratory syndrome coronavirus 2 infection in Washington State. American Journal of Obstetrics and Gynecology. 2021; 225(1): 77.e1–77.e14.
- Nayak M, Panda S, Panda S, et al. Neonatal outcomes of pregnant women with COVID-19 in a developing country setup. Pediatrics & Neonatology. 2021; 62(5): 499–505.
- Chen Y, Peng H, Wang L, et al. Infants Born to Mothers With a New Coronavirus (COVID-19). Front Pediatr. 2020; 8: 104.
- Angelidou A, Sullivan K, Melvin P, et al. Association of Maternal Perinatal SARS-CoV-2 Infection With Neonatal Outcomes During the COVID-19 Pandemic in Massachusetts. JAMA Network Open. 2021; 4(4): e217523.
- Zhu H, Wang L, Fang C, et al. Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia. Translational Pediatrics. 2020; 9(1): 51–60.
