Maternal, fetal and neonatal outcomes of large series of SARS-CoV-2 positive pregnancies in peripartum period: A single-center prospective comparative study

被引:61
作者
Hcini, Najeh [1 ]
Maamri, Fatma [1 ]
Picone, Olivier [2 ,3 ,4 ]
Carod, Jean-Francois [5 ]
Lambert, Veronique [1 ]
Mathieu, Meredith [1 ]
Carles, Gabriel [1 ]
Pomar, Leo [6 ]
机构
[1] West French Guiana Hosp Ctr, Dept Obstet & Gynaecol, St Laurent Du Maroni 97320, French Guiana
[2] Hop Louis Mourier, Assistance Publ Hop Paris, Serv Gynecol Obstet, Colombes, France
[3] Univ Paris, INSERM, IAME, U1137, Paris, France
[4] Grp Rech Infect Pendant Grossesse GRIG, Velizy Villacoublay, France
[5] West French Guiana Hosp Ctr, Dept Biol, St Laurent Du Maroni, French Guiana
[6] Lausanne Univ Hosp, Dept Woman Mother Child, Maternofetal & Obstet Res Unit, Lausanne, Switzerland
关键词
Pregnancy; SARS-CoV-2; infection; Maternal outcomes; Stillbirth; Neonatal outcomes; WOMEN;
D O I
10.1016/j.ejogrb.2020.11.068
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
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 %Cl 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. (C) 2020 Elsevier B.V. All rights reserved.
引用
收藏
页码:11 / 18
页数:8
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