Clinical characteristics of Covid-19 in pregnancy and newborn: A retrospective study

Objective

To describe the clinical characteristics of pregnant women infected with COVID-19, 4 weeks before delivery and their neonates and to investigate the possibility of vertical transmission during pregnancy.

Design

A retrospective study.

Methods

A data review of existing electronic medical records (Cerner) for all pregnant women who were positive for COVID-19, 4 weeks before delivery and delivered in any facility in Qatar from 1st of April 2020 till 7th of April 2021 and their newborns. RtPCR tests using a nasopharyngeal swab were done for symptomatic pregnant women at the time of disease onset and for all pregnant women when they were admitted for delivery regardless if they had symptoms or not. RtPCR tests using a nasopharyngeal swab was done for the newborns whom delivered to positive mothers. 300 women and their newborns were included. Data included the frequency (number of cases, N) and percentage (%) of total study patients observed in each category.

Results

A total of 300 pregnant women were tested positive for COVID-19 before delivery, 59.67% (179/300) were asymptomatic and 40.33% (121/300) were symptomatic. From symptomatic patients 90.09% (109/121) had mild symptoms and recovered without complications and 9.91% (12/121) developed severe respiratory symptoms requiring admission to intensive care unit, all were recovered. Mortality rate was zero.

All mothers delivered live babies and no IUFD, 55% (165/300) delivered by vaginal delivery while 45% (135/300) delivered by cesarean section. 84.67% (254/300) were term and 15.33% (46/300) were preterm. 46.34% (139/300) were separated from mothers and kept in isolation after delivery and 53.66% (161/300) were kept with mother in same room and restricted contact precaution was applied. 87.4% (262/300) were asymptomatic at delivery and 12.6% (38/300) were symptomatic and needed admission to NICU. PCR test for COVID-19 was done for all newborns, 295 were negative (98.33%), 3 were inconclusive (1%) and 2 were positive (0.67%).

Conclusion

There was increase in the rate of premature deliveries. There is low risk of transmission of COVID-19 to newborn babies. None of the neonates developed sign and symptoms of SARS-CoV-2 infection during breast feeding and rooming in.

Although nearly sixty percent of pregnant women with positive COVID-19 were asymptomatic, Covid 19 can cause serious complication during pregnancy.