Pregnancy Outcomes in COVID-19: A Prospective Cohort Study in Singapore.
10.47102/annals-acadmedsg.2020437
- Author:
Citra Nz MATTAR
1
;
Shirin KALIMUDDIN
;
Sapna P SADARANGANI
;
Shephali TAGORE
;
Serene THAIN
;
Koh Cheng THOON
;
Eliane Y HONG
;
Abhiram KANNEGANTI
;
Chee Wai KU
;
Grace Mf CHAN
;
Kelvin Zx LEE
;
Jeannie Jy YAP
;
Shaun S TAN
;
Benedict YAN
;
Barnaby E YOUNG
;
David C LYE
;
Danielle E ANDERSON
;
Liying YANG
;
Lin Lin SU
;
Jyoti SOMANI
;
Lay Kok TAN
;
Mahesh A CHOOLANI
;
Jerry Ky CHAN
Author Information
1. Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
- Publication Type:Observational Study
- MeSH:
Abortion, Spontaneous/epidemiology*;
Adult;
COVID-19/transmission*;
COVID-19 Nucleic Acid Testing;
COVID-19 Serological Testing;
Cohort Studies;
Disease Transmission, Infectious/statistics & numerical data*;
Female;
Fetal Blood/immunology*;
Humans;
Infectious Disease Transmission, Vertical/statistics & numerical data*;
Live Birth/epidemiology*;
Maternal Age;
Milk, Human/virology*;
Obesity, Maternal/epidemiology*;
Placenta/pathology*;
Pregnancy;
Pregnancy Complications, Infectious/physiopathology*;
Pregnancy Outcome/epidemiology*;
Pregnancy Trimester, First;
Pregnancy Trimester, Second;
Prospective Studies;
RNA, Viral/analysis*;
Risk Factors;
SARS-CoV-2;
Severity of Illness Index;
Singapore/epidemiology*;
Umbilical Cord/pathology*;
Young Adult
- From:Annals of the Academy of Medicine, Singapore
2020;49(11):857-869
- CountrySingapore
- Language:English
-
Abstract:
INTRODUCTION:Pregnant women are reported to be at increased risk of severe coronavirus disease 2019 (COVID-19) due to underlying immunosuppression during pregnancy. However, the clinical course of COVID-19 in pregnancy and risk of vertical and horizontal transmission remain relatively unknown. We aim to describe and evaluate outcomes in pregnant women with COVID-19 in Singapore.
METHODS:Prospective observational study of 16 pregnant patients admitted for COVID-19 to 4 tertiary hospitals in Singapore. Outcomes included severe disease, pregnancy loss, and vertical and horizontal transmission.
RESULTS:Of the 16 patients, 37.5%, 43.8% and 18.7% were infected in the first, second and third trimesters, respectively. Two gravidas aged ≥35 years (12.5%) developed severe pneumonia; one patient (body mass index 32.9kg/m2) required transfer to intensive care. The median duration of acute infection was 19 days; one patient remained reverse transcription polymerase chain reaction (RT-PCR) positive >11 weeks from diagnosis. There were no maternal mortalities. Five pregnancies produced term live-births while 2 spontaneous miscarriages occurred at 11 and 23 weeks. RT-PCR of breast milk and maternal and neonatal samples taken at birth were negative; placenta and cord histology showed non-specific inflammation; and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific immunoglobulins were elevated in paired maternal and umbilical cord blood (n=5).
CONCLUSION:The majority of COVID-19 infected pregnant women had mild disease and only 2 women with risk factors (obesity, older age) had severe infection; this represents a slightly higher incidence than observed in age-matched non-pregnant women. Among the women who delivered, there was no definitive evidence of mother-to-child transmission via breast milk or placenta.
