In:
Annals of the Academy of Medicine, Singapore, Academy of Medicine, Singapore, Vol. 49, No. 11 ( 2020-11-30), p. 857-869
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.
Keywords: Pregnancy outcomes, maternal morbidity, mother-child transmission, SARS-CoV-2, transferred immunity
Type of Medium:
Online Resource
ISSN:
0304-4602
DOI:
10.47102/annals-acadmedsg.
DOI:
10.47102/annals-acadmedsg.2020437
Language:
English
Publisher:
Academy of Medicine, Singapore
Publication Date:
2020
detail.hit.zdb_id:
2186627-2
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