Maternal and perinatal outcomes of pregnant women with SARS-CoV-2 infection

Saccone, G.; Sen, C.; Di Mascio, D.; Galindo, A.; Grunebaum, A.; Yoshimatsu, J.; Stanojevic, M.; Kurjak, A.; Chervenak, F.; Suarez, M. J. R.; Gambacorti-Passerini, Z. M.; de los Angeles Anaya Baz, M.; Galan, E. V. A.; Lopez, Y. C.; Luis, J. A. D. L.; Hernandez, I. C.; Herraiz, I.; Villalain, C.; Venturella, R.; Rizzo, G.; Mappa, I.; Gerosolima, G.; Hellmeyer, L.; Konigbauer, J.; Ameli, G.; Frusca, T.; Volpe, N.; Schera, G. B. L.; Fieni, S.; Esposito, E.; Simonazzi, G.; Di Donna, G.; Youssef, A.; Gatta, A. N. D.; Di Donna, M. C.; Chiantera, V.; Buono, N.; Sozzi, G.; Greco, P.; Morano, D.; Bianchi, B.; Marino, M. G. L.; Laraud, F.; Ramone, A.; Cagnacci, A.; Barra, F.; Gustavino, C.; Ferrero, S.; Ghezzi, F.; Cromi, A.; Lagana, A. S.; Longo, V. L.; Stollagli, F.; Sirico, A.; Lanzone, A.; Driul, L.; Cecchini, F.; Xodo, S.; Rodriguez, B.; Mercado-Olivares, F.; Elkafrawi, D.; Sisti, G.; Esposito, R.; Coviello, A.; Cerbone, M.; Morlando, M.; Schiattarella, A.; Colacurci, N.; De Franciscis, P.; Cataneo, I.; Lenzi, M.; Sandri, F.; Buscemi, R.; Gattei, G.; Sala, F. D.; Valori, E.; Rovellotti, M. C.; Done, E.; Faron, G.; Gucciardo, L.; Esposito, V.; Vena, F.; Giancotti, A.; Brunelli, R.; Muzii, L.; Nappi, L.; Sorrentino, F.; Liberati, M.; Buca, D.; Leombroni, M.; Di Sebastiano, F.; Franchi, M.; Ianniciello, Q. C.; Garzon, S.; Petriglia, G.; Borrello, L.; Nieto-Calvache, A. J.; Burgos-Luna, J. M.; Kadji, C.; Carlin, A.; Bevilacqua, E.; Moucho, M.; Viana Pinto, P.; Figueiredo, R.; Morales Rosello, J.; Loscalzo, G.; Martinez-Varea, A.; Diago, V.; Jimenez Lopez, J. S.; Aykanat, A. Y.; Cosma, S.; Carosso, A.; Benedetto, C.; Bermejo, A.; Feuerschuette, O. H. M.; Uyaniklar, O.; Ocakouglu, S. R.; Atak, Z.; Gunduz, R.; Haberal, E. T.; Froessler, B.; Parange, A.; Palm, P.; Samardjiski, I.; Taccaliti, C.; Okuyan, E.; Daskalakis, G.; de Sa, R. A. M.; Pittaro, A.; Gonzalez-Duran, M. L.; Guisan, A. C.; Genc, S. O.; Zlatohlavkova, B.; Piqueras, A. L.; Oliva, D. E.; Cil, A. P.; Api, O.; Antsaklis, P.; Ples, L.; Kyvernitakis, I.; Maul, H.; Malan, M.; Lila, A.; Granese, R.; Ercoli, A.; Zoccali, G.; Villasco, A.; Biglia, N.; Madalina, C.; Costa, E.; Daelemans, C.; Pintiaux, A.; Cueto, E.; Hadar, E.; Dollinger, S.; Brzezinski-Sinai, N. A.; Huertas, E.; Arango, P.; Sanchez, A.; Schvartzman, J. A.; Cojocaru, L.; Turan, S.; Turan, O.; Di Dedda, M. C.; Molpeceres, R. G.; Zdjelar, S.; Premru-Srsen, T.; Kornhauser-Cerar, L.; Druskovic, M.; De Robertis, V.; Stefanovic, V.; Nupponen, I.; Nelskyla, K.; Khodjaeva, Z.; Gorina, K. A.; Sukhikh, G. T.; Maruotti, G. M.; Visentin, S.; Cosmi, E.; Ferrari, J.; Gatti, A.; Luvero, D.; Angioli, R.; Puri, L.; Palumbo, M.; D'Urso, G.; Colaleo, F.; Rapisarda, A. M. C.; Carbone, I. F.; Manzoli, L.; Flacco, M. E.; Nazzaro, G.; Locci, M.; Guida, M.; Sardo, A. D. S.; Panici, P. B.; Khalil, A.; Berghella, V.; Bifulco, G.; Scambia, G.; Zullo, F.; D'Antonio, F.

doi:10.1002/uog.23107

Objectives: To evaluate the maternal and perinatal outcomes of pregnancies affected by SARS-CoV-2 infection. Methods: This was a multinational retrospective cohort study including women with a singleton pregnancy and laboratory-confirmed SARS-CoV-2 infection, conducted in 72 centers in 22 different countries in Europe, the USA, South America, Asia and Australia, between 1 February 2020 and 30 April 2020. Confirmed SARS-CoV-2 infection was defined as a positive result on real-time reverse-transcription polymerase chain reaction (RT-PCR) assay of nasopharyngeal swab specimens. The primary outcome was a composite measure of maternal mortality and morbidity, including admission to the intensive care unit (ICU), use of mechanical ventilation and death. Results: In total, 388 women with a singleton pregnancy tested positive for SARS-CoV-2 on RT-PCR of a nasopharyngeal swab and were included in the study. Composite adverse maternal outcome was observed in 47/388 (12.1%) women; 43 (11.1%) women were admitted to the ICU, 36 (9.3%) required mechanical ventilation and three (0.8%) died. Of the 388 women included in the study, 122 (31.4%) were still pregnant at the time of data analysis. Among the other 266 women, six (19.4% of the 31 women with first-trimester infection) had miscarriage, three (1.1%) had termination of pregnancy, six (2.3%) had stillbirth and 251 (94.4%) delivered a liveborn infant. The rate of preterm birth before 37 weeks' gestation was 26.3% (70/266). Of the 251 liveborn infants, 69/251 (27.5%) were admitted to the neonatal ICU, and there were five (2.0%) neonatal deaths. The overall rate of perinatal death was 4.1% (11/266). Only one (1/251, 0.4%) infant, born to a mother who tested positive during the third trimester, was found to be positive for SARS-CoV-2 on RT-PCR. Conclusions: SARS-CoV-2 infection in pregnant women is associated with a 0.8% rate of maternal mortality, but an 11.1% rate of admission to the ICU. The risk of vertical transmission seems to be negligible. © 2020 International Society of Ultrasound in Obstetrics and Gynecology.