Poor Maternal-neonatal Outcomes in Pregnant Patients with Confirmed SARS-Cov-2 Infection: Analysis of 145 Cases

Purpose: The coronavirus 2 (SARS-CoV-2) infection has recently spread causing millions of individuals affected globally. The raising mortality rate highlighted the necessity to identify the most susceptible populations, such as pregnant women and their fetuses, in order to protect them. Few studies have been conducted trying to identify maternal-neonatal outcomes among pregnant patients affected by COVID 19. In this scenario, this study aims to analyse poor maternal-neonatal outcomes in pregnant women affected by SARS-CoV-2 infection.

Methods: This was a double-centre, 5 months retrospective analysis conducted in Italy. The study population consisted of pregnant women with confirmed SARS-CoV-2 infection assessed by Time Quantitative Reverse Transcription PCR (qRT-PCR) nasopharyngeal swabs.

Results: 145 pregnant women affected by confirmed SARS-CoV-2 infection were included. Among them, 116 (80%) were symptomatic and 29 (20%) were asymptomatic. Up to half of the patients (n = 111; 76.5%) had a past history of respiratory disease. The mean gestational age at delivery was 36 weeks ± 5 days, while the mean maternal age was 31.5 ± 5.63. Reactive C protein (CRP) serum levels were higher than the normal range corresponding to a mean value of 56.93 ± 49.57 mg/L. The mean interval between the diagnosis of maternal COVID-19 infection and the delivery was 8.5 days. With regard to the type of delivery, the percentage of patients who delivered vaginally was higher than those who experienced a caesarean section. (74.4% vs 25.6%). The percentage of term birth was higher than preterm one (62% vs 38%). Finally, the percentages of maternal and neonatal death were found to be 5% and 6%, respectively; similarly, the percentage of the infection vertical transmission was 5%.

Conclusion: COVID-19 infection in pregnant women seems to negatively affect both maternal and neonatal outcomes. However, it is important to emphasize that most of the cases of maternal death occurred in patients with severe symptoms and highly altered parameters related to SARS-CoV-2 infection. In the future, larger studies are warranted in order to validate these findings.