Clinical Findings and Disease Severity in Hospitalized Pregnant Women With Coronavirus Disease 2019 (COVID-19) : Obstetrics & Gynecology

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Contents: Original Research

Clinical Findings and Disease Severity in Hospitalized Pregnant Women With Coronavirus Disease 2019 (COVID-19)

Savasi, Valeria M. MD, PhD; Parisi, Francesca MD, PhD; Patanè, Luisa MD; Ferrazzi, Enrico MD; Frigerio, Luigi MD, PhD; Pellegrino, Antonio MD; Spinillo, Arsenio MD; Tateo, Saverio MD; Ottoboni, Mariacristina MD; Veronese, Paola MD, PhD; Petraglia, Felice MD; Vergani, Patrizia MD; Facchinetti, Fabio MD; Spazzini, Donata MD; Cetin, Irene MD, PhD

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Obstetrics & Gynecology 136(2):p 252-258, August 2020. | DOI: 10.1097/AOG.0000000000003979

OBJECTIVE: 

To investigate the clinical evolution of coronavirus disease 2019 (COVID-19) in hospitalized pregnant women and potential factors associated with severe maternal outcomes.

METHODS: 

We designed a prospective multicenter cohort study of pregnant women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who were admitted to 12 Italian maternity hospitals between February 23 and March 28, 2020. Clinical records, laboratory and radiologic examinations, and pregnancy outcomes were collected. A subgroup of patients with severe disease was identified based on intensive care unit (ICU) admission, delivery for respiratory compromise, or both.

RESULTS: 

Seventy-seven patients were included, 14 of whom had severe disease (18%). Two thirds of the patients in the cohort were admitted during the third trimester, and 84% were symptomatic on admission. Eleven patients underwent urgent delivery for respiratory compromise (16%), and six were admitted to the ICU (8%). One woman received extracorporeal membrane oxygenation; no deaths occurred. Preterm delivery occurred in 12% of patients, and nine newborns were admitted to the neonatal intensive care unit. Patients in the severe subgroup had significantly higher pregestational body mass indexes (BMIs) and heart and respiratory rates and a greater frequency of fever or dyspnea on admission compared with women with a nonsevere disease evolution.

CONCLUSION: 

In our cohort, one in five women hospitalized with COVID-19 infection delivered urgently for respiratory compromise or were admitted to the ICU. None, however, died. Increased pregestational BMI and abnormal heart and respiratory rates on admission were associated with severe disease.

© 2020 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.

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