Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records
- PMID: 32151335
- PMCID: PMC7159281
- DOI: 10.1016/S0140-6736(20)30360-3
Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records
Erratum in
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Department of Error.Lancet. 2020 Mar 28;395(10229):1038. doi: 10.1016/S0140-6736(20)30606-1. Epub 2020 Mar 12. Lancet. 2020. PMID: 32171424 Free PMC article. No abstract available.
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Department of Error.Lancet. 2020 Mar 28;395(10229):1038. doi: 10.1016/S0140-6736(20)30639-5. Epub 2020 Mar 23. Lancet. 2020. PMID: 32213320 Free PMC article. No abstract available.
Abstract
Background: Previous studies on the pneumonia outbreak caused by the 2019 novel coronavirus disease (COVID-19) were based on information from the general population. Limited data are available for pregnant women with COVID-19 pneumonia. This study aimed to evaluate the clinical characteristics of COVID-19 in pregnancy and the intrauterine vertical transmission potential of COVID-19 infection.
Methods: Clinical records, laboratory results, and chest CT scans were retrospectively reviewed for nine pregnant women with laboratory-confirmed COVID-19 pneumonia (ie, with maternal throat swab samples that were positive for severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) who were admitted to Zhongnan Hospital of Wuhan University, Wuhan, China, from Jan 20 to Jan 31, 2020. Evidence of intrauterine vertical transmission was assessed by testing for the presence of SARS-CoV-2 in amniotic fluid, cord blood, and neonatal throat swab samples. Breastmilk samples were also collected and tested from patients after the first lactation.
Findings: All nine patients had a caesarean section in their third trimester. Seven patients presented with a fever. Other symptoms, including cough (in four of nine patients), myalgia (in three), sore throat (in two), and malaise (in two), were also observed. Fetal distress was monitored in two cases. Five of nine patients had lymphopenia (<1·0 × 10⁹ cells per L). Three patients had increased aminotransferase concentrations. None of the patients developed severe COVID-19 pneumonia or died, as of Feb 4, 2020. Nine livebirths were recorded. No neonatal asphyxia was observed in newborn babies. All nine livebirths had a 1-min Apgar score of 8-9 and a 5-min Apgar score of 9-10. Amniotic fluid, cord blood, neonatal throat swab, and breastmilk samples from six patients were tested for SARS-CoV-2, and all samples tested negative for the virus.
Interpretation: The clinical characteristics of COVID-19 pneumonia in pregnant women were similar to those reported for non-pregnant adult patients who developed COVID-19 pneumonia. Findings from this small group of cases suggest that there is currently no evidence for intrauterine infection caused by vertical transmission in women who develop COVID-19 pneumonia in late pregnancy.
Funding: Hubei Science and Technology Plan, Wuhan University Medical Development Plan.
Copyright © 2020 Elsevier Ltd. All rights reserved.
Figures
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Comment in
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SARS-CoV-2 infection in children: Transmission dynamics and clinical characteristics.J Formos Med Assoc. 2020 Mar;119(3):670-673. doi: 10.1016/j.jfma.2020.02.009. Epub 2020 Mar 2. J Formos Med Assoc. 2020. PMID: 32139299 Free PMC article. No abstract available.
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What are the risks of COVID-19 infection in pregnant women?Lancet. 2020 Mar 7;395(10226):760-762. doi: 10.1016/S0140-6736(20)30365-2. Epub 2020 Feb 12. Lancet. 2020. PMID: 32151334 Free PMC article. No abstract available.
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Lack of maternal-fetal SARS-CoV-2 transmission.Nat Med. 2020 Mar;26(3):312. doi: 10.1038/s41591-020-0810-y. Nat Med. 2020. PMID: 32161408 Free PMC article. No abstract available.
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Impact of COVID-19 infection on pregnancy outcomes and the risk of maternal-to-neonatal intrapartum transmission of COVID-19 during natural birth.Infect Control Hosp Epidemiol. 2020 Jun;41(6):748-750. doi: 10.1017/ice.2020.84. Infect Control Hosp Epidemiol. 2020. PMID: 32279693 Free PMC article. No abstract available.
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[Impact of the pandemic COVID-19 in andrology. Recommendations in daily clinical practice].Rev Int Androl. 2020 Jul-Sep;18(3):124-126. doi: 10.1016/j.androl.2020.05.001. Epub 2020 Jun 5. Rev Int Androl. 2020. PMID: 32546419 Free PMC article. Spanish. No abstract available.
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The first pregnant woman with COVID-19 in Venezuela: Pre-symptomatic transmission.Travel Med Infect Dis. 2020 Jul-Aug;36:101805. doi: 10.1016/j.tmaid.2020.101805. Epub 2020 Jun 25. Travel Med Infect Dis. 2020. PMID: 32593868 Free PMC article. No abstract available.
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COVID-19 and pregnancy outcomes: initial findings show little threat, but more data are needed.Evid Based Nurs. 2021 Apr;24(2):59. doi: 10.1136/ebnurs-2020-103296. Epub 2020 Sep 2. Evid Based Nurs. 2021. PMID: 32878906 No abstract available.
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