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To evaluate consequences of COVID-19 during pregnancy, U.K. investigators applied an existing protocol to assess pregnancy outcomes during a pandemic. Between March 1 and April 14, 2020, 427 pregnant women with confirmed SARS-CoV-2 infection were hospitalized across the U.K.; outcomes available by the end of April are presented.
Median gestation at admission was 34 weeks. Forty-one women (10%) required ICU admission and five (1.2%) died, three of whom had COVID-19 complications. Among deliveries occurring during the study period, 75% were term and 15% were preterm (7% because of COVID-19 complications). In all, 59% of women had a cesarean delivery, most for non-COVID-19–related reasons. Two neonates died and three were stillborn, but the relation to SARS-CoV-2 infection was unclear. Twelve infants tested positive for SARS-CoV-2, including 6 within 12 hours of birth. Risk for maternal admission was 4 times higher for Asian women and 8 times higher for black women compared with white women. Age >35 and obesity also carried higher risk for hospitalization.
Knight M et al. Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: National population based cohort study. BMJ 2020 Jun 8; 369:m2107. (https://doi.org/10.1136/bmj.m2107)
Comment
As with other respiratory viral infections, risk for hospitalization with COVID-19 increases substantially during the third trimester; however, most outcomes are favorable. As the authors note, given the U.K.'s universal healthcare, higher hospitalization rates among women of color are unlikely to be linked only to healthcare inequities. Still, substantial differences in socioeconomic status may negatively affect comorbidities, nutritional status, and risk for exposure to infected persons.