| [Objectives] Since December 2019,the pandemic caused by SARS-CoV-2 has widely spread to more than 200 countries.So far,the clinical,pregnancy,and neonatal outcomes and prognosis of pregnant women with COVID-19 remained controversial.Reports regarding long-term large-sample case-control studies were scarce.This study aimed to analyze the clinical and follow-up data of pregnant women with COVID-19 and their newborns,non-pregnant women with COVID-19,and pregnant women without COVID-19,and to explore the impact of COVID-19 on clinical,pregnancy,perinatal,and neonatal outcomes and prognosis of pregnant women.[Methods] This study included 122 pregnant women with COVID-19 and 106 newborns born from these mothers from 31 hospitals of Hubei province during January 15 and July 9,2020.Two control groups,106 non-pregnant women with COVID-19 and 518 pregnant women without COVID-19,were included with matched age,comorbidities,the same study period,and the same regions.This study obtained medical data from electronic health records,including the demographic,epidemiological,clinical,laboratory,imaging,therapeutic,and prognosis data and pregnancy,perinatal,and neonatal outcomes.The SARS-CoV-2 nucleic acid testing,antibody tests,and the growth and development information of newborns and mothers were telephone followed-up.The follow-up lasted until September 25,2020.[Results] Among 122 pregnant women with COVID-19,the median age was 31.0years(IQR 28.75 to 33.0),the median incubation period was 7 days(IQR 5.5 to 13.5);the most common symptoms at presentation were fever(40.2%,49 of 122 cases)and cough(37.7%,46 of 122 cases),36.9% of 122 cases were asymptomatic.On admission,most of pregnant women with COVID-19 were categorized as mild(12.3% of 122 cases)or moderate cases(77.9% of 122 cases),11 patients(9.0%)and1 patient(0.8%)were severe and critical cases,respectively.All patients recovered and were discharged after treatment.Compared to non-pregnant women with COVID-19,pregnant women with COVID-19 had similar clinical manifestation,outcome and prognosis.Of 122 pregnant women with COVID-19,11 patients were in the first trimester,11 were in the second trimester,and 100 were in the third trimester on admission.By September 25,103 deliveries(including 3 sets of twins)comprised89 cesarean sections and 14 vaginal deliveries,with 19 preterm and 84 full-term deliveries.Nine cases in the first trimester had induced abortions,1 case in the second trimester was stillborn,but there was no evidence indicating that these adverse pregnancy outcomes were associated with COVID-19.Compared to pregnant women without COVID-19,pregnant women with COVID-19 had similar pregnancy,perinatal,and neonatal outcomes.Among newborns born from pregnant women with COVID-19,1 newborn tested positive for SARS-CoV-2 nucleic acid,and 7 newborns were viral antibody-positive: 6 IgG(+)and IgM(-),and 1 IgG(+)and IgM(+).Surveillance during rehabilitation period found that COVID-19 seemed to have no short-term impact on the growth and development of newborns of pregnant women with COVID-19.[Conclusions] Compared to non-pregnant women with COVID-19 and pregnant women without COVID-19,pregnant women with COVID-19 had similar clinical manifestation and prognosis.No significant increase of the incidence of adverse clinical,pregnancy,perinatal,and neonatal outcomes was observed.Suffering from COVID-19 may not be an absolute indication for immediate termination of pregnancy.The most appropriate delivery time and mode for the pregnancy management should be determined by a comprehensive assessment of both maternal and fetal conditions.Moreover,this study found no evidence supporting the possibility of maternal-to-fetal transmission of SARS-CoV-2.Follow-up data showed that there was no short-term impact of SARS-CoV-2 on pregnant women and newborns.To further explore the long-term impact of COVID-19 on pregnant women and their offspring,the long-lasting large-sample studies are necessary. |
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