SARS-CoV-2 infection in pregnant women assisted in a high-risk maternity hospital in Brazil: Clinical aspects and obstetric outcomes

• Published in: PloS one Vol. 17; no. 3; p. e0264901
• Main Authors: Ferrugini, Carolina Loyola Prest, Boldrini, Neide Aparecida Tosato, Costa, Franco Luis Salume, Salgueiro, Michelle Anne de Oliveira Batista, Coelho, Pamella Dunga de Paula, Miranda, Angelica Espinosa
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 11.03.2022; Public Library of Science (PLoS)
• Subjects: Admission and discharge; Apgar score; Biology and life sciences; Cesarean section; Clinical aspects; Coronaviruses; Cough; COVID-19; Fetuses; Fever; Health aspects; Hospitals; Immunoglobulin G; Immunoglobulin M; Jaundice; Medicine and Health Sciences; Neonates; Newborn babies; Olfaction; Patient outcomes; Patients; Perinatal infection; Phototherapy; Polymerase chain reaction; Pregnancy; Pregnant women; Premature birth; Research and Analysis Methods; Respiratory diseases; Resuscitation; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Smell; Testing; Viral diseases; Womens health; Brazil
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0264901

The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the possible development of serious illness, and the possibility of severe obstetric outcomes highlight the importance of addressing SARS-CoV-2 infection in obstetric management. A cross-sectional study of pregnant women assisted in a high-risk maternity hospital in Brazil in 2020. All patients admitted for delivery or miscarriage care were tested for SARS-CoV-2 using polymerase chain reaction (PCR) and for immunoglobulin (I)gM, and/or IgG by immunochromatography. Clinical aspects and obstetric outcomes were analyzed. A total of 265 pregnant women were included in the study. There were 38 (14.4%) PCR positive cases during pregnancy, 12 (31.6%) on admission screening, and 71(27.2%) patients were IgM- and/or IgG-positive. Among the participants, 86 (32.4%) had at least one positive test during pregnancy. SARS-CoV-2 positive patients had greater contact with known positive patients (p = 0.005). The most frequently reported symptoms were runny nose, cough, loss of smell and taste, headache, and fever. There was also a 35% rate of asymptomatic infections and a 4.6% rate of severe or critical infections. Patients exposed or infected with SARS-CoV-2 had a higher incidence of preterm delivery, cesarean section, need for resuscitation in the delivery room, Apgar score <7 at 5 min, admission to the neonatal intensive care unit, and jaundice. Newborns with at least one positive test had a significantly greater need for phototherapy after delivery (p = 0.05). The results showed a high rate of positive tests among newborns (37.5%), which seems to be compatible with both neonatal and perinatal infection. It is important to further investigate SARS-CoV-2 infection during pregnancy, including the clinical course and the possibility of adverse outcomes with impact on maternal and fetal health, regardless of the development of symptoms.