NEW CORONAVIRUS IN PREGNANT WOMEN. Maternal and perinatal outcomes

  1. Jaime Sánchez
  2. Jorge Espinosa
  3. Luis Carlos Caballero
  4. B Sara Campana
  5. Arelys Quintero
  6. Carlos Luo
  7. C Jorge Ng
  8. Rafael de Gracia
  9. Paulino Vigil-De Gracia

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Abstract

Objectives

To report the maternal and neonatal results of patients infected with COVID-19 in Panama.

Methods

The study is based on the analysis of pregnant women with COVID-19, in 5 hospitals in the Republic of Panama. The inclusion criteria were: Patients with or without symptoms, positive RT-PCR for SARS-CoV-2 in the period from March 23 to 6 months after, whose births were attended in one of those 5 hospitals and who signed the consent. Data was obtained at the time of diagnosis of the infection and at the time of termination of pregnancy for the mother and newborn.

Results

253 patients met the inclusion criteria. Most were diagnosed in the third trimester (89.3%). 10.3% of the patients presented in a severe form of COVID-19. The most frequent complication was pre-eclampsia and if we add gestational hypertension they represent 21.2%; most of the patients terminated the pregnancy by caesarean section (58%). 26.9% (95% CI 21.3-32.9%) of the births were premature, and perinatal mortality was 5.4% (95% CI 3.0-9.0%). There was a need for mechanical ventilation in 5.9% (95% CI 3.6-9.6%) of the cohort and there were four maternal deaths (1.6% - 95% CI 0.6-4.0%).

Conclusions

This study of pregnant women infected with COVID-19 and diagnosed with RT-PCR shows serious maternal complications such as high admission to the ICU, need for mechanical ventilation and one death in every 64 infected. Frequent obstetric complications such as hypertension, premature rupture of membranes, high rate of prematurity and perinatal lethality were also seen.

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  1. ScreenIT

    SciScore for 10.1101/2021.06.03.21258328: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsConsent: Informed consent was required and the patients had to be admitted or delivered in one of the following hospitals: Complejo Hospitalario “Dr. AAM “Social Security Fund in Panama, Santo Tomás Hospital in Panama, José Domingo de Obaldía Hospital in Chiriquí, Luis” Chico “Fábrega Hospital in Veraguas and San Miguel Arcángel Hospital in Panama.
    Field Sample Permit: The sampling, processing, and laboratory techniques in patients with clinical suspicion, contacts, or specific indication were done following the national guidelines given by the ministry of health of Panama, which are those required by the World Health Organization.
    IRB: The protocol was approved by the national bioethics committee of Panama, protocol reference: EC-CNBI-2020-04-45.
    Sex as a biological variableWe conducted a prospective and observational cohort study from the beginning of the epidemic in Panama (mid-March 2020) for a period of 6 months, in pregnant women with a diagnosis of SARS-CoV-2 confirmed by RT-PCR.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    The limitations of this survey is the type of study (simple survey); the study does not involve the entire population; short duration, it was only for a period of 6 months, newborns are not followed-up after birth and do not know the risk of neonatal infections. The main strengths are the contribution for the country and obvious for Latin America regarding the experience and results of mothers with COVID-19 and their perinatal outcomes, all patients have RT-PCR confirming the diagnosis of SARS-CoV-2. In summary, this observational cohort study conducted in Panama with COVID-19 patients diagnosed with RT-PCR shows a high percentage of maternal complications, high admission to the ICU and mechanical ventilation, with about 2% maternal death; in addition to obstetric complications such as hypertension, premature rupture of membranes, high rate of prematurity and perinatal lethality. At the time of birth (using for PCR diagnosis) neonatal infection with SARS-CoV-2 is very low.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2021.06.03.21258328v1 on medRxiv