Maternal and perinatal characteristics and outcomes of pregnancies complicated with COVID-19 in Kuwait

  1. Amal Ayed
  2. Alia Embaireeg
  3. Asmaa Benawadh
  4. Wadha Al-Fouzan
  5. Majdeda Hammoud
  6. Monif Al-Hathal
  7. Abeer Alzaydai
  8. Ashraf Ahmad
  9. Mariam Ayed

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Abstract

Background

The effect of SARS-CoV-2 infection in pregnant women and newborns is incompletely understood. Preliminary data shows a rather fluctuating course of the disease from asymptomatic or mild symptoms to maternal death. However, it is not clear whether the disease increases the risk of pregnancy-related complications. The aim of the study is to describe the maternal and neonatal clinical characteristics and outcome of pregnancies with SARS-CoV-2 infection.

Methods

In this retrospective national-based study, we analyzed the medical records of all pregnant women infected with SARS-CoV-2 and their neonates who were admitted to New-Jahra Hospital (NJH), Kuwait, between March 15th 2020 and May 31st 2020. During the study period and as part of the public health measures, a total of 185 pregnant women infected with SARS-CoV-2, regardless of symptoms, were hospitalized at NJH, and were included. Maternal and neonatal clinical manifestations, laboratory tests and treatments were collected. The outcomes of pregnancies included miscarriage, intrauterine fetal death (IUFD), preterm birth and live birth were assessed until the end date of the outcomes follow-up (November 10th 2020).

Results

A total of 185 pregnant women infected with SARS-CoV-2 were enrolled with a median age of 31 years (interquartile range, IQR: 27.5–34), and median gestational age at diagnosis of SARS-CoV2 infection was 29 weeks (IQR: 18–34). The majority (88%) of these women had mild symptoms, with fever (58%) being the most common presenting symptom followed by cough (50.6%). At the time of the analysis, out of the 185, 3 (1.6%) of the pregnant women had a miscarriage, 1 (0.54%) had IUFD which was not related to COVID-19, 16 (8.6%) had ongoing pregnancies and 165 (89%) had a live birth. Only 2 (1.1%) of these women developed severe pneumonia and required intensive care. A total of 167 neonates with two sets of twins were born with median gestational age at birth was 38 (IQR: 36–39) weeks. Most of the neonates were asymptomatic, and only 2 of them tested positive on day 5 by nasopharyngeal swab testing.

Conclusions

In this national-based study, most of the pregnant women infected with SARS-CoV-2 showed mild symptoms. Although mother-to-child vertical transmission of SARS-CoV-2 is possible, COVID-19 infection during pregnancy may not lead to unfavorable maternal and neonatal outcomes.

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  1. Version published to 10.1186/s12884-020-03461-2
  2. ScreenIT

    SciScore for 10.1101/2020.07.10.20150623: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementIRB: The study was approved by the Ethics Committee of the Ministry of Health of Kuwait (2020/1420) Patient selection criteria: We enrolled all pregnant women admitted to the maternity department due to SARS-CoV-2 infection, as confirmed by real-time reverse transcriptase-polymerase chain reaction (RT-PCR) assay of nasopharyngeal swab specimens (Cobas 6800 Systems, Roche, Switzerland) /
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variableAs part of Kuwait’s national COVID-19 policy, all pregnant women were tested if they had SARS-CoV-2 symptoms or had been in contact with infected patients.

    Table 2: Resources

    Experimental Models: Organisms/Strains
    SentencesResources
    Data entry and quality were checked and reviewed independently by two investigators (AE and AB).
    AB
    suggested: RRID:BDSC_203)

    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:
    However, there are also some inherent limitations to this study due to its retrospective study design. In conclusion, the clinical features of pregnant women with SARS-CoV-2 infection were similar to those of the general population infected with COVID-19. Favorable outcomes among pregnant women with SARS-CoV-2 infection suggest that pregnant women are not at higher risk to the COVID 19 than the general population, nor are they susceptible to severe pneumonia. Moreover, the neonatal outcome is also reassuring.

    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.

    About SciScore

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  3. Version published to 10.1101/2020.07.10.20150623v1 on medRxiv