Pregnancy and Perinatal Outcomes of Women with COVID-19 Pneumonia: A Preliminary Analysis

Abstract

Background: The extensive studies on the Computed Tomography (CT) and clinical manifestations of coronavirus disease 2019 (COVID-19) patients and the treatment monitoring, attention on pregnant women with COVID-19 pneumonia (PWCP) remains relatively rare.

Methods: Our hospital is a designated hospital for the PWCP. We reviewed the clinical data and CT imaging of 15 consecutive PWCP patients in our hospital from January 20 to February 10, 2020. A semi-quantitative scoring system was used to estimate the time course change on chest CT. Symptoms and laboratory results were analyzed, treatment experience summarized, and clinical outcome tracked.

Findings: 11 patients had successful delivery (10 cesarean and 1 vaginal) during the study and 4 are still in pregnancy (3 in the second trimester and 1 in the third). No neonatal asphyxia, death, still birth, and abortion reported. Up to February 20, 2020, no severe pneumonia or severe pneumonia and acute respiratory distress syndrome (ARDS) occurred. A total of 25 low-dose chest CT scans were performed in all the 15 patients. The most common early finding on chest CT was ground glass opacity (GGO). With disease progression, crazy paving pattern and consolidations occurred. The abnormalities had shown absorptive changes at the end of the study for all patients. The chest CT imaging progression pattern was similar to that of non-pregnant women. The most common onset symptoms of PWCP were fever (13/15) and cough (9/15). The most common laboratory finding was lymphocytopenia (12/15). In this report, CT images before and after delivery showed no signs of pneumonia aggravation. The 4 cases still in pregnancy were not treated with antiviral drugs, but also achieved good recovery.

Interpretation: Pregnancy and childbirth did not aggravate the course of symptoms or CT features of COVID-19 Pneumonia. Pregnant women with COVID-19 pneumonia were mostly mild type, presenting with clinical features and CT imaging progression pattern similar to those of non-pregnant women. No infection was found in the newborns. In this report, the pregnant women achieved a good recovery without use of antiviral drugs.

Funding Statement: No funding is provided in this study.

Declaration of Interests: The authors declare no competing interests.

Ethics Approval Statement: This study was approved by the Ethics Committee of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology. Informed consent for this retrospective study was waived.

Keywords: ARDS: Acute respiratory distress syndrome; CT: Computed Tomography; COVID-19: Coronavirus Disease 2019; PWCP: pregnant women with COVID-19 pneumonia; PTPCR: reverse-transcription-polymerase chain- reaction; GGO: ground glass opacity