SARS-CoV-2 infection in pregnancy and newborn in a Spanish multicentric cohort (GESNEO-COVID)

Background: Knowledge about SARS-CoV-2 infection in pregnancy and newborn is scarce [1,2] The objective of the study is to describe clinical and epidemiological characteristics of a cohort of women infected with SARS-CoV-2 during pregnancy and their newborns Materials and methods: Multicentre observational study of five hospitals of the GESNEO-COVID cohort, participants in RECLIP Women with confirmed SARS-CoV-2 infection by PCR and/or serology during pregnancy, diagnosed and delivering during the period 15 March to 1 July 2020 were included Epidemiological and clinical data were collected Results: There were two twin births so 74 mothers and 76 newborns were included The median age of pregnant women was 33 5 (IQR 28 8 to 37 0) years;52 7% were Spanish and 47 3% were foreigners (68 6% from Latin America) Almost 7% were diagnosed during the second quarter and 90 5% during the third quarter More than half (67 6%) of pregnant women had symptoms, fever (56%) and cough (52%) the most frequent 37 8% received treatment for COVID-19 One-third (35 1%) had pneumonia and three (11 5%) of them were admitted to the ICU, requiring invasive mechanical ventilation All pneumonia was diagnosed during the first month of the study Pregnant women with pneumonia had a higher proportion of Caesarean sections (61 5% vs 29 2%;p = 0 014) and premature newborns (42 3% vs 12 5%;p = 0 009) than those not having pneumonia Globally, 40 5% of pregnant women had a Caesarean delivery (around 20% last year), the indication was severity of COVID-19 for 30% of them Overall prematurity was 23% (around 15% last year) and in C-sections by COVID-19, 77 8% 19 7% of newborns required admission to intensive care with a median duration of 4 (IQR 1 to 13) days 64 5% were breastfed Nasopharyngeal PCR was performed at birth, being 100% negative (71/71), and at 15 days of life, being 1/42 positive (4 2%), assuming contagion in the family environment A 20-days-old newborn died due to prematurity-related causes Conclusions: SARS-CoV-2 infection during pregnancy could cause COVID-19 pneumonia that would condition an alteration in the course of pregnancy We find a high proportion of Caesarean sections and prematurity, being higher in pregnant women with pneumonia, which would worsen neonatal prognosis There is no vertical transmission in our series but a case of horizontal transmission by intra-family contact was found