Coronavirus disease 2019 in pregnancy

Highlights • Most pregnant women with SARS-CoV-2 infection present as mild to moderate type. • Pregnant women have clinical courses and outcomes that are comparable with reproductive-aged non-pregnant women infected with SARS-CoV-2. • No evidence supports vertical transmission of COVID-19, including vaginal delivery. Objectives This study aimed to compare clinical courses and outcomes between pregnant and reproductive-aged non-pregnant women with COVID-19, and to assess the vertical transmission potential of COVID-19 in pregnancy. Methods Medical records of pregnant and reproductive-aged non-pregnant women hospitalized with COVID-19 from January 15 to March 15, 2020 were retrospectively reviewed. The severity of disease, virus clearance time, and length of hospital stay were measured as the primary objective, while the vertical transmission potential of COVID-19 was also assessed. Results Eighty-two patients (28 pregnant women, 54 reproductive-aged non-pregnant women) with laboratory-confirmed COVID-19 were enrolled in this study. Univariate regression indicated no association between pregnancy and severity of disease (OR 0.73, 95% CI 0.08–5.15; p = 0.76), virus clearance time (HR 1.16, 95% CI 0.65–2.01; p = 0.62), and length of hospital stay (HR 1.10, 95% CI 0.66–1.84; p = 0.71). Of the pregnant women, 22 delivered 23 live births, either by cesarean section (17, 60.7%) or vaginal delivery (5, 17.9%), and no neonate was infected with SARS-CoV-2. Conclusions Pregnant women have comparable clinical courses and outcomes with reproductive-aged non-pregnant women when infected with SARS-CoV-2. No evidence supported vertical transmission of COVID-19 in the late stage of pregnancy, including vaginal delivery.