Maternal and perinatal outcomes in pregnant women with confirmed severe and mild COVID-19 at one large maternity hospital in Chile

We conducted a prospective observational cohort study in 458 pregnant and puerperal women, with confirmed COVID-19 at Hospital San Jose, Santiago, Chile, to determine the impact of COVID-19 on pregnancy and confirm safety and feasibility of a management protocol based on clinical presentation of the disease. 25.5% (117/458) of women were severe and 74.4% (341/458) mild presentation. Three percent (9/341) of mild presentations required a subsequent hospitalization. Overall, 26/458 women (5.6%) were admitted to ICU, and 13/458 (2.8%) required mechanical ventilation. One maternal death occurred at 49-days postpartum. Severe presentation, infection above 24 weeks, and comorbidities were associated with an adverse maternal outcome. Of total deliveries, 16.5% (36/217) were A quarter of the women had severe COVID-19 that, combined with occurrence of disease in the second half of pregnancy, resulted in substantial maternal compromise. Perinatal morbidity and mortality in women with severe disease were high and warrant consideration. Outpatient management was safe for mild cases.

本研究于智利圣地亚哥圣何塞医院开展一项前瞻性观察队列研究，纳入458名确诊新型冠状病毒肺炎（COVID-19）的妊娠及产褥期女性，旨在明确COVID-19对妊娠的影响，并验证基于疾病临床分型制定的管理方案的安全性与可行性。其中25.5%（117/458）的女性为重型COVID-19，74.4%（341/458）为轻型病例。轻型病例中有3%（9/341）后续需住院治疗。整体而言，26名（占比5.6%）受试者需入住重症监护室（Intensive Care Unit，ICU），13名（占比2.8%）需接受机械通气。1名产妇于产后49天死亡。重型临床分型、妊娠24周后感染以及合并症与不良妊娠结局相关。在总计217例分娩中，16.5%（36/217）为；四分之一的女性患有重型COVID-19，若叠加妊娠中晚期感染，则会导致产妇出现显著不良转归。重型病例的围产期发病率与死亡率均较高，值得临床重视。轻型病例采取门诊管理方案安全性良好。