Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: national population based cohort study

BMJ. 2020 Jun 8;369:m2107. doi: 10.1136/bmj.m2107.

Abstract

Objectives: To describe a national cohort of pregnant women admitted to hospital with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the UK, identify factors associated with infection, and describe outcomes, including transmission of infection, for mothers and infants.

Design: Prospective national population based cohort study using the UK Obstetric Surveillance System (UKOSS).

Setting: All 194 obstetric units in the UK.

Participants: 427 pregnant women admitted to hospital with confirmed SARS-CoV-2 infection between 1 March 2020 and 14 April 2020.

Main outcome measures: Incidence of maternal hospital admission and infant infection. Rates of maternal death, level 3 critical care unit admission, fetal loss, caesarean birth, preterm birth, stillbirth, early neonatal death, and neonatal unit admission.

Results: The estimated incidence of admission to hospital with confirmed SARS-CoV-2 infection in pregnancy was 4.9 (95% confidence interval 4.5 to 5.4) per 1000 maternities. 233 (56%) pregnant women admitted to hospital with SARS-CoV-2 infection in pregnancy were from black or other ethnic minority groups, 281 (69%) were overweight or obese, 175 (41%) were aged 35 or over, and 145 (34%) had pre-existing comorbidities. 266 (62%) women gave birth or had a pregnancy loss; 196 (73%) gave birth at term. Forty one (10%) women admitted to hospital needed respiratory support, and five (1%) women died. Twelve (5%) of 265 infants tested positive for SARS-CoV-2 RNA, six of them within the first 12 hours after birth.

Conclusions: Most pregnant women admitted to hospital with SARS-CoV-2 infection were in the late second or third trimester, supporting guidance for continued social distancing measures in later pregnancy. Most had good outcomes, and transmission of SARS-CoV-2 to infants was uncommon. The high proportion of women from black or minority ethnic groups admitted with infection needs urgent investigation and explanation.

Study registration: ISRCTN 40092247.

MeSH terms

  • Adult
  • Betacoronavirus*
  • Cesarean Section / statistics & numerical data
  • Coronavirus Infections / complications
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / virology
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Incidence
  • Minority Groups / statistics & numerical data
  • Pandemics
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / epidemiology*
  • Pneumonia, Viral / virology
  • Pregnancy
  • Pregnancy Complications, Infectious / epidemiology*
  • Pregnancy Complications, Infectious / virology*
  • Premature Birth / epidemiology
  • Premature Birth / virology
  • Prospective Studies
  • Risk Factors
  • United Kingdom / epidemiology

Supplementary concepts

  • COVID-19
  • severe acute respiratory syndrome coronavirus 2