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

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

Marian Knight  1 , Kathryn Bunch  2 , Nicola Vousden  3 , Edward Morris  4 , Nigel Simpson  5 , Chris Gale  6 , Patrick O'Brien  7 , Maria Quigley  2 , Peter Brocklehurst  8 , Jennifer J Kurinczuk  2 ; UK Obstetric Surveillance System SARS-CoV-2 Infection in Pregnancy Collaborative Group
Affiliations

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

Marian Knight et al. BMJ. .

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.

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Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at http://www.icmje.org/coi_disclosure.pdf and declare: MK, MQ, PB, POB, and JJK received grants from the NIHR in relation to the submitted work; EM is trustee and president of the Royal College of Obstetricians and Gynaecologists, trustee of the British Menopause Society, and chair of the Multiprofessional Advisory Committee, Baby Lifeline; no other relationships or activities that could appear to have influenced the submitted work.

Figures

Fig 1
Fig 1
Maternal symptoms at diagnosis of covid-19
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