Abstract
Objective This study aimed to describe baseline characteristics of a cohort of pregnant women
infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and determine
if these correlate with disease severity and perinatal outcomes.
Study Design This was a retrospective cohort trial conducted at the University of Texas Medical
Branch Galveston, Texas. All pregnant women presented to our medical center, who were
screened and tested positive for SARS-CoV-2 virus, were included. We stratified our
study population in three groups: asymptomatic, symptomatic not requiring oxygen therapy,
and patients requiring oxygen support to maintain oxygen saturation >94%. Relevant
population characteristics, laboratory data, and maternal and neonatal outcomes were
abstracted. A p-value <0.05 was considered statistically significant.
Results Between March and July 2020, 91 women tested positive for SARS-CoV-2 upon admission
to our labor and delivery unit. Among these, 61.5% were asymptomatic, 34.1% were symptomatic,
and 4.4% required oxygen support. Our population was mainly Hispanic (80.2%), multiparous
(76.9%), obese (70.3%), and with a median age of 27 years. Median gestational age
at symptom onset or diagnosis was 36 weeks. Significant differences were found between
gestational age and disease severity. Maternal characteristics including age, body
mass index (BMI), and presence of comorbid conditions did not appear to influence
severity of SARS-CoV-2 infection. Significant laboratory findings associated with
increasing disease severity included decreasing hemoglobin and white blood cell count,
lymphopenia, and increasing levels of inflammatory markers including CRP, ferritin,
and procalcitonin. Maternal and neonatal outcomes did not differ among groups. No
SARS-CoV-2 was detected by polymerase chain reaction testing in neonates of mothers
with COVID-19.
Conclusion Pregnant patients with COVID-19 infection are predominantly asymptomatic. Patients
appear to be at increased risk for more severe infection requiring oxygen support
later in pregnancy.
Key Points
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The majority of pregnant patients with COVID-19 are asymptomatic and <1 in 20 require
oxygen support.
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Women in the later stages of pregnancy may be at increased risk for severe infection.
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Anemia, leukopenia, CRP, ferritin, and procalcitonin are associated with increasing
severity.
Keywords
COVID-19 - pregnancy - severity - characteristics - outcomes
