Introduction
The World Health Organisation (WHO) was alerted on the 31st of December
2019 by Chinese authorities of a series of pneumonia-like cases in the
city of Wuhan 11WHO. Pneumonia of unknown cause—China. 2020.https://www.who.int/csr/don/05-january-2020-pneumonia-of-unkown-cause-china/en/.The Chinese Centre for Disease Control and Prevention identified this
infection as a novel coronavirus infection on Jan 7, 2020 and on Feb 11,
2020, the WHO announced a new name for the epidemic disease as 2019-new
coronavirus disease (2019-nCoV and now known as COVID-19). Symptoms of
the infection had included fever, malaise, dry cough, shortness of
breath and respiratory distress 22Organization, W.H. Vol. 28.
2020. Clinical management of severe acute respiratory infection when
novel coronavirus (nCoV) infection is suspected: interim guidance.
Published January..
Data from China have indicated that older adults, particularly those
with serious underlying health conditions, are at higher risk for severe
COVID-19–associated illness and death than younger persons. Although
most reported COVID-19 cases in China were mild (81%), approximately
80% of deaths had occurred among adults population older than 60 years
of age; only one (0.1%) death had occurred in a person under 19 years
of age 33Novel Coronavirus Pneumonia Emergency Response
Epidemiology Team. The epidemiological characteristics of an outbreak
of 2019 novel coronavirus diseases (COVID-19) in China [Chinese].
Chinese Center for Disease Control and Prevention Weekly 2020;
41:145–5..
It is reasonable to anticipate that pregnant women might be at greater
risk for severe illness, morbidity or mortality, compared to the general
population due to immunologic and physiologic changes. This is observed
with other related coronavirus infections [including severe acute
respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory
syndrome coronavirus (MERS-CoV)]. Data from MERS-CoV and SARS-CoV,
although limited, suggest that infection in pregnancy is associated with
severe infection and adverse neonatal outcomes, including increased risk
of miscarriage, fetal growth restriction, and preterm birth, 44Schwartz
DA, Graham AL. Potential maternal and infant outcomes from (Wuhan)
coronavirus 2019-nCoV infecting pregnant women: lessons from SARS,
MERS, and other human coronavirus infections [J]. Viruses, 2020,12
(2). pii: e194. DOI: 10.3390 / v12020194.,55Chen HJ, Guo JJ, Wang C, et al. Clinical characteristics and
intrauterine vertical transmission potential of COVID-19 infection in
nine pregnant women: a retrospective review of medical records [J /
OL]. Lancet. [2020-02-12]. DOI: 10.1016 / s0140-6736 (20)
30360-3., 66Qiao J. What are the risks of
COVID-19 infection in pregnant women. Lancet. [2020-02-13]. DOI:
10.1016 / S0140-6736 (20) 30365-2., 77Di
Mascio D, Khalil A, Saccone G. Outcome of Coronavirus spectrum
infections (SARS, MERS, COVID-19) during pregnancy: a systematic
review and meta-analysis. Am J Obstet Gynecol MFM. however, data
specific to COVID-19 are not yet available. At present, there are few
reports of COVID-19 infection in pregnancy, including clinical
characteristics, maternal and neonatal outcomes; while the risk of an
intrauterine vertical transmission is inconclusive4,6.
The Royal College of Obstetrics and Gynaecology (RCOG) developed a
guidance for delivery and neonatal care in pregnancies affected by
COVID-19, which recommends that delivery mode be determined primarily by
obstetric indication and recommends against routine separation of
affected mothers and their babies. 88Royal College of
Obstetricians and Gynaecologists (RCOG). COVID 19 Pregnancy Guidelines
RCOG, United Kingdom (2020) Available from:
https://www.rcog.org.uk/globalassets/documents/guidelines/2020-03-21-covid19-pregnancy-guidance-2118.pdf
Concurrently, our institution issued an updated guidance for use of PPE
in view of the COVID-19 pandemic. We started prospective data collection
based on the developed guidance. We aim to analyse the clinical
characteristics of pregnant women with 2019-nCoV infection, to report
maternal and neonatal outcomes and to evaluate intrauterine vertical
transmission.