Characteristics and Outcomes of Pregnant Women Admitted to Hospital With Confirmed SARS-CoV-2 Infection in UK: National Population Based Cohort Study

Acesse o original: https://pubmed.ncbi.nlm.nih.gov/32513659/

Characteristics and Outcomes of Pregnant Women Admitted to Hospital With Confirmed SARS-CoV-2 Infection in UK: National Population Based Cohort Study

Affiliations

Free PMC article

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.

Preeclampsia-like Syndrome Induced by Severe COVID-19: A Prospective Observational Study

Preeclampsia-like Syndrome Induced by Severe COVID-19: A Prospective Observational Study

Abstract

Objectives: To investigate the incidence of clinical, ultrasonographic and biochemical findings related to preeclampsia (PE) in pregnancies with COVID-19, and to assess their accuracy to differentiate between PE and the PE-like features associated with COVID-19.

Design: A prospective, observational study.

Setting: Tertiary referral hospital.

Participants: Singleton pregnancies with COVID-19 at >20+0 weeks.

Methods: 42 consecutive pregnancies were recruited and classified into two groups: severe and nonsevere COVID-19, according to the occurrence of severe pneumonia. Uterine artery pulsatility index (UtAPI) and angiogenic factors (soluble fms-like tyrosine kinase-1/placental growth factor [sFlt-1/PlGF]) were assessed in women with suspected PE.

Main outcome measures: Incidence of signs and symptoms related to PE, such as hypertension, proteinuria, thrombocytopenia, elevated liver enzymes, abnormal UtAPI and increased sFlt-1/PlGF.

Results: 34 cases were classified as nonsevere and 8 as severe COVID-19. Six (14.3%) women presented signs and symptoms of PE, all six being among the severe COVID-19 cases (75.0%). However, abnormal sFlt-1/PlGF and UtAPI could only be demonstrated in one case. Two cases remained pregnant after recovery from severe pneumonia and had a spontaneous resolution of the PE-like syndrome.

Conclusions: Pregnant women with severe COVID-19 can develop a PE-like syndrome that might be distinguished from actual PE by sFlt-1/PlGF, LDH and UtAPI assessment. Health care providers should be aware of its existence and monitor pregnancies with suspected preeclampsia with caution.

Keywords: COVID-19; PlGF; SARS; SARS-CoV-2; angiogenic factors; preeclampsia; preeclampsia-like syndrome; pregnancy; sFlt-1.

WHO recommends breastfeeding, says no live coronavirus found in mothers’ milk

ZURICH/GENEVA (Reuters) – Breastfeeding mothers do not seem to be passing on the new coronavirus to their infants, and based on current evidence the benefits outweigh any potential risks of transmission, the World Health Organization (WHO) said on Friday.

WHO director-general Tedros Adhanom Ghebreyesus said that it had carefully investigated the risks of women transmitting COVID-19 to their babies during breastfeeding.

“We know that children are at relatively low risk of COVID-19, but are at high risk of numerous other diseases and conditions that breastfeeding prevents,” Tedros told a news conference.

“Based on the available evidence, WHO’s advice is that the benefits of breastfeeding outweigh any potential risks of transmission of COVID-19,” he said.

Advertisement

Anshu Banerjee, a senior advisor in WHO’s Department of Reproductive Health and Research, said that only “fragments” of the virus had been detected in breast milk, not live virus.

“So far we have not been able to detect live virus in breast milk,” he said. “So the risk of transmission from mother to child so far has not been established.”

Reporting by John Revill and Stephanie Nebehay; editing by Emelia Sithole-Matarise

Positive lockdown influence credited with fall in pre-term births

Trend in maternity hospital marked by healthy living, say researchers

Do Irish Times

More than 15m babies are born too early, too sick and too small in the world every year, and 1m of these children die. File photograph: Getty

An “unprecedented” fall in pre-term births in one of the country’s largest maternity hospitals is being credited to the effect of positive lifestyle influences during the lockdown.

The number of underweight babies fell dramatically in University Maternity Hospital Limerick in the first four months of the year, a trend researchers believe is due to reduced stress and healthier lifestyles brought on by the Covid-19 restrictions.

There was a 73 per cent reduction in the number of very low birth-weight babies born in the hospital, compared to the average for the same first four months of the year in the preceding two decades, a study has found.

If the same finding is replicated nationally for the first four months of the year, there could be up to 200 fewer very-low-weight births this year, and several hundred more if the effect were to last to the end of the year.

Likening the unique conditions of the lockdown to “nature’s experiment”, lead author Prof Roy Philip said the improvements were due to a mix of self-imposed behavioural changes by mothers and externally imposed socio-environmental changes.

These include: reduced work; stress; commuting and financial strain; increased family support; reduced environmental pollution; better infection avoidance; improved sleep and nutritional support; adequate exercise; and reduced exposure to tobacco and illegal drugs.

The findings, if reflected in other countries with lockdown, could trigger greater understanding of the poorly understood pathways that lead to pre-term birth (before 37 weeks of gestation), the authors say.

More than 15 million babies are born too early, too sick and too small in the world every year, and one million of these children die.

Just three very low-birth-weight babies (less than 1.5kg), and no extreme low-weight babies (less than 1kg), were born in Limerick between January and April this year – there were 1,381 births during the period; the rate in the previous 20 years was 3.77 times higher for this period of the year.

Prof Philip said a normal yearly variation might be 5-10 per cent but he described the 73 per cent fall as “unprecedented”.

Public-health vigilance

The study, which has yet to be peer-reviewed, investigated the possibility that the very small number of low-weight babies born in 2020 was the result of the change in abortion law.

An examination of regional and national historic data suggests this is not the case, it says.

The trend seen from early March onwards was influenced by the pre-lockdown period of extra public-health vigilance that started in mid-February, it says.

The effects will continue to be seen in the coming months “until such time as normality influencers are operating again”.

“However, post-lockdown deterioration in socio-environmental factors or a baby boom in late 2020 could increase the pre-term birth rates.”

Similar findings have been reported in Denmark, were a 90 per cent reduction in extremely low-weight babies has occurred.

UFSCar publica cartilhas com informações sobre cuidados com autistas ante COVID-19 Objetivo é orientar as famílias de crianças e adolescentes com autismo no contexto da pandemia, principalmente em relação aos cuidados em prevenir a contaminação UFSCar publica cartilhas com informações sobre cuidados com autistas ante COVID-19

O Laboratório de Terapia Ocupacional e Saúde mental da Universidade federal de São Carlos desenvolveu este material, duas cartilhas, que podem vir a ser úteis para familiares de crianças autistas.
Se você conhece alguém que possa se beneficiar, compartilhe.
————-

Agência FAPESP * – A equipe do Laboratório de Terapia Ocupacional e Saúde Mental (LaFollia) da Universidade Federal de São Carlos (UFSCar) elaborou duas cartilhas com orientações para o enfrentamento da COVID-19, tendo como foco as famílias de pessoas com autismo.

O trabalho foi coordenado pelas professoras Amanda Dourado Fernandes e Maria Fernanda Cid, do Departamento de Terapia Ocupacional da UFSCar.

O objetivo dos guias é orientar as famílias de crianças e adolescentes com autismo, conscientizar a população sobre os problemas e criar uma rede de solidariedade visando o enfrentamento dos problemas decorrentes do cenário de saúde atual.

O guia Autismo em tempos de coronavírus: como podemos ajudar? estimula a reflexão sobre as particularidades de famílias com crianças e adolescentes autistas. A segunda cartilha, Orientações às famílias de crianças e adolescentes com autismo em tempos de coronavírus, aborda os impactos que essas famílias podem sofrer com a pandemia e traz orientações sobre como enfrentar a situação.

Em entrevista à Coordenadoria de Comunicação Social da UFSCar, Fernandes reforça a necessidade de se prevenir a contaminação, uma vez que as medidas de controle e segurança podem não ser tão simples de serem adotadas por essa população. “Como os autistas podem não entender a gravidade do que está acontecendo, é fundamental atenção redobrada em cuidados, como a higienização das mãos”, alerta a professora.

Os materiais estão disponíveis para acesso gratuito nas páginas do Facebook e do Instragram do LaFollia.

*Com informações da Coordenadoria de Comunicação Social da UFSCar .

 

Este texto foi originalmente publicado por Agência FAPESP de acordo com a licença Creative Commons CC-BY-NC-ND. Leia o original aqui.