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Safety of Vaginal Birth Compared to Caesearean Section Among Patients with COVID-19: A European Cohort Study
32 Pages Posted: 2 Jun 2020
More...Abstract
Background: The number of cases of coronavirus disease 19 (COVID-19) is rapidly increasing, including among pregnant patients. Current data are reassuring regarding the clinical course of COVID-19 among pregnant women and suggest the absence of vertical transmission. Caesarean sections (CS), however, were performed in almost all cases. This study aimed to assess the safety of vaginal birth in patients with COVID-19 and the risk of vertical transmission compared to patients undergoing CS.
Methods: In this multicentre cohort study, we included all pregnant patients with a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection close to delivery. Maternal and neonatal outcomes were recorded.
Findings: 82 patients were included. 78 (95.1%) presented with mild to moderate symptoms at admission and 4 (4.9%) presented with severe symptoms. Patients with severe symptoms were delivered by pre-labour CS. Among the patients with mild to moderate symptoms, 41 (52.6%) had a vaginal birth and 37 (47.4%) underwent CS. Among patients with a CS, 9 (11%) patients developed severe adverse outcomes and 6 (7.3%) required mechanical ventilation. No maternal complications were noted among patients with a vaginal birth. Evidence of vertical transmission was not documented, but perinatal transmission was suspected in two new-borns, all delivered by CS.
Interpretation: Maternal outcomes are generally good among COVID-19 patients infected close to delivery, with a minority of patients requiring intensive care management. Vaginal birth in pregnant women with mild to moderate COVID-19 symptoms seems safe. Though perinatal transmission cannot be excluded, delivery by CS does not seem to prevent it.
Funding Statement: None.
Declaration of Interests: The authors declare that they have no conflicts of interest.
Ethics Approval Statement: The study was approved by the Ethics committee (Ref PI 55/20).
Keywords: Vaginal delivery, Cesarean delivery, SARS-CoV-2, COVID-19, Vertical transmission
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