Clinical Characteristics and Vertical Transmission Potential of 2019-nCoV Infection in Patients with Pregnancy
43 Pages Posted: 11 Feb 2020More...
Background: Previous studies on the caronavirus (2019-nCoV)-infected pneumonia (NCIP) were based on the information from general population, and limited data are available in NCIP with pregnancy. This study aimed to evaluate clinical characteristics, pregnancy outcomes, and vertical transmission potential of pregnancy with 2019-nCoV infection.
Methods: We retrospectively reviewed the data of nine pregnant patients with laboratory-confirmed NCIP hospitalized in the Zhongnan Hospital of Wuhan University from Jan 20 to Jan 31, 2020. Detailed epidemiological, demographic, laboratory, and clinical data were collected for each patient. Evidence of vertical transmission was assessed by qRT-PCR for 2019-nCoV in amniotic fluid, cord blood, breast milk and neonatal throat swab samples from 6 of 9 cases.
Results: All of the 9 cases had an epidemiological exposure, which defined as having either a travel/residence history in the epidemic area or direct contacts with NCIP patients. They were all in the third trimester of pregnancy. Seven patients presented fever without chill on admission. Other atypical symptoms, including cough(4/9), myalgia(3/9), sore throat(2/9) and malaise(2/9), were also observed. Complications, including gestational hypertension(1/9), severe preeclampsia(1/9), Premature rupture of membrane(PROM) (2/9), and fetal distress(2/9), were monitored. Most of the cases(5/9) had lymphopenia (<1.0x109/L). Particularly, 3 cases showed abnormal liver function. One patient complicated with sever preeclampsia and influenza was characterized by elevated aminotransferase and no sign of fever before delivery. None of the cases developed severe NCIP or died as of Feb 3, 2020. A total of 9 live births were recorded. All tests on specimens from 6 of 9 patients, including amniotic fluid, cord blood, breast milk and neonatal throat swab samples showed negative results.
Interpretation: The clinical characteristics of NCIP in pregnancy were atypical. In our limited cases, no evidence of vertical transmission was found in NCIP patients with third trimester pregnancy.
Funding: Hubei Science and Technology Plan, Wuhan University Medical Development Plan.
Declaration of Interest: The authors declare that there are no conflicts of interest in this manuscript.
Ethical Approval: This study was reviewed and approved by Medical Ethical Committee of Zhongnan Hospital of Wuhan University (Approval Number: 2020004). Written informed consents were obtained from all enrolled patients.
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