Viral Shedding of COVID-19 in Pregnant Women

36 Pages Posted: 27 Mar 2020

See all articles by Yanting Wu

Yanting Wu

Shanghai Jiao Tong University (SJTU) - International Peace Maternity and Child Health Hospital

Chen Liu

Government of the People's Republic of China - Department of Radiology

Lan Dong

Wuhan University - Renmin Hospital; Wuhan University - Renmin Hospital

Chenjie Zhang

Shanghai Jiao Tong University (SJTU) - International Peace Maternity and Child Health Hospital

Yang Chen

Huazhong University of Science and Technology - Wuhan Children’s Hospital

Jun Liu

Wuhan University - Renmin Hospital

Chen Zhang

Shanghai Jiao Tong University (SJTU) - International Peace Maternity and Child Health Hospital

Chenchi Duan

Shanghai Jiao Tong University (SJTU) - International Peace Maternity and Child Health Hospital

Hanqiu Zhang

Shanghai Jiao Tong University (SJTU) - International Peace Maternity and Child Health Hospital

Ben Willem Mol

Monash University - Department of Obstetrics and Gynaecology

Cindy-Lee Dennis

University of Toronto - Lawrence S. Bloomberg Faculty of Nursing

Tailang Yin

Wuhan University - Renmin Hospital

Jing Yang

Wuhan University - Renmin Hospital

He-Feng Huang

Shanghai Jiao Tong University (SJTU) - International Peace Maternity and Child Health Hospital; Zhejiang University - Key Laboratory of Reproductive Genetics (Ministry of Education); Shanghai Jiao Tong University (SJTU) - Shanghai Key Laboratory of Embryo Original Diseases; Shanghai Jiao Tong University (SJTU) - Institute of Embryo-Fetal Original Adult Disease; Zhejiang University - Key Laboratory of Reproductive Genetics (Ministry of Education)

Date Written: March 25, 2020

Abstract

Background: Since there is little awareness of the consequences of coronavirus disease 2019 (COVID-19) in pregnancy, data on the safety of vaginal delivery and breastfeeding in pregnant women with COVID-19 are urgently needed.

Methods: We studied COVID-19- infected pregnant women diagnosed at the Renmin Hospital of Wuhan University between January 31 and March 9, 2020, and collected clinical data, vaginal secretion, and stool specimens during different stages of pregnancy. We also collected breast milk samples, as well as throat and anal swabs from the corresponding infants to detect the presence of the virus.

Results: Of the 13 women with COVID-19, 5 were in their first trimester, 3 in their second trimester, and 5 in their third trimester. Clinical manifestations observed among the 13 women included fever (n = 8), cough (n = 5), increased leukocyte count (n = 3), lymphopenia (n = 2), impaired liver function (n = 3), dyspnea (n = 1), myalgia (n = 1), and diarrhea (n = 1). Of the 5 women during their third trimester who gave birth, all delivered live newborns. Among these 5 deliveries, the primary adverse perinatal outcomes included premature delivery (n = 2) and neonatal pneumonia (n = 2). One of the 5 women followed from the first trimester experienced a biochemical pregnancy. One of 9 stool samples was positive; and all 13 vaginal secretion samples, and 5 throat swabs and 4 anal swabs collected from newborns were negative for the novel coronavirus. However, 1 of 3 samples of breast milk was positive by viral nucleic acid testing.

Conclusions: In this case series of 13 pregnant women with COVID-19, we observed negative viral test results in vaginal secretion specimens, suggesting that a vaginal delivery may be a safe delivery option. However, additional research is urgently needed to examine breast milk and the potential risk for viral contamination.

Note: Funding: This work was supported by the National Key Research and Development Program of China (2018YFC1002804, 2016YFC1000203).

Conflict of Interest: Ben W. Mol is supported by a NHMRC Investigator grant (GNT1176437). BWM reports consultancies for ObsEva, Merck KGaA, iGenomix, and Guerbet, with no potential conflicts of interest.

Ethical Approval: This study was approved by the Medical Ethical Committee of Renmin Hospital of Wuhan University (No. WDRY2020-K097), Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science &Technology (No. WHCH 2020014), and the Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University (No. GKLW2020-05).

Keywords: COVID-19, breast milk, vaginal secretions, pregnant women

Suggested Citation

Wu, Yanting and Liu, Chen and Dong, Lan and Zhang, Chenjie and Chen, Yang and Liu, Jun and Zhang, Chen and Duan, Chenchi and Zhang, Hanqiu and Mol, Ben Willem and Dennis, Cindy-Lee and Yin, Tailang and Yang, Jing and Huang, He-Feng and Huang, He-Feng, Viral Shedding of COVID-19 in Pregnant Women (March 25, 2020). Available at SSRN: https://ssrn.com/abstract=3562059 or http://dx.doi.org/10.2139/ssrn.3562059

Yanting Wu

Shanghai Jiao Tong University (SJTU) - International Peace Maternity and Child Health Hospital

1961 Huashan Rd
Shanghai Shi, 200030
China

Chen Liu

Government of the People's Republic of China - Department of Radiology

Chongqing, 400038
China

Lan Dong

Wuhan University - Renmin Hospital

Wuhan, Hubei 442000
China

Wuhan University - Renmin Hospital

Wuhan, Hubei 442000
China

Chenjie Zhang

Shanghai Jiao Tong University (SJTU) - International Peace Maternity and Child Health Hospital

1961 Huashan Rd
Shanghai Shi, 200030
China

Yang Chen

Huazhong University of Science and Technology - Wuhan Children’s Hospital

China

Jun Liu

Wuhan University - Renmin Hospital

Wuhan, Hubei 442000
China

Chen Zhang

Shanghai Jiao Tong University (SJTU) - International Peace Maternity and Child Health Hospital ( email )

1961 Huashan Rd
Shanghai Shi, 200030
China

Chenchi Duan

Shanghai Jiao Tong University (SJTU) - International Peace Maternity and Child Health Hospital

1961 Huashan Rd
Shanghai Shi, 200030
China

Hanqiu Zhang

Shanghai Jiao Tong University (SJTU) - International Peace Maternity and Child Health Hospital

1961 Huashan Rd
Shanghai Shi, 200030
China

Ben Willem Mol

Monash University - Department of Obstetrics and Gynaecology

Clayton, Victoria 3800
Australia

Cindy-Lee Dennis

University of Toronto - Lawrence S. Bloomberg Faculty of Nursing ( email )

Canada

Tailang Yin

Wuhan University - Renmin Hospital ( email )

Wuhan, Hubei 442000
China

Jing Yang

Wuhan University - Renmin Hospital ( email )

Wuhan, Hubei 442000
China

He-Feng Huang (Contact Author)

Shanghai Jiao Tong University (SJTU) - International Peace Maternity and Child Health Hospital ( email )

1961 Huashan Rd
Shanghai Shi, 200030
China

Zhejiang University - Key Laboratory of Reproductive Genetics (Ministry of Education)

Zhejiang, 310058
China

Shanghai Jiao Tong University (SJTU) - Shanghai Key Laboratory of Embryo Original Diseases ( email )

Shanghai
China

Shanghai Jiao Tong University (SJTU) - Institute of Embryo-Fetal Original Adult Disease ( email )

China

Zhejiang University - Key Laboratory of Reproductive Genetics (Ministry of Education)

Zhejiang, 310058
China

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