Obstetric–neonatal care during birth and postpartum in symptomatic and asymptomatic women infected with SARS-CoV-2: a retrospective multicenter study

This study analyses the obstetric–neonatal outcomes of women in labour with symptomatic and asymptomatic COVID-19. A retrospective, multicenter, observational study was carried out between 1 March 2020 and 28 February 2021 in eight public hospitals in the Valencian community (Spain). The chi-squared test compared the obstetric–neonatal outcomes and general care for symptomatic and asymptomatic women. In total, 11,883 births were assisted in participating centers, with 10.9 per 1000 maternities (n = 130) infected with SARS-CoV-2. The 20.8% were symptomatic and had more complications both upon admission (p = 0.042) and during puerperium (p = 0.042), as well as transfer to the intensive care unit (ICU). The percentage of admission to the Neonatal Intensive Care Unit (NICU) was greater among offspring of symptomatic women compared to infants born of asymptomatic women (p < 0.001). Compared with asymptomatic women, those with symptoms underwent less labour companionship (p = 0.028), less early skin-to-skin contact (p = 0.029) and greater mother–infant separation (p = 0.005). The overall maternal mortality rate was 0.8%. No vertical transmission was recorded. In conclusion, symptomatic infected women are at increased risk of lack of labour companionship, mother–infant separation, and admission to the ICU, as well as to have preterm births and for NICU admissions

Manejo del parto, puerperio y lactancia en mujeres positivas por SARS-CoV-2. Estudio multicéntrico en la Comunidad Valenciana

Objetivo: Determinar las repercusiones maternas y perinatales de las gestantes con reacciónen cadena de la polimerasa positiva para SARS-CoV-2 durante el parto y el puerperio clínico.Método: Estudio observacional descriptivo, retrospectivo y multicéntrico realizado mediantela revisión de historias clínicas de las gestantes ingresadas por parto desde el 1 de marzo hastael 30 de junio de 2020.Resultados: Se analizaron 13 mujeres con reacción en cadena de la polimerasa positiva a SARS-CoV-2. La prevalencia de casos positivos fue del 0,48% sobre el total de partos atendidos en elperiodo de estudio. Ninguna de las madres desarrolló complicaciones derivadas de la infecciónpor COVID-19 ni necesitó ingreso en la Unidad de Cuidados Intensivos. El 15,4% de los partosterminó en cesárea, el 7,7% fueron prematuros, el 53,8% de los recién nacidos fueron aislados desu madre, en el 61,5% se realizó pinzamiento tardío del cordón umbilical y la tasa de lactanciamaterna exclusiva al alta fue del 76,9%. Todos los recién nacidos fueron negativos a COVID-19 mediante reacción en cadena de la polimerasa y no tuvieron complicaciones posteriores alparto.Conclusiones: No ha quedado constatada la transmisión vertical durante el parto en los reciénnacidos de madres positivas a COVID-19. Han sido detectadas prácticas clínicas no avaladas porla evidencia científica al inicio de la pandemia que han ido adaptándose a las recomendacionesinternacionales a medida que esta evolucionaba.Objective: To determine the maternal and perinatal impact of pregnant women with SARS-CoV-2positive polymerase chain reaction during childbirth and post clinical period.Method: Observational descriptive, retrospective, and multicentre study carried out throughthe review of clinical records of pregnant women admitted for delivery from 1 March to 30 June2020.Results: Thirteen women with SARS-CoV-2 positive polymerase chain reaction were tested. Theprevalence of positive cases was 0.48% of the total number of births attended during the studyperiod. None of the mothers developed complications from COVID-19 infection, nor did theyrequire admission to the Intensive Care Unit. Of the births,15.4% ended in caesarean section,7.7% were premature, 53.8% of the newborns were isolated from their mothers, 61.5% had lateclamping of the umbilical cord and the rate of exclusive breastfeeding at discharge was 76.9%.All the newborns were polymerase chain reaction-negative for COVID-19 and had no postpartumcomplications.Conclusions: Vertical transmission during childbirth in newborns of COVID-19 positive mothershas not been reported. Clinical practices not supported by scientific evidence were detected atthe beginning of the pandemic and adapted to international recommendations as the pandemicevolved