Abstract
Objective To estimate the incidence rate of vertical transmission of coronavirus disease 2019 (COVID-19) to the neonate during the third trimester. Study Design. We conducted a retrospective observational study of pregnant women diagnosed with COVID-19 during the third trimester, who delivered at Flushing Hospital Medical Centre (FHMC) or Jamaica Hospital Medical Centre (JHMC) between March 20, 2020, and April 30, 2020. The study participants were symptomatic pregnant women diagnosed with COVID-19 via positive SARS-CoV-2 RNA, real-time reverse transcription-polymerase chain reaction (SARS-CoV-2 rRT-PCR) test. Evidence of vertical transmission was assessed in the neonate via a SARS-CoV-2 rRT-PCR test, with nasopharyngeal swab samples collected on the neonates after 24 hours of birth. The exclusion criteria for this study were maternal or neonate records without SARS-CoV-2 rRT-PCR test results, neonates not delivered at FHMC or JHMC, and foetuses with suspected foetal anomalies or incomplete medical records. Results We identified 19 symptomatic pregnant women diagnosed with COVID-19, including two women with twin pregnancies. Seven patients (36.8%) were delivered via cesarean. 12 patients (63.1%) presented in spontaneous labour, and 8 (38.1%) had preterm delivery. No maternal intensive care unit admission, maternal sepsis, or maternal mortality was observed. Twenty-one neonates were evaluated for COVID-19 after birth. SARS-CoV-2 rRT-PCR test results were negative in 100% of the neonates. Thirteen neonates (61.9%) were admitted to the neonatal intensive care unit. Prematurity was the most common cause of NICU admission 6 (46.1%), with a length of stay of 5.5 ± 6.4 days. No invasive mechanical ventilation, neonatal sepsis, or neonatal mortality was observed. Conclusion In our cohort, symptomatic COVID-19 during the third trimester of pregnancy was not associated with vertical transmission to the neonate.
Highlights
Coronavirus disease 2019 (COVID-19) is a highly infectious disease that was declared a pandemic by the World Health Organisation (WHO) on March 11, 2020 [1]
This was a retrospective observational study of symptomatic women diagnosed with COVID-19 during the third trimester of pregnancy who delivered at Flushing Hospital Medical Centre (FHMC) or Jamaica Hospital Medical Centre (JHMC) between March 20, 2020, and April 30, 2020
All pregnant women who presented to FHMC or JHMC labour and delivery units with signs or symptoms concerning for COVID-19 had nasopharyngeal swab samples taken after obtaining NYS Department of Health (NYSDOH) authorisation
Summary
Coronavirus disease 2019 (COVID-19) is a highly infectious disease that was declared a pandemic by the World Health Organisation (WHO) on March 11, 2020 [1]. The first case of COVID-19 was reported in Wuhan, China [1]. Since late 2019, widespread transmission of COVID-19 has been reported in every country [2]. The United States has the highest number of COVID-19 cases to date: 6,562,390 and total deaths reaching 200,275. NYS currently has the highest COVID-19 incidence [3]. The borough of Queens, one of the most ethnically diverse urban areas in the world, has become an epicentre of COVID-19 with 70,824 cases and total deaths reaching 7,245 to date [4]
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