Overview and Aims:

The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on maternal/fetal wellbeing remains unknown. Currently, epidemiological data regarding pregnant women infected in Portugal are scarse. Our aim was to describe the clinical characteristics and maternal-fetal outcomes of pregnant women infected with SARS-CoV-2 in a Portuguese hospital.

Study design:

Single-center, retrospective, cohort-study.

Population:

Pregnant women with SARS-CoV-2 infection between March-30 and July-31, 2020, in a tertiary referral center for obstetrical care.

Methods:

Pregnant and immediately postpartum women with positive RT-PCR test for SARS-CoV-2 were included. We reviewed mother and neonate medical records for demographics, medical history, disease severity and pregnancy and neonatal outcomes including newborn infection.

Results:

75 women were included, the majority infected in the 3rd-trimester (66.7%). Most were asymptomatic or had mild disease, with fever, cough and headache being commonly found. Only 2 cases presented with severe disease. SARS-CoV-2 prevalence rate at delivery was 6.2% and most patients had a cesarean delivery (64%). Lymphopenia was associated with symptomatic disease (p<0.001) and preterm delivery (p=0.025). Preterm birth was also more frequent in symptomatic women (p=0.048). There were 2 confirmed cases of vertical transmission (4%), one of which died.

Conclusion:

SARS-CoV-2 infection in pregnancy was associated with higher caesarian rates and prematurity. Lymphopenia may be an important marker for fetal distress and consequent iatrogenic preterm delivery. Vertical transmission occurred in 4% and may lead to fetal death.

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