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Di Mascio D; WAPM (The World Association of Perinatal Medicine) working group on COVID-19. Maternal and Perinatal Outcomes of Pregnant Women with SARS-COV-2 infection [published online ahead of print, 2020 Sep 14]. Ultrasound Obstet Gynecol. 2020;10.1002/uog.23107. doi:10.1002/uog.23107

Objectives: To evaluate maternal and perinatal outcomes of pregnant women affected by SARS-COV-2.

Methods: This was a multinational retrospective cohort study including women with laboratory-confirmed SARS-COV-2 from 73 centers from 22 different countries in Europe, United States, South America, Asia and Australia from February 1, 2020 to April 30, 2020. Confirmed SARS-COV-2 infection was defined as a positive result on real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay of nasal and pharyngeal swab specimens. The primary outcome was a composite measure of maternal mortality and morbidity including admission to intensive care unit (ICU), use of mechanical ventilation, or death.

Results: 388 singleton pregnancies tested positive to SARS-COV-2 at RT-PCR nasal and pharyngeal swab were included in the study. The primary outcome was observed in 47/388 women (12.1%). 43/388 women (11.1%) were admitted to ICU, 36/388 (9.3%) required mechanical ventilation, and 3/388 women deceased (0.8%). Of the 388 women included in the study, 122 (31.4%) were still pregnant at the time of the study. Among the other 266 women, 6 had spontaneous first-trimester abortion, 3 had elective termination of pregnancy, 6 had stillbirth, and 251 delivered a live-born infant. The rate of preterm birth less than 37 weeks of gestation was 26.3% (70/266). Of the 251 live-born infants, 69/251 (27.5%) were admitted to NICU, with 5 neonatal deaths (2.0%). The overall rate of perinatal death was 4.1% (11/266). Only one infant (1/251, 0.4%) born from a mother tested positive during the third trimester, was found positive to SARS-COV-2 at RT-PCR.

Conclusions: SARS-COV-2 in pregnant women is associated with 0.8% rate of maternal mortality, but 11.1% rate of admission to ICU. The risk of vertical transmission seems to be negligible.

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