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Ferrazzi E, Frigerio L, Savasi V, Vergani P, Prefumo F, et al. Vaginal delivery in SARS-CoV-2 infected pregnant women in Northern Italy: a retrospective analysis. BJOG. 2020 Apr 27. doi: 10.1111/1471-0528.16278.

OBJECTIVE: To report mode of delivery and immediate neonatal outcome in COVID-19 infected women.

DESIGN: This is a retrospective study.

SETTING: Twelve hospitals in northern Italy.

PARTICIPANTS: Pregnant women with COVID-19 confirmed infection who delivered.

EXPOSURE: COVID 19 infection in pregnancy.

METHODS: SARS-CoV-2 infected women who were admitted and delivered during the period 1-20 march 2020 were eligible. Data were collected from the clinical records using a standardized questionnaire on maternal general characteristics, any medical or obstetric co-morbidity, course of pregnancy, clinical signs and symptoms, treatment of COVID 19 infection, mode of delivery, neonatal data and breastfeeding MAIN OUTCOME AND MEASURE: Data on mode of delivery and neonatal outcome RESULTS: 42 women with COVID-19 delivered at the participating centres: 24(57,1%, 95% CI= 41,0-72,3) delivered vaginally. An elective cesarean section was performed in 18/42 (42,9%, 95%CI 27,7-59,0) cases: in 8 cases the indication was unrelated to COVID-19 infection. Pneumonia was diagnosed in 19/42(45,2%, 95%CI 29,8-61,3) cases: of these 7/19(36,8%,95CI 16,3-61,6) required oxygen support and 4/19(21,1%,95%CI=6,1-45,6) were admitted to a critical care unit. Two women with COVID-19 breastfed without a mask because infection was diagnosed in the post-partum period: their new-borns tested positive for SARS-Cov-2 infection. In one case a new-born had a positive test after a vaginal operative delivery.

CONCLUSIONS: Although post-partum infection cannot be excluded with 100% certainty, these findings suggest that vaginal delivery is associated with a low risk of intrapartum SARS-Cov-2 transmission to the new-born.

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