PLoS ONE (Jan 2021)

Prevalence, clinical features, and outcomes of SARS-CoV-2 infection in pregnant women with or without mild/moderate symptoms: Results from universal screening in a tertiary care center in Mexico City, Mexico.

  • J Arturo Cardona-Pérez,
  • Isabel Villegas-Mota,
  • A Cecilia Helguera-Repetto,
  • Sandra Acevedo-Gallegos,
  • Mario Rodríguez-Bosch,
  • Mónica Aguinaga-Ríos,
  • Irma Coronado-Zarco,
  • Moisés León-Juárez,
  • Diana Aguilar-Ayala,
  • María Yolotzin Valdespino-Vázquez,
  • Elsa Romelia Moreno-Verduzco,
  • María Antonieta Rivera,
  • Carolina Valencia-Contreras,
  • María de Lourdes Gómez-Sousa,
  • Mario Solis-Paredes,
  • Brenda Frías-Madrid,
  • César Velasco-Téllez,
  • Juan Carlos Rodriguez-Aldama,
  • Valeria Avila-Sosa,
  • Rafael Galván-Contreras,
  • Ricardo Figueroa-Damian,
  • Manuel Cortés-Bonilla,
  • Guadalupe Estrada-Gutierrez,
  • Salvador Espino-Y-Sosa,
  • Claudine Irles

DOI
https://doi.org/10.1371/journal.pone.0249584
Journal volume & issue
Vol. 16, no. 4
p. e0249584

Abstract

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The perinatal consequences of SARS-CoV-2 infection are still largely unknown. This study aimed to describe the features and outcomes of pregnant women with or without SARS-CoV-2 infection after the universal screening was established in a large tertiary care center admitting only obstetric related conditions without severe COVID-19 in Mexico City. This retrospective case-control study integrates data between April 22 and May 25, 2020, during active community transmission in Mexico, with one of the highest COVID-19 test positivity percentages worldwide. Only pregnant women and neonates with a SARS-CoV-2 result by quantitative RT-PCR were included in this study. Among 240 pregnant women, the prevalence of COVID-19 was 29% (95% CI, 24% to 35%); 86% of the patients were asymptomatic (95% CI, 76%-92%), nine women presented mild symptoms, and one patient moderate disease. No pregnancy baseline features or risk factors associated with severity of infection, including maternal age > 35 years, Body Mass Index >30 kg/m2, and pre-existing diseases, differed between positive and negative women. The median gestational age at admission for both groups was 38 weeks. All women were discharged at home without complications, and no maternal death was reported. The proportion of preeclampsia was higher in positive women than negative women (18%, 95% CI, 10%-29% vs. 9%, 95% CI, 5%-14%, P<0.05). No differences were found for other perinatal outcomes. SARS-CoV-2 test result was positive for nine infants of positive mothers detected within 24h of birth. An increased number of infected neonates were admitted to the NICU, compared to negative neonates (44% vs. 22%, P<0.05) and had a longer length of hospitalization (2 [2-18] days vs. 2 [2-3] days, P<0.001); these are potential proxies for illness severity. This report highlights the importance of COVID-19 detection at delivery in pregnant women living in high transmission areas.