J Gynecol Obstet Hum Reprod A Snapshot of the Covid-19 Pandemic Among Pregnant Women in France

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J Gynecol Obstet Hum Reprod


. 2020 Jun 4;101826.
doi: 10.1016/j.jogoh.2020.101826. Online ahead of print.
A Snapshot of the Covid-19 Pandemic Among Pregnant Women in France


Gilles Kayem ¹ , Vivien Alessandrini ² , Elie Azria ³ , Julie Blanc ⁴ , Caroline Bohec ⁵ , Marie Bornes ² , Florence Bretelle ⁴ , Pierre-Fran?ois Ceccaldi ² , Yasmine Chalet ² , C?line Chauleur ⁶ , Anne-Gael Cordier ² , Philippe Deruelle ⁷ , Raoul Desbri?re ⁸ , Muriel Doret ⁹ , Michel Dreyfus ¹⁰ , Marine Driessen ² , Marion Fermaut ² , Denis Gallot ¹¹ , Charles Garab?dian ¹² , Cyril Huissoud ⁹ , Edouard Lecarpentier ¹³ , Dominique Luton ² , Olivier Morel ¹⁴ , Franck Perrotin ¹⁵ , Olivier Picone ² , Patrick Rozenberg ¹⁶ , Thomas Schmitz ² , Lo?c Sentilhes ¹⁷ , Jeremy Sroussi ² , Christophe Vayssi?re ¹⁸ , Eric Verspyck ¹⁹ , Alexandre J Vivanti ² , Norbert Winer ²⁰



Affiliations

• PMID: 32505805
• DOI: 10.1016/j.jogoh.2020.101826

Abstract

Objective: To describe the course over time of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in French women from the beginning of the pandemic until mid-April, the risk profile of women with respiratory complications, and short-term pregnancy outcomes.
Methods: We collected a case series of pregnant women with COVID-19 in a research network of 33 French maternity units between March 1 and April 14, 2020. All cases of SARS-CoV-2 infection confirmed by a positive result on real-time reverse transcriptase polymerase chain reaction tests of a nasal sample and/or diagnosed by a computed tomography chest scan were included and analyzed. The primary outcome measures were COVID-19 requiring oxygen (oxygen therapy or noninvasive ventilation) and critical COVID-19 (requiring invasive mechanical ventilation or extracorporeal membrane oxygenation, ECMO). Demographic data, baseline comorbidities, and pregnancy outcomes were also collected.
Results: Active cases of COVID-19 increased exponentially during March 1-31, 2020; the numbers fell during April 1-14, after lockdown was imposed on March 17. The shape of the curve of active critical COVID-19 mirrored that of all active cases. By April 14, among the 617 pregnant women with COVID-19, 93 women (15.1%; 95%CI 12.3-18.1) had required oxygen therapy and 35 others (5.7%; 95%CI 4.0-7.8) had had a critical form of COVID-19. The severity of the disease was associated with age older than 35 years and obesity, as well as preexisting diabetes, previous preeclampsia, and gestational hypertension or preeclampsia. One woman with critical COVID-19 died (0.2%; 95%CI 0-0.9). Among the women who gave birth, rates of preterm birth in women with non-severe, oxygen-requiring, and critical COVID-19 were 13/123 (10.6%), 14/29 (48.3%), and 23/29 (79.3%) before 37 weeks and 3/123 (2.4%), 4/29 (13.8%), and 14/29 (48.3%) before 32 weeks, respectively. One neonate in the critical group died from prematurity.
Conclusion: COVID-19 can be responsible for significant rates of severe acute, potentially deadly, respiratory distress syndromes. The most vulnerable pregnant women, those with comorbidities, may benefit particularly from prevention measures such as a lockdown.

Keywords: COVID 19; lockdown; respiratory complications; risk factors.