Viruses


. 2021 Jan 15;13(1):E112.
doi: 10.3390/v13010112.
Obstetric Outcomes of SARS-CoV-2 Infection in Asymptomatic Pregnant Women


Monica Cruz-Lemini 1 , Elena Ferriols Perez 2 , Maria Luisa de la Cruz Conty 3 , Africa Caño Aguilar 4 , Maria Begoña Encinas Pardilla 5 , Pilar Prats Rodríguez 6 , Marta Muner Hernando 7 , Laura Forcen Acebal 8 , Pilar Pintado Recarte 9 , Maria Del Carmen Medina Mallen 1 , Noelia Perez Perez 10 , Judit Canet Rodriguez 11 , Ana Villalba Yarza 12 , Olga Nieto Velasco 13 , Pablo Guillermo Del Barrio Fernandez 14 , Carmen Maria Orizales Lago 15 , Beatriz Marcos Puig 16 , Begoña Muñoz Abellana 17 , Laura Fuentes Ricoy 18 , Agueda Rodriguez Vicente 19 , Maria Jesus Janeiro Freire 20 , Macarena Alferez Alvarez-Mallo 21 , Cristina Casanova Pedraz 22 , Onofre Alomar Mateu 23 , Cristina Lesmes Heredia 24 , Juan Carlos Wizner de Alva 25 , Alma Posadas San Juan 26 , Montserrat Macia Badia 27 , Cristina Alvarez Colomo 28 , Antonio Sanchez Muñoz 29 , Laia Pratcorona Alicart 30 , Ruben Alonso Saiz 31 , Monica Lopez Rodriguez 32 , Maria Carmen Barbancho Lopez 33 , Marta Ruth Meca Casbas 34 , Oscar Vaquerizo Ruiz 35 , Eva Moran Antolin 36 , Maria Jose Nuñez Valera 37 , Camino Fernandez Fernandez 38 , Albert Tubau Navarra 39 , Alejandra Maria Cano Garcia 40 , Susana Soldevilla Perez 41 , Irene Gattaca Abasolo 42 , Jose Adanez Garcia 43 , Alberto Puertas Prieto 44 , Rosa Ostos Serna 45 , Maria Del Pilar Guadix Martin 46 , Monica Catalina Coello 47 , Silvia Espuelas Malon 2 , Jose Antonio Sainz Bueno 48 , Maria Reyes Granell Escobar 49 , Sara Cruz Melguizo 5 , Oscar Martinez Perez 5 , On Behalf Of The Spanish Obstetric Emergency Group



Affiliations

Abstract

Around two percent of asymptomatic women in labor test positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Spain. Families and care providers face childbirth with uncertainty. We determined if SARS-CoV-2 infection at delivery among asymptomatic mothers had different obstetric outcomes compared to negative patients. This was a multicenter prospective study based on universal antenatal screening for SARS-CoV-2 infection. A total of 42 hospitals tested women admitted for delivery using polymerase chain reaction, from March to May 2020. We included positive mothers and a sample of negative mothers asymptomatic throughout the antenatal period, with 6-week postpartum follow-up. Association between SARS-CoV-2 and obstetric outcomes was evaluated by multivariate logistic regression analyses. In total, 174 asymptomatic SARS-CoV-2 positive pregnancies were compared with 430 asymptomatic negative pregnancies. No differences were observed between both groups in key maternal and neonatal outcomes at delivery and follow-up, with the exception of prelabor rupture of membranes at term (adjusted odds ratio 1.88, 95% confidence interval 1.13-3.11; p = 0.015). Asymptomatic SARS-CoV-2 positive mothers have higher odds of prelabor rupture of membranes at term, without an increase in perinatal complications, compared to negative mothers. Pregnant women testing positive for SARS-CoV-2 at admission for delivery should be reassured by their healthcare workers in the absence of symptoms.

Keywords: SARS-CoV-2; asymptomatic infection; coronavirus; delivery; maternal complications; perinatal outcomes; pregnancy.