Clinical Characteristics and Outcomes between Pregnant and Non-Pregnant Women with Coronavirus Disease 2019: A Retrospective Cohort Study

Background: Since December 2019, an outbreak of Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread rapidly worldwide. Previous studies on pregnant patients were limited and based on single-center studies. Therefore, this study was undertaken to evaluate the clinical characteristics and outcomes of pregnant and non-pregnant women with COVID-19 based on case-control cohort. Methods: This study retrospectively collected epidemiological, clinical, laboratory, imaging, management, and outcome data for pregnant and non-pregnant women with COVID-19 who were admitted to Tongji hospital of Huazhong University of Science and Technology, Wuhan, China, from Jan 19 to Mar 2, 2020· Clinical outcomes were assessed by statistical analysis. Findings: 17 pregnant and 26 non-pregnant patients infected with COVID-19 were included in this study, and none developed severe adverse illness and died. Pregnant patients had a higher proportion of history exposure to hospitals within two weeks before onset (53% vs 19%, P=0·0211), and a lower proportion of other family members affected (24% vs 73%%, P=0·0041). Fever (47% vs 69%) and cough (53% vs 46%) were common onset of symptoms for two groups. Abdominal pain (24%), vaginal bleeding (6%), reduced fetal movement (6%), and increased fetal movement (13%) were observed at onset in pregnant patients. Higher neutrophil and lower lymphocyte percent were observed in pregnant group (79% vs 56%, P <0·0001; 15% vs 33%, P<0·0001, respectively). In both groups were observed elevated concentration of high sensitivity C-reactive protein, erythrocyte sedimentation rate, aminotransferase and lactate dehydrogenase. Concentrations of alkaline phosphatase and D-dimer in pregnant group were higher than those of non-pregnant group (119·0 vs 48·0 U/L, P<0·0001; 2·1vs 0·3ug/mL, P<0·0001). Four (40%) of pregnant patients and eight (53%) of non-pregnant patients were tested positive for influenza A virus. A majority of pregnant and non-pregnant groups received antiviral (76% vs 96%) and antibiotic (76% vs 88%) therapy. Additionally, two (18%) of pregnant and two (11%) of non-pregnant recovered patients were tested positive for SARS-CoV-2 after being discharged. Interpretation: The clinical characteristics and outcomes of pregnant women with COVID-19 appear good and were similar to non-pregnant women in this study. Based on our findings, there is currently no evidence to indicate that pregnant women were more susceptible to the occurrence and severe adverse outcomes of COVID-19 than general population. Funding Statement: The study was supported by the research grants from the National Key Research and Development Program of China (grant number 2018YFC1002900, 2020YFC0846300), and the Fundamental Research Funds for the Central Universities (grant number 2020kfyXGYJ00). Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: Ethical approval for this study was obtained from the Ethics Committee of Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology (TJ-IRB20200222). And written informed consent was obtained from patients involved before enrolment when data were collected retrospectively.