Maternal Fetal Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Maternal Fetal Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran; Division of Maternal-Fetal Medicine, Departments of Obstetrics & Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX; Division of Fetal Therapy and Surgery, Department of Surgery, Baylor College of Medicine and Texas Children's Hospital, Houston, TX; Department of Obstetrics and Gynecology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Am J Obstet Gynecol. 2020 Jul;223(1):109.e1-109.e16. doi: 10.1016/j.ajog.2020.04.030. Epub 2020 Apr 28.
Despite 2.5 million infections and 169,000 deaths worldwide (as of April 20, 2020), no maternal deaths and only a few pregnant women afflicted with severe respiratory morbidity have been reported to be related to COVID-19 disease. Given the disproportionate burden of severe and fatal respiratory disease previously documented among pregnant women following other coronavirus-related outbreaks (SARS-CoV in 2003 and MERS-CoV in 2012) and influenza pandemics over the last century, the absence of reported maternal morbidity and mortality with COVID-19 disease is unexpected.
To describe maternal and perinatal outcomes and death in a case series of pregnant women with COVID-19 disease.
We describe here a multiinstitution adjudicated case series from Iran that includes 9 pregnant women diagnosed with severe COVID-19 disease in their second or third trimester. All 9 pregnant women received a diagnosis of SARS-CoV-2 infection by reverse transcription polymerase chain reaction nucleic acid testing. Outcomes of these women were compared with their familial/household members with contact to the affected patient on or after their symptom onset. All data were reported at death or after a minimum of 14 days from date of admission with COVID-19 disease.
Among 9 pregnant women with severe COVID-19 disease, at the time of reporting, 7 of 9 died, 1 of 9 remains critically ill and ventilator dependent, and 1 of 9 recovered after prolonged hospitalization. We obtained self-verified familial/household cohort data in all 9 cases, and in each and every instance, maternal outcomes were more severe compared with outcomes of other high- and low-risk familial/household members (n=33 members for comparison).
We report herein maternal deaths owing to COVID-19 disease. Until rigorously collected surveillance data emerge, it is prudent to be aware of the potential for maternal death among pregnant women diagnosed as having COVID-19 disease in their second or third trimester.
截至 2020 年 4 月 20 日，全球已报告 250 万例感染病例和 16.9 万例死亡病例，但据报道，没有孕产妇死亡病例，仅有少数孕妇出现严重呼吸道疾病。鉴于在以往其他冠状病毒相关疫情（2003 年的 SARS-CoV 和 2012 年的 MERS-CoV）和上个世纪的流感大流行中，孕妇发生严重和致命呼吸道疾病的比例过高，因此，COVID-19 疾病未报告孕产妇发病率和死亡率的情况出乎意料。
描述一系列 COVID-19 疾病孕妇的母婴和围产期结局及死亡情况。
本研究描述了来自伊朗的一个多机构判定病例系列，其中包括 9 名在妊娠第二或第三孕期被诊断患有严重 COVID-19 疾病的孕妇。所有 9 名孕妇均通过逆转录聚合酶链反应核酸检测诊断为 SARS-CoV-2 感染。将这些女性的结局与在其症状出现后与其有接触的家庭/家庭成员进行比较。所有数据均在 COVID-19 疾病入院后 14 天或死亡时报告。
在 9 名患有严重 COVID-19 疾病的孕妇中，报告时，9 名孕妇中有 7 名死亡，1 名仍病重且依赖呼吸机，1 名在长时间住院后康复。我们在所有 9 例中均获得了自我验证的家庭/家庭成员队列数据，在每种情况下，孕妇的结局均比其他高危和低危家庭/家庭成员（共 33 名成员进行比较）的结局更严重。
本研究报告了 COVID-19 疾病导致的孕产妇死亡。在严格收集监测数据出现之前，应注意到在妊娠第二或第三孕期被诊断患有 COVID-19 疾病的孕妇中发生孕产妇死亡的可能性。
