Serum hepatic biomarkers in women with obstetric cholestasis and a concurrent SARS-CoV-2 infection.

AIM: The aim of the study was to evaluate the association between SARS-CoV-2 infection and serum hepatic biomarker levels among women with obstetric cholestasis. METHODS: In this prospective study, we recruited all pregnant women admitted in our hospital with obstetric cholestasis. Among those with a concurrent SARS-CoV-2 infection, we evaluated the following serum hepatic biomarkers: aspartate aminotransferase (AST), alanine aminotransferase (ALT), and biliar acids (BA). RESULTS: Among the 88 women enrolled in the study, 20 presented with a SARS-CoV-2 infection while 68 were negative. SARS-CoV-2 infected women were younger (mean age 30.5 ± 5.7 vs. 34.3 ± 5.4; p < 0.01) and in a greater percentage of non-Caucasian ethnicity when compared to noninfected women (60.0% vs. 17.6%; p < 0.01). Regarding levels of hepatic biomarkers, they showed higher levels of AST (111.5 ± 134.1 vs. 37.3 ± 43.4 UI/L; p = 0.02), ALT (132.2 ± 115.7 vs. 50.5 ± 73.173.1 UI/L; p < 0.01), and BA (41.4 ± 46.8 vs. 18.4 ± 13.4 µmol/L; p = 0.04) compared to noninfected patients. No significant differences in maternal or fetal outcomes were found between infected and noninfected women. CONCLUSION: SARS-CoV-2 infection was associated with higher levels of liver enzymes in patients with obstetric cholestasis. This could be the result of a possible hepatic involvement in patients with SARS-CoV-2 infection.

Maternity ward management and COVID-19 pandemic: Experience of a single center in Northern Italy during lockdown.

INTRODUCTION: The aim of our study is to describe the management of a maternity ward in a referral center during the COVID-19 pandemic and 2020 lockdown. METHODS: This is a retrospective single-center study. We analyzed the records of all women consecutively admitted to our delivery ward during lockdown and compared them with those of women admitted in the same period in 2019. RESULTS: The number of patients (1260) admitted to our department in 2020 was similar (1215) to that in 2019. Among patients admitted during lockdown, 50 presented with a Sars-CoV-2 infection (3.9%). In 2020, the number of antenatal check-ups was lower than in 2019 [7.9 (1.5) vs 8.2 (1.3), p<0.001] and the rate of labor inductions was higher [436 (34.6) vs 378 (31.1), p=0.008] although no difference in delivery mode was found. Moreover, women admitted during lockdown were more likely to give birth alone [140 (11.1) vs 50 (4.1), p<0.001]. However, during 2020, the rate of mother and newborn skinto-skin contact [1036 (82.2) vs 897 (73.8), p<0.001] and that of breastfeeding within 2 hours from birth [1003 (79.6) vs 830 (68.3), p<0.001] was higher. We found no significant differences in maternal or neonatal outcomes. CONCLUSIONS: Despite the COVID-19 pandemic, we were able to guarantee a safe birth assistance to all pregnant women, both for those infected and those not infected by Sars-CoV-2.

Sociodemographic characteristics of pregnant women tested positive for COVID‐19 admitted to a referral center in Northern Italy during lockdown period

IntroductionWe investigated association between sociodemographic characteristics and COVID‐19 disease among pregnant women admitted to our unit, the largest high‐risk maternity unit in the Milan metropolitan area.MethodsBetween March 1, 2020 and April 30, 2020, 896 pregnant women were admitted to our Institution and tested for COVID‐19. We collected information regarding their sociodemographic characteristics. Additional information on geographical area of residence, number of family members, number of family members tested positive for COVID‐19, and clinical data was collected for women tested positive for COVID‐19. Odds ratios (ORs) and 95% confidence intervals (CIs) for the risk of developing COVID‐19 according to sociodemographic characteristics were estimated by unconditional logistic regression models.ResultsAmong the 896 women enrolled, 50 resulted positive for COVID‐19. Pregnant women aged ≥35 years had a significantly lower risk of developing the infection (crude OR = 0.29;95% CI:0.16–0.55). Conversely, foreign women (crude OR = 3.32;95% CI:1.89–5.81), unemployed women (crude OR = 3.09;95% CI: 1.77–5.40), and women with an unemployed partner (crude OR = 3.16;95% CI: 1.48–6.79) showed a significantly higher risk of infection. Ethnicity was positively associated with the risk of developing COVID‐19 (mutually adjusted OR = 2.15;95% CI:1.12–4.11) in the multivariate analysis. Foreign women with COVID‐19 were more likely to have a lower education level (p < 0.01), to be unemployed (p < 0.01), and to live in larger families (p < 0.01) compared to Italian pregnant women.ConclusionsThe socioeconomic conditions described are characteristic of immigration patterns in our metropolitan area. These factors may increase the risk of viral transmission, reducing the effectiveness of lockdown and social distancing.