Obstetric-Neonatal Care during Birth and Postpartum in Symptomatic and Asymptomatic Women Infected with SARS-CoV-2: A Retrospective Multicenter Study.

This study analyses the obstetric−neonatal outcomes of women in labour with symptomatic and asymptomatic COVID-19. A retrospective, multicenter, observational study was carried out between 1 March 2020 and 28 February 2021 in eight public hospitals in the Valencian community (Spain). The chi-squared test compared the obstetric−neonatal outcomes and general care for symptomatic and asymptomatic women. In total, 11,883 births were assisted in participating centers, with 10.9 per 1000 maternities (n = 130) infected with SARS-CoV-2. The 20.8% were symptomatic and had more complications both upon admission (p = 0.042) and during puerperium (p = 0.042), as well as transfer to the intensive care unit (ICU). The percentage of admission to the Neonatal Intensive Care Unit (NICU) was greater among offspring of symptomatic women compared to infants born of asymptomatic women (p < 0.001). Compared with asymptomatic women, those with symptoms underwent less labour companionship (p = 0.028), less early skin-to-skin contact (p = 0.029) and greater mother−infant separation (p = 0.005). The overall maternal mortality rate was 0.8%. No vertical transmission was recorded. In conclusion, symptomatic infected women are at increased risk of lack of labour companionship, mother−infant separation, and admission to the ICU, as well as to have preterm births and for NICU admissions.

Manejo del parto, el puerperio y la lactancia en mujeres positivas para SARS-CoV-2. Estudio multicéntrico en la Comunidad Valenciana / Management of labour, puerperium, and lactation in SARS-CoV-2 positive women. Multicentric study in the Valencian Community

Objetivo: Determinar las repercusiones maternas y perinatales de las gestantes con reacción en cadena de la polimerasa positiva para SARS-CoV-2 durante el parto y el puerperio clínico. Método: Estudio observacional descriptivo, retrospectivo y multicéntrico realizado mediante la revisión de historias clínicas de las gestantes ingresadas por parto desde el 1 de marzo hasta el 30 de junio de 2020. Resultados: Se analizaron 13 mujeres con reacción en cadena de la polimerasa positiva a SARS-CoV-2. La prevalencia de casos positivos fue del 0,48% sobre el total de partos atendidos en el periodo de estudio. Ninguna de las madres desarrolló complicaciones derivadas de la infección por COVID-19 ni necesitó ingreso en la Unidad de Cuidados Intensivos. El 15,4% de los partos terminó en cesárea, el 7,7% fueron prematuros, el 53,8% de los recién nacidos fueron aislados de su madre, en el 61,5% se realizó pinzamiento tardío del cordón umbilical y la tasa de lactancia materna exclusiva al alta fue del 76,9%. Todos los recién nacidos fueron negativos a COVID-19 mediante reacción en cadena de la polimerasa y no tuvieron complicaciones posteriores al parto. Conclusiones: No ha quedado constatada la transmisión vertical durante el parto en los recién nacidos de madres positivas a COVID-19. Han sido detectadas prácticas clínicas no avaladas por la evidencia científica al inicio de la pandemia que han ido adaptándose a las recomendaciones internacionales a medida que esta evolucionaba.(AU)

Objective: To determine the maternal and perinatal impact of pregnant women with SARS-CoV-2 positive polymerase chain reaction during childbirth and post clinical period. Method: Observational descriptive, retrospective, and multicentre study carried out through the review of clinical records of pregnant women admitted for delivery from 1 March to 30 June 2020. Results: Thirteen women with SARS-CoV-2 positive polymerase chain reaction were tested. The prevalence of positive cases was 0.48% of the total number of births attended during the study period. None of the mothers developed complications from COVID-19 infection, nor did they require admission to the Intensive Care Unit. Of the births,15.4% ended in caesarean section, 7.7% were premature, 53.8% of the newborns were isolated from their mothers, 61.5% had late clamping of the umbilical cord and the rate of exclusive breastfeeding at discharge was 76.9%. All the newborns were polymerase chain reaction-negative for COVID-19 and had no postpartum complications. Conclusions: Vertical transmission during childbirth in newborns of COVID-19 positive mothers has not been reported. Clinical practices not supported by scientific evidence were detected at the beginning of the pandemic and adapted to international recommendations as the pandemic evolved.(AU)

Management of labour, puerperium, and lactation in SARS-CoV-2 positive women. Multicentric study in the Valencian Community. / Manejo del parto, el puerperio y la lactancia en mujeres positivas para SARS-CoV-2. Estudio multicéntrico en la Comunidad Valenciana.

OBJECTIVE: To determine the maternal and perinatal impact of pregnant women with SARS-CoV-2 positive polymerase chain reaction during childbirth and post clinical period. METHOD: Observational descriptive, retrospective, and multicentre study carried out through the review of clinical records of pregnant women admitted for delivery from 1 March to 30 June 2020. RESULTS: Thirteen women with SARS-CoV-2 positive polymerase chain reaction were tested. The prevalence of positive cases was 0.48% of the total number of births attended during the study period. None of the mothers developed complications from COVID-19 infection, nor did they require admission to the Intensive Care Unit. Of the births,15.4% ended in caesarean section, 7.7% were premature, 53.8% of the newborns were isolated from their mothers, 61.5% had late clamping of the umbilical cord and the rate of exclusive breastfeeding at discharge was 76.9%. All the newborns were polymerase chain reaction-negative for COVID-19 and had no postpartum complications. CONCLUSIONS: Vertical transmission during childbirth in newborns of COVID-19 positive mothers has not been reported. Clinical practices not supported by scientific evidence were detected at the beginning of the pandemic and adapted to international recommendations as the pandemic evolved.

[Management of labour, puerperium, and lactation in SARS-CoV-2 positive women. Multicentric study in the Valencian Community]. / Manejo del parto, el puerperio y la lactancia en mujeres positivas para SARS-CoV-2. Estudio multicéntrico en la Comunidad Valenciana.

Objective: To determine the maternal and perinatal impact of pregnant women with SARS-CoV-2 positive polymerase chain reaction during childbirth and post clinical period. Method: Observational descriptive, retrospective, and multicentre study carried out through the review of clinical records of pregnant women admitted for delivery from 1 March to 30 June 2020. Results: Thirteen women with SARS-CoV-2 positive polymerase chain reaction were tested. The prevalence of positive cases was 0.48% of the total number of births attended during the study period. None of the mothers developed complications from COVID-19 infection, nor did they require admission to the Intensive Care Unit. Of the births,15.4% ended in caesarean section, 7.7% were premature, 53.8% of the newborns were isolated from their mothers, 61.5% had late clamping of the umbilical cord and the rate of exclusive breastfeeding at discharge was 76.9%. All the newborns were polymerase chain reaction-negative for COVID-19 and had no postpartum complications. Conclusions: Vertical transmission during childbirth in newborns of COVID-19 positive mothers has not been reported. Clinical practices not supported by scientific evidence were detected at the beginning of the pandemic and adapted to international recommendations as the pandemic evolved.