Results
A total of 21 women were included. Table 1 shows the baseline characteristics and the clinical outcomes. Of note, 15 (71.4%) women were admitted for an obstetrical condition and 6 (28.6%) for lower-respiratory signs or symptoms. The median (IQR)[range] gestational age at admission of the respiratory cases was 36.5 (4.8)[32.4-40], while it was 40.0 (1)[33-42] among those women admitted for obstetric conditions. A total of 3 women (14.3%) had co-morbidities (one case of obesity and 2 women with asthma). Regarding disease severity, 19% of women remained asymptomatic, 38.1% presented a mild disease, 28.6% had a moderate infection and 14.3% a severe maternal disease. Radiological abnormalities were present in 47.6% of cases. Eleven women (52.4) received specific treatment for COVID-19, and oxygen therapy was needed in 6 of them (28.6). One third of women presented clinical deterioration, at a median of 7.4 days after symptoms onset, and 3 of them required transfer to critical care unit. There were no cases of sepsis, septic shock, thrombotic or cardiac complications. No maternal deaths occurred.
Table 2 shows the perinatal outcomes, and Figure 1 depicts the gestational age and birthweight centile distribution. Vaginal delivery was achieved in two thirds of cases (12 spontaneous and 2 operative vaginal delivery for fetal indications), with good neonatal outcome. Caesarean section was performed for maternal compromise related to COVID-19 in 3 cases (14.3%), and no indications for fetal distress were reported. Among the cases without respiratory compromise, the global caesarean section rate was 22% (4 cases out of 18). Preterm delivery occurred in 4 cases (19%), half of them related to COVID-19. Table 3 compares the observed main perinatal outcomes to those expected in the same population: of note, the observed outcome did not significantly differ from the expected. All newborns tested negative for SARS-CoV-2 in the first 48h of life.
In 4 cases hospital postpartum readmission was needed, in two due to postpartum fever and two related to COVID-19 disease, with no need for critical care support in any case.