Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: national population based cohort study

UK Obstetric Surveillance System SARS-CoV-2 Infection in Pregnancy Collaborative Group

doi:10.1136/bmj.m2107

Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: national population based cohort study

UK Obstetric Surveillance System SARS-CoV-2 Infection in Pregnancy Collaborative Group

Birmingham Clinical Trials Unit

Research output: Contribution to journal › Article › peer-review

Abstract

OBJECTIVES: To describe a national cohort of pregnant women admitted to hospital with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the UK, identify factors associated with infection, and describe outcomes, including transmission of infection, for mothers and infants.

DESIGN: Prospective national population based cohort study using the UK Obstetric Surveillance System (UKOSS).

SETTING: All 194 obstetric units in the UK.

PARTICIPANTS: 427 pregnant women admitted to hospital with confirmed SARS-CoV-2 infection between 1 March 2020 and 14 April 2020.

MAIN OUTCOME MEASURES: Incidence of maternal hospital admission and infant infection. Rates of maternal death, level 3 critical care unit admission, fetal loss, caesarean birth, preterm birth, stillbirth, early neonatal death, and neonatal unit admission.

RESULTS: The estimated incidence of admission to hospital with confirmed SARS-CoV-2 infection in pregnancy was 4.9 (95% confidence interval 4.5 to 5.4) per 1000 maternities. 233 (56%) pregnant women admitted to hospital with SARS-CoV-2 infection in pregnancy were from black or other ethnic minority groups, 281 (69%) were overweight or obese, 175 (41%) were aged 35 or over, and 145 (34%) had pre-existing comorbidities. 266 (62%) women gave birth or had a pregnancy loss; 196 (73%) gave birth at term. Forty one (10%) women admitted to hospital needed respiratory support, and five (1%) women died. Twelve (5%) of 265 infants tested positive for SARS-CoV-2 RNA, six of them within the first 12 hours after birth.

CONCLUSIONS: Most pregnant women admitted to hospital with SARS-CoV-2 infection were in the late second or third trimester, supporting guidance for continued social distancing measures in later pregnancy. Most had good outcomes, and transmission of SARS-CoV-2 to infants was uncommon. The high proportion of women from black or minority ethnic groups admitted with infection needs urgent investigation and explanation.

STUDY REGISTRATION: ISRCTN 40092247.

Original language	English
Pages (from-to)	m2107
Journal	BMJ
Volume	369
DOIs	https://doi.org/10.1136/bmj.m2107
Publication status	Accepted/In press - 8 Jun 2020

Bibliographical note

Keywords

Adult
Betacoronavirus
COVID-19
Cesarean Section/statistics & numerical data
Coronavirus Infections/complications
Female
Hospitalization/statistics & numerical data
Humans
Incidence
Minority Groups/statistics & numerical data
Pandemics
Pneumonia, Viral/complications
Pregnancy
Pregnancy Complications, Infectious/epidemiology
Premature Birth/epidemiology
Prospective Studies
Risk Factors
SARS-CoV-2
United Kingdom/epidemiology

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10.1136/bmj.m2107

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@article{9bca235f0c1748a5a645a088937d88a6,

title = "Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: national population based cohort study",

abstract = "OBJECTIVES: To describe a national cohort of pregnant women admitted to hospital with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the UK, identify factors associated with infection, and describe outcomes, including transmission of infection, for mothers and infants.DESIGN: Prospective national population based cohort study using the UK Obstetric Surveillance System (UKOSS).SETTING: All 194 obstetric units in the UK.PARTICIPANTS: 427 pregnant women admitted to hospital with confirmed SARS-CoV-2 infection between 1 March 2020 and 14 April 2020.MAIN OUTCOME MEASURES: Incidence of maternal hospital admission and infant infection. Rates of maternal death, level 3 critical care unit admission, fetal loss, caesarean birth, preterm birth, stillbirth, early neonatal death, and neonatal unit admission.RESULTS: The estimated incidence of admission to hospital with confirmed SARS-CoV-2 infection in pregnancy was 4.9 (95% confidence interval 4.5 to 5.4) per 1000 maternities. 233 (56%) pregnant women admitted to hospital with SARS-CoV-2 infection in pregnancy were from black or other ethnic minority groups, 281 (69%) were overweight or obese, 175 (41%) were aged 35 or over, and 145 (34%) had pre-existing comorbidities. 266 (62%) women gave birth or had a pregnancy loss; 196 (73%) gave birth at term. Forty one (10%) women admitted to hospital needed respiratory support, and five (1%) women died. Twelve (5%) of 265 infants tested positive for SARS-CoV-2 RNA, six of them within the first 12 hours after birth.CONCLUSIONS: Most pregnant women admitted to hospital with SARS-CoV-2 infection were in the late second or third trimester, supporting guidance for continued social distancing measures in later pregnancy. Most had good outcomes, and transmission of SARS-CoV-2 to infants was uncommon. The high proportion of women from black or minority ethnic groups admitted with infection needs urgent investigation and explanation.STUDY REGISTRATION: ISRCTN 40092247.",

keywords = "Adult, Betacoronavirus, COVID-19, Cesarean Section/statistics & numerical data, Coronavirus Infections/complications, Female, Hospitalization/statistics & numerical data, Humans, Incidence, Minority Groups/statistics & numerical data, Pandemics, Pneumonia, Viral/complications, Pregnancy, Pregnancy Complications, Infectious/epidemiology, Premature Birth/epidemiology, Prospective Studies, Risk Factors, SARS-CoV-2, United Kingdom/epidemiology",

author = "{UK Obstetric Surveillance System SARS-CoV-2 Infection in Pregnancy Collaborative Group} and Marian Knight and Kathryn Bunch and Nicola Vousden and Edward Morris and Nigel Simpson and Chris Gale and Patrick O'Brien and Maria Quigley and Peter Brocklehurst and Kurinczuk, {Jennifer J}",

note = "{\textcopyright} Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. No commercial re-use. See rights and permissions. Published by BMJ.",

year = "2020",

month = jun,

day = "8",

doi = "10.1136/bmj.m2107",

language = "English",

volume = "369",

pages = "m2107",

journal = "BMJ",

issn = "1756-1833",

publisher = "BMJ Publishing Group",

}

TY - JOUR

T1 - Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK

T2 - national population based cohort study

AU - UK Obstetric Surveillance System SARS-CoV-2 Infection in Pregnancy Collaborative Group

AU - Knight, Marian

AU - Bunch, Kathryn

AU - Vousden, Nicola

AU - Morris, Edward

AU - Simpson, Nigel

AU - Gale, Chris

AU - O'Brien, Patrick

AU - Quigley, Maria

AU - Brocklehurst, Peter

AU - Kurinczuk, Jennifer J

N1 - © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2020/6/8

Y1 - 2020/6/8

N2 - OBJECTIVES: To describe a national cohort of pregnant women admitted to hospital with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the UK, identify factors associated with infection, and describe outcomes, including transmission of infection, for mothers and infants.DESIGN: Prospective national population based cohort study using the UK Obstetric Surveillance System (UKOSS).SETTING: All 194 obstetric units in the UK.PARTICIPANTS: 427 pregnant women admitted to hospital with confirmed SARS-CoV-2 infection between 1 March 2020 and 14 April 2020.MAIN OUTCOME MEASURES: Incidence of maternal hospital admission and infant infection. Rates of maternal death, level 3 critical care unit admission, fetal loss, caesarean birth, preterm birth, stillbirth, early neonatal death, and neonatal unit admission.RESULTS: The estimated incidence of admission to hospital with confirmed SARS-CoV-2 infection in pregnancy was 4.9 (95% confidence interval 4.5 to 5.4) per 1000 maternities. 233 (56%) pregnant women admitted to hospital with SARS-CoV-2 infection in pregnancy were from black or other ethnic minority groups, 281 (69%) were overweight or obese, 175 (41%) were aged 35 or over, and 145 (34%) had pre-existing comorbidities. 266 (62%) women gave birth or had a pregnancy loss; 196 (73%) gave birth at term. Forty one (10%) women admitted to hospital needed respiratory support, and five (1%) women died. Twelve (5%) of 265 infants tested positive for SARS-CoV-2 RNA, six of them within the first 12 hours after birth.CONCLUSIONS: Most pregnant women admitted to hospital with SARS-CoV-2 infection were in the late second or third trimester, supporting guidance for continued social distancing measures in later pregnancy. Most had good outcomes, and transmission of SARS-CoV-2 to infants was uncommon. The high proportion of women from black or minority ethnic groups admitted with infection needs urgent investigation and explanation.STUDY REGISTRATION: ISRCTN 40092247.

AB - OBJECTIVES: To describe a national cohort of pregnant women admitted to hospital with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the UK, identify factors associated with infection, and describe outcomes, including transmission of infection, for mothers and infants.DESIGN: Prospective national population based cohort study using the UK Obstetric Surveillance System (UKOSS).SETTING: All 194 obstetric units in the UK.PARTICIPANTS: 427 pregnant women admitted to hospital with confirmed SARS-CoV-2 infection between 1 March 2020 and 14 April 2020.MAIN OUTCOME MEASURES: Incidence of maternal hospital admission and infant infection. Rates of maternal death, level 3 critical care unit admission, fetal loss, caesarean birth, preterm birth, stillbirth, early neonatal death, and neonatal unit admission.RESULTS: The estimated incidence of admission to hospital with confirmed SARS-CoV-2 infection in pregnancy was 4.9 (95% confidence interval 4.5 to 5.4) per 1000 maternities. 233 (56%) pregnant women admitted to hospital with SARS-CoV-2 infection in pregnancy were from black or other ethnic minority groups, 281 (69%) were overweight or obese, 175 (41%) were aged 35 or over, and 145 (34%) had pre-existing comorbidities. 266 (62%) women gave birth or had a pregnancy loss; 196 (73%) gave birth at term. Forty one (10%) women admitted to hospital needed respiratory support, and five (1%) women died. Twelve (5%) of 265 infants tested positive for SARS-CoV-2 RNA, six of them within the first 12 hours after birth.CONCLUSIONS: Most pregnant women admitted to hospital with SARS-CoV-2 infection were in the late second or third trimester, supporting guidance for continued social distancing measures in later pregnancy. Most had good outcomes, and transmission of SARS-CoV-2 to infants was uncommon. The high proportion of women from black or minority ethnic groups admitted with infection needs urgent investigation and explanation.STUDY REGISTRATION: ISRCTN 40092247.

KW - Adult

KW - Betacoronavirus

KW - COVID-19

KW - Cesarean Section/statistics & numerical data

KW - Coronavirus Infections/complications

KW - Female

KW - Hospitalization/statistics & numerical data

KW - Humans

KW - Incidence

KW - Minority Groups/statistics & numerical data

KW - Pandemics

KW - Pneumonia, Viral/complications

KW - Pregnancy

KW - Pregnancy Complications, Infectious/epidemiology

KW - Premature Birth/epidemiology

KW - Prospective Studies

KW - Risk Factors

KW - SARS-CoV-2

KW - United Kingdom/epidemiology

U2 - 10.1136/bmj.m2107

DO - 10.1136/bmj.m2107

M3 - Article

C2 - 32513659

SN - 1756-1833

VL - 369

SP - m2107

JO - BMJ

JF - BMJ

ER -

Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: national population based cohort study

Abstract

Bibliographical note

Keywords

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