Maternal characteristics and pregnancy outcomes of hospitalized pregnant women with SARS-CoV-2 infection in South Africa: An INOSS-based cohort study.

Budhram, Samantha; Vannevel, Valerie; Botha, Tanita; Chauke, Lawrence; Bhoora, Shastra; Balie, Gaynor M; Odell, Natalie; Lombaard, Hennie; Wise, Amy; Georgiou, Chrysanthi; Ngxola, Nondumiso; Wynne, Emma; Mbewu, Unati; Mabenge, Mfundo; Phinzi, Sibusiso; Gubu-Ntaba, Nontsikelelo; Goldman, Gareth; Tunkyi, Kay; Prithipal, Sudhir; Naidoo, Keshree; Venkatachalam, Santhi; Moodley, Terence; Mould, Sean; Hlabisa, Mzuvele; Govender, Logie; Maistry, Charlene; Habineza, John P; Israel, Priya; Foolchand, Serantha; Tsibiyane, Nomandla V; Panday, Mala; Soma-Pillay, Priya; Adam, Sumaiya; Molokoane, Felicia; Mojela, Matthew S; van Rensburg, Elizabeth J; Mashamba, Tshililo; Matjila, Mushi; Fawcus, Sue; Osman, Ayesha; Venter, Mareli; Petro, Gregory; Fakier, Ahminah; Langenegger, Eduard; Cluver, Catherine A; Bekker, Adrie; de Waard, Liesl; Stewart, Chantal; Ngene, Nnabuike C; Lunda, Ongombe; Cebekhulu, Sylvia N; Moodley, Siva; Koranteng-Peprah, Mama-Asu; Ati, Emmanuel M C; Maswime, Salome; Yates, Laura M

OBJECTIVE To describe risk factors and outcomes of pregnant women infected with SARS-CoV-2 admitted to South African healthcare facilities. METHODS A population-based cohort study was conducted utilizing an amended International Obstetric Surveillance System protocol. Data on pregnant women with SARS-CoV-2 infection, hospitalized between April 14, 2020, and November 24, 2020, were analyzed. RESULTS A total of 36 hospitals submitted data on 673 infected hospitalized pregnant women; 217 (32.2%) were admitted for COVID-19 illness and 456 for other indications. There were 39 deaths with a case fatality rate of 6.3%: 32 (14.7%) deaths occurred in women admitted for COVID-19 illness compared to 7 (1.8%) in women admitted for other indications. Of the women, 106 (15.9%) required critical care. Maternal tuberculosis, but not HIV co-infection or other co-morbidities, was associated with admission for COVID-19 illness. Rates of cesarean delivery did not differ significantly between women admitted for COVID-19 and those admitted for other indications. There were 179 (35.4%) preterm births, 25 (4.7%) stillbirths, 12 (2.3%) neonatal deaths, and 162 (30.8%) neonatal admissions. Neonatal outcomes did not differ significantly from those of infected women admitted for other indications. CONCLUSION The maternal mortality rate was high among women admitted with SARS-CoV-2 infection and higher in women admitted primarily for COVID-19 illness with tuberculosis being the only co-morbidity associated with admission.