Characteristics and short‐term obstetric outcomes in a case series of 67 women tested positive for SARS‐CoV‐2 in Stockholm, Sweden

Remaeus, Katarina; Savchenko, Julia; Brismar Wendel, Sophia; Gidlöf, Sebastian Brusell; Graner, Sophie; Jones, Elin; Molin, Johanna; Saltvedt, Sissel; Wallström, Tove; Pettersson, Karin

INTRODUCTION: The Stockholm region was the first area in Sweden to be hit by the pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). Our national guidelines regarding care of women with positive test for SARS‐CoV‐2 (detection with polymerase chain reaction) recommend individualized antenatal care, mode of delivery based on obstetric considerations, and no routine separation of the mother and newborn after birth. Breastfeeding is encouraged, and although there is no specific recommendation on wearing a face mask to prevent viral transmission to the newborn while nursing, instructions are given to keep high hygiene standards. All studies based on cases tested due to hospital admittance, including our, will capture more women with pregnancy complications than in the general population. Our aim was to describe the clinical characteristics in 67 SARS‐CoV‐2 positive women and their 68 neonates, and to report short‐term maternal and neonate outcomes. MATERIAL AND METHODS: A retrospective case series with data from medical records including all test‐positive women (n=67) who gave birth from March 19 to April 26, 2020 in Stockholm, Sweden. Means, proportions and percentages were calculated for characteristics and outcomes. RESULTS: The mean age was 32 years, 40% were nulliparous, and 61% were overweight or obese. Further, 15% had diabetes and 21% a hypertensive disease. 70% of the women had a vaginal birth. Preterm delivery occurred in 19% of the women. The preterm deliveries were mostly medically indicated, including two women who were delivered preterm due to severe coronavirus disease 19 (COVID‐19) illness, corresponding to 15% of the preterm births. Four women (6%) were admitted to intensive care unit postpartum. Three neonates were PCR‐positive for SARS‐CoV‐2 after birth. CONCLUSIONS: In this case series of 67 test‐positive women with clinical presentation ranging from asymptomatic to manifest COVID‐19 disease few women presented with severe COVID‐19 illness, a majority had a vaginal birth at term with a healthy neonate that were test‐negative for SARS‐CoV‐2.