Sars-Cov-2 Infection in Pregnant Women, Colombia March – November 2020

  • Maternal and child health
  • Vaccine preventable diseases
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Background:
Adverse maternal and perinatal outcomes related to COVID-19 during pregnancy are yet to be established. Pregnancy increases the susceptibility of developing severe COVID-19. This analysis aims to describe the epidemiological behavior of SARS-CoV-2 infection in Colombian pregnant women and explore factors associated with the risk of an adverse events.

Methods:
An analytical cross-sectional study including laboratory confirmed SARS-CoV-2 cases in pregnant women reported to the Colombian Public Health Surveillance System between March and November 2020 was developed. A descriptive analysis for person, time, and place was carried out. Prevalence ratios (PR) for COVID-19 symptomatic pregnant women were calculated according to the following outcomes: extreme maternal morbidity, maternal mortality, preterm birth, low term birth weight, perinatal mortality, neonatal mortality, and miscarriage.

Results:
There were 5,138 confirmed cases of pregnant women with COVID-19. The ratio of COVID19 in pregnant women was 12.4 cases per 1,000 live births. Older age (> 40 years) concentrated the highest ratio (27.8 cases per 1,000 live births). A high proportion (75.4%) of cases were symptomatic; frequent symptoms were cough, fever, and fatigue. Fifty-four maternal deaths due to COVID-19 were reported. The PR of deaths due to COVID19 was 2.75 (95% CI 2.10-3.60) in infected pregnant women when compared with infected non-pregnant women. A PR of 1.23 (95% CI 1.00-1.50) was found for preterm birth when comparing symptomatic versus asymptomatic COVID19 cases. No relationship was found between symptomatic cases and miscarriage or perinatal death.

Conclusions:
A potential risk of death was identified in COVID19 pregnant women when compared to infected non-pregnant women, and of preterm birth in symptomatic cases versus asymptomatic cases. These findings should prompt for interventions aimed to mitigate COVID19 impacts in pregnant women and their newborns. Integrated activities including public health surveillance, prevention efforts, quality health care, and scientific research should be prioritized.

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