Treatment, Maternal complications and Pregnancy outcomes in late pregnancy
Among 14 patients in late pregnancy, gestational age at diagnosis ranged from 28 weeks to 39 weeks. Only one (7.1%) developed severe disease and the others were moderate (57.1%) or mild type (35.7%). Hypothyroidism was observed in patient 1, gestational diabetes mellitus (GDM) was observed in patient 7 without use of corticosteroid and pregnancy-induced hypertension (PIH) was showed in patient 14. All patients received oxygen inhalation and antiviral treatment(Arbidol/Ribavirin/Lianhua Qingwen/Oseltamivir). Systemic glucocorticoids were used in 72.7% of patients and antibiotics were used in 57.1% of patients. All had been discharged for recovered from the disease as of April 10. No patients developed critical disease, requiring mechanical ventilation, or died of COVID-19.
All patients had a caesarean section in their third trimester. Four of them had preterm labor between 33 weeks and 37 weeks. Three neonates (21.4%) had a low birthweight (<2500 g). All the fourteen neonates had a 1-min Apgar score of 9 and a 5-min Apgar score of 10 except one. Neonate 12 had a 1-min and 5-min Apgar score of 7 and 9, respectively.
Nasopharyngeal swab specimens were collected successfully in 6 cases at birth (neonate 1, 3, 4, 7, 11 and 12) for SARS-CoV-2 test by RT-PCR, and all the results were negative. Additional SARS-CoV-2 test was performed on cord blood of neonate 7 and the result was negative. However, the anal swab which performed just after delivery from neonate 11 was positive for SARS-CoV-2. Additionally, IgG and IgM antibody against SARS-CoV-2 were analyzed from the peripheral blood of neonate 11. Both were increased with the IgG titer of 140.32 (reference, 0-10 AU/ml) and IgM titer of 45.83 (reference, 0-10 AU/ml), respectively (Table 4).