Pregnant women with COVID-19 infection were less likely than other seriously ill patients to present with fever, according to a major new analysis published today.
The study sets out how infection affected the course of pregnancy and outcomes for mothers and their babies. It is one of several released highlighting risk factors for serious COVID-19 disease.
Many reviews have been written in this area, though these often contain bias and were found to be outdated as new evidence emerged, say Professor Shakila Thangaratinam, University of Birmingham, UK, and colleagues.
The team reports on their new study in the BMJ today (2 September). They included 77 studies in their analysis, and found that overall, 10% of pregnant and recently pregnant women attending or admitted to hospital for any reason were positive for COVID-19.
The top symptoms were (40%) and cough (39%). Compared with non-pregnant women, they were less likely to report fever and muscle ache but were more likely to need admission to intensive care and to need ventilation.
The analysis also found that a quarter of all babies born to mothers with COVID-19 were admitted to a neonatal unit and were at increased risk of admission than those born to mothers without the disease. However, stillbirth and newborn death rates were low.
The authors report: “Risk factors for severe COVID-19 in pregnancy include increasing maternal age, high body mass index, and pre-existing comorbidities. These women will need to be considered as a high risk group for COVID-19.”
They add: “Pregnant women with COVID-19 are more likely to experience preterm birth and their neonates are more likely to be admitted to a neonatal unit.”
* A European conference has heard of a “clear relationship” between obesity and the severity of the disease.
A French study found that half of patients in intensive care units were obese. The findings were reported to the European and International Congress on Obesity.
Professor François Pattou, head of the Department of General and Endocrine Surgery at Lille University Hospital, France, said: "Several months into the COVID-19 pandemic, the increased risk posed by this virus to people living with obesity could not be clearer. Our data show that the chances of increasing to more severe disease increases with BMI, to the point where almost all intensive care COVID-19 patients with severe obesity will end up on a ventilator."
* A UK study has found that a quarter of all deaths in England and Wales involved people with dementia. Globally 75% of victims of the virus in care facilities had dementia, according to a study by the London School of Economics and University College, London.
Allotey, J. et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ 2 September 2020 doi: 10.1136/bmj.m3320
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