Previous studies have shown that SARS during pregnancy is associated with a high incidence of adverse maternal and neonatal complications, such as spontaneous miscarriage, preterm delivery, intrauterine growth restriction, application of endotracheal intubation, admission to the intensive care unit, renal failure, and disseminated intravascular coagulopathy.
However, pregnant women with COVID-19 infection in the present study had fewer adverse maternal and neonatal complications and outcomes than would be anticipated for those with SARS-CoV-1 infection. Although a small number of cases was analysed and the findings should be interpreted with caution, the findings are mostly consistent with the clinical analysis done by Zhu and colleagues of ten neonates born to mothers with COVID-19 pneumonia. The clinical characteristics reported in pregnant women with confirmed COVID-19 infection are similar to those reported for non-pregnant adults with confirmed COVID-19 infection in the general population and are indicative of a relatively optimistic clinical course and outcomes for COVID-19 infection compared with SARS-CoV-1 infection.
Nonetheless, because of the small number of cases analysed and the short duration of the study period, more follow-up studies should be done to further evaluate the safety and health of pregnant women and newborn babies who develop COVID-19 infection. As discussed in the study, pregnant women are susceptible to respiratory pathogens and to development of severe pneumonia, which possibly makes them more susceptible to COVID-19 infection than the general population, especially if they have chronic diseases or maternal complications. Therefore, pregnant women and newborn babies should be considered key at-risk populations in strategies focusing on prevention and management of COVID-19 infection. Based on evidence from the latest studies and expert recommendations, as well as previous experiences from the prevention and control of SARS, the National Health Commission of China launched a new notice on Feb 8, 2020, which proposed strengthening health counselling, screening, and follow-ups for pregnant women, reinforcing visit time and procedures in obstetric clinics and units with specialised infection control preparations and protective clothing, and emphasised that neonates of pregnant women with suspected or confirmed COVID-19 infection should be isolated in a designated unit for at least 14 days after birth and should not be breastfed, to avoid close contact with the mother while she has suspected or confirmed COVID-19 infection.