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Beth Rowley

September 27, 2020

Supporting artists during lockdown

   

If your spine tingled to the introductory music to the BBC drama Strike (click here) you’re a Beth Rowley fan. She comes from my birthtown, Bristol, and has released two albums. I think she’s right up there with Adele and Amy Winehouse. But it was through Strike that I discovered her. Normally I’d have played her on Spotify and checked if she ever performed near Nottingham. But she won’t be touring now.

Until streaming came along, musicians used to make most of their money from LP & CD sales. Then live performance took over, surely a good thing.  Now that has stopped we need to go back to buying CDs. Her latest Gota Fria is £11.99 on Amazon, and an extra 95p on her own website. I love Amazon but they are doing well out of lockdown. I still have a job and less to spend my money on, so the latter it was (click here).

It’s a wonderful record. Time to buy Little Dreamer.

Jim Thornton

OASI care bundle evaluation project

September 23, 2020

A well-conducted study, but an unclear result

I admit it. I was sceptical. A stepped wedge (type of cluster) trial evaluating a “care bundle” (leaflets, a manoevre called the “Finnish grip”, 60o episiotomy & routine rectal examination) with, at best, a shaky evidence base (click here & here), evaluated by researchers who clearly already believed in it, and driven by two political organisations (RCM & RCOG) whose leaders felt that “something must be done” and were claiming success even before it started (2016 links no longer available). When the project ended, and more press releases announced success (2018 links not available), without any results appearing for over two years, I feared the worst; sample size changes, centres excluded for “low compliance”, participants disappearing from analysis groups, outcome switching, statistical shenanigans.

The “Finnish grip” is a bit odd too. Although mentioned on the Care Bundle website (click here), it doesn’t appear in the protocol or trial registry – I did a word search. Both call the 3rd element “Manual perineal protection”. The “Finnish grip” is mentioned, but not described, in the main trial report, and the references cited as sources (click here and here) describe it as “a technique for guiding the head through the introitus by gripping the baby’s chin with a flexed middle finger of the other hand”. They both refer to (Pirhonen et al 1998 click here) as the original source. In 1998 Jouko Pirhonen was a trainee in Lund, Sweden, and he is now a professor in Oslo, Norway. But Pirhonen is a Finnish name, and his co-authors included three obstetricians (no midwives) from Finland. They wrote:

“The delivery assistant presses the baby’s head with her left hand to control the speed of crowning through the vaginal introitus. Simultaneously, using the thumb and index finger of the right hand to support the perineum while the flexed middle finger is used to take a grip on the baby’s chin. When a good grip has been achieved, the woman is asked to stop pushing, to breathe rapidly, while the midwife slowly helps baby’s head through the vaginal introitus. When most of the head is out, the perineal ring is pushed under the baby’s chin.”

This is anatomically impossible, unless the flexed middle finger enters the rectum – surely they don’t mean that! – and even then it would be a stretch to reach the chin. Something probably got lost in translation. In practice it’s likely that midwives using the Care Bundle controlled delivery of the head by perineal pressure and discouraging maternal pushing.

I confess I feared the whole study would shed more heat than light on the topic, and together with a colleague, Hannah Dahlen, wrote a grumbling opinion piece (click here).

But the results are in (click here or gurol-urganci), together with a qualitative study of the implementation process (click here or bidwell), and I’m eating my words.

The study was registered (click here), and the protocol published (click here). Registration was a bit late 22/09/2017 – the project ran from 1 October 2016 and 31 March 2018 – but that’s made clear in the paper, and the protocol had been publicly available since January 2017. There’s no reason to believe either was written after peeking at the data.

Four regions, each containing a mixture of different size and type of birth unit were studied over the same 18-month period, with routine data collected all through. Only four randomised units is rather few, but unavoidable due to funding contraints.

Regions were randomised to have the care bundle taught and implemented sequentially over months 4-6, 7-9, 10-12 or 13-15 respectively. These transition periods were excluded from analysis. This left four 3, 6, 9 or 12-month duration baseline phases, and four same duration evaluation phases to compare. The Consort flow diagram, for some reason relegated to supplementary material* (click here), shows the design nicely. Exclusions were all for objective reasons, Caesarean, multiple or still-birth and did not alter over the trial.

All women having a singleton vaginal birth were included and the size of the before and after groups was approximately equal (baseline 27,668, evaluation 27,932). This is reassuring. Differential rates of Caesarean birth, baseline 12,807 (31.6%) v evaluation 12,472 (31.3%), had not muddied the waters.

The primary, indeed the only, endpoint was OASI (obsteric anal sphincter injury) as recorded on the hospital routine database, and the primary analysis was done after statistical adjustment for a range of potentially relevant factors. Here are the relevant methods as reported in the paper.

“We used multi-level logistic regression to estimate adjusted odds ratios (aOR) […]. The regression model included a linear term for calendar time […] a random effect to account for clustering at both region and unit levels and individual case-mix factors (maternal age, ethnicity, body mass index, parity, mode of birth and birthweight).”

And here they are as planned in the protocol.

“We will use logistic mixed effects regression to model the log odds of sustaining an OASI, with a fixed effect for each step and a random effect to account for clustering at the unit level. The model will include a linear secular trend and also adjust for risk factors for OASI (maternal age, BMI, ethnicity, mode of delivery, episiotomy, birthweight, prolonged labour, and shoulder dystocia).”

Perfect. The planned analysis was done.

And the result. The recorded OASI rate decreased from 911/27,668 (3.3%) baseline phase to 817/27392 (3.0%) evaluation phase (aOR 0.80, 95% CI 0.65–0.98) p=0.03.

But what does it mean? Did manual perineal protection prevent 94 women suffering OASI? Did the 60o episiotomy do the trick? Did a few women read the leaflet and, fearful of OASI, choose Caesarean? Or a mixture of all three? Or was the difference in the “diagnosis” of OASI?

The original research, which had inspired the trial, had shown a much larger increase in recorded OASI from 1.8% in 2000 to 5.9% in 2011 (click here). The authors of that study, who included many of the current trial authors, had concluded that “improved recognition of tears following the implementation of a standardised classification of perineal tears was the most likely explanation”. They were surely correct. Diagnosing OASI is not easy. It can be both over and underdiagnosed. An effect size of 0.3% in an endpoint which can vary by 4.1% due “improved recognition” must be susceptible to ascertainment bias.

And this was an “open” trial. Staff may not have realised they were in the baseline phase but they certainly knew about the implementation and evaluation phases. This is from the qualitative study report (click here or bidwell).

“Many participants spoke about a well advertised launch, which created a lot of ‘noise’ and got the project off to a good start: ‘Yes, we had a launch day at the unit….on that day they had many sessions talking about it. We had the models.….they had pictures of how you would give an episiotomy, things like that, to add to this…There was quite a lot of noise about this. (Midwife)'”

“Many talked about the positive and passionate way with which the champions delivered the training. ‘She [the champion] was like a hound! …. if you weren’t trained and you were on her list, she would hunt you down….She would come in early to catch people on night shifts and stuff……If you have somebody like that who is passionate about the training and gets the training done, then I think that’s what makes it better. (Obstetrician)'”

How did midwives and doctors in the midst of such a campaign classify borderline cases?

Consider, for example, a woman with suspected OASI transferred to the operating theatre for repair, who when reviewed under good light by a senior staff member was found to have an intact sphincter? Would the theatre staff recode the planned operation to “repair of episiotomy”? In the baseline phase they might not even have realised the diagnosis had changed. But in the implementation and evaluation phases, with champions “hounding” everyone, the coding surely would be altered. Of course the effect might also have gone in the other direction. Routine rectal examination might have increased diagnosis. We just don’t know.

These doubts matter because the underlying evidence base for each component of the bundle is so weak. Well designed individually randomised trials do not support manual perineal protection (click here), there have been no trials of 60o angle episiotomy, and rectal examination after normal birth in the absence of a tear makes no sense (click here).

We can all support information giving, avoiding midline episiotomies and doing rectal examinations in the presence of tears. But the debate over manual perineal protection, extremely lateral episiotomy, and routine rectal examination even after normal birth with an intact perineum, will surely continue.

Jim Thornton

Footnote. *The Consort flow diagram belongs in the main report, especially for complex designs. Come on BJOG!

An improved martini

September 4, 2020

Not a better recipe, but a better technique – freezing water in the glass

Last week, dipping into Kingsley Amis’s Everyday Drinking (click here) on holiday, I came across this under “the Dry Martini”.

“A couple of hours before the party get your glasses together. They should be on the small side – the second half of a too large martini will have become too warm by the time the average drinker gets to it – and have some sort of stem or base to prevent the hand-imparting warmth. […] Fill each with water and put in the refrigerator.”

I read it as “put in the freezer”. As Amis says.

“It is more important that a cold drink should be as cold as possible than that it should be as concentrated as possible.”

I should have realised that in Amis’s day the freezer section of a domestic fridge would barely hold a tray of ice; no chance even a small martini glass. But I’ve got a modern monster freezer, so undaunted I made my martini. Freezing the water in the glass in emulation, and using a modern vermouth, Regal Rogue – Daringly Dry (click here), to annoy him. Click here for the video. It worked a treat.

    

Only afterwards did I realise he’d never meant “freeze the ice in the glass”. He wrote.

“While the jug is standing, empty the water out of the glasses and drop a bit of lemon rind in each.”

Nor, from a brief google search, does anyone else. People add ice cubes, sometimes large ones to avoid the over-dilution problem, but never my technique.  I offer it to the world.

Jim Thornton

6 September update

I was wrong, or rather right first time. Amis did advocate freezing water in the glass, albeit ten years later. My volume is a compendium of three books; On Drink (1974), Everyday Drinking (1983) and How’s Your Glass? (1985). The quotations were from On Drink. By the time of Everyday Drinking he must have got a larger freezer. He writes.

“The best Dry Martini known to man is the one I make myself. In the cold part of the refrigerator I have a bottle of gin and a small wineglass, half full of water that has been allowed to freeze.”

“When the hour strikes I half fill the remaining space with gin, flick in a few drops of vermouth and add a couple of cocktail onions, the small white hard kind. Now that is a drink.”

Oh well. Nothing new.

Lockdown cocktails

July 13, 2020

Drinking – not paddling – down the Loire

Our small gang have been walking the Camino de Santiago (click here or here), and more recently canoeing the Loire (click here or here). When lockdown put paid to our 2020 trip from Blois to Saumur we met up on Zoom instead, and inspired by Stanley Tucci (click here and here), drank cocktails. Here they are; some with a poem.

Hemingway’s daiquiri (click here).

Philip Larkin’s gin & tonic (click here).

A “No”groni (click here).

A conventional Negroni under adverse conditions (click here).

James Bond’s Vesper martini (click here).

The Gilles Villeneuve martini (click here).

A Radish Walked into a Bar (click here)

The Kingsley Amis martini (click here).

Forgive the rough edges. Filmed on different phones, and once made you’ve gotta drink it, so a second take wouldn’t help.

We also drank appropriate wine from the brothers Yapp, but no videos of that. First day sweet Vouvray (click here), 2nd a dry one (click here), 3rd Bourgueil (click here), 4th Saint-Nicolas-de-Bourgueil (click here) and 5th Saumur (click here). Forgotten the others, but to end with we popped open a fizz (click here). All more expensive than our usual riverbank plonk, but I guess we’d saved on the ferry crossing. 

Jim Thornton

Wild swimming in the river Trent.

June 6, 2020

Downstream of Nottingham

One of my projects for the 2020 lock-down summer has been to swim the best spots. If you don’t mind disclaimer forms, safety briefings, and signing in and out [1], there’s a dedicated centre on Colwick Park lake (click here). But that’s not for me.

These swims are for privateers. All, bar Farndon, are on the left, northern, bank. I’ll try to remedy that in any updates. Update 16 June – Cromwell.

Stoke Bardolph

Right in front of the Ferry Boat pub, two or three slipways and landing stages provide easy access. Great spot. Crowded on sunny days.

  

It’s also about 100 yards upstream of the discharge from Severn Trent’s, state of the art, Stoke Bardolph treatment plant! Ideal if you’re nervous of pollution.

Gunthorpe

Park in front of the Unicorn Hotel, and swim off the metal boat ramp next to the water ski club.

      

Don’t forget Gunthorpe gravel pit. Some fishermen claim swimming is prohibited there, so be discreet. Walk under the road bridge for about 1/2 mile, and turn right immediately after footbridge. Lots of easy access and a lovely stony bed. Magical.

 

Hoveringham

On sunny days the parking along the river bank road gets full early, but the bank is stony and access easy. Any slight smell is from muck-spreading on the surrounding fields, not the river. Another good spot.

Hazleford

One of my favourites. The metal slipway at the end of the road provides easy access, albeit slippery. The car park is private and locked, but there’s plenty of space on the road. The boat moorings leave a sheltered area near the slipway for those who are nervous of venturing into midstream.

If the slipway’s crowded try upstream, along the river path, past the moorings and caravan park. Plenty of the fishing pegs have good access. I swam by the Km 23 mark.

Downstream is less good. Although there’s plenty of access points below the weir, the water tends to be frothy.

   

Fiskerton

Park about 1/4 mile downstream of the Bromley Arms and walk upstream. The problem here is the high river wall. Don’t even think of jumping! Some pontoons are barred off, and they all have “private mooring” signs, but no-one has ever objected to me using one of the open ones. Getting back on is tricky. Swim round to the river wall – shallow stony bed – and step back on with your dignity intact.

        

Peg 18 below Fiskerton

Park as above and walk downstream. Nottingham Piscatorial Society have marked their fishing pegs with numbers set in the grass. Peg 18 is obscured but it’s the best spot. If you avoid the fishing season, usually quiet enough for a skinny dip.

 

Farndon

From the roundabout at the south end of Newark bypass, take the B166, the old Fosse Way to Farndon. Turn right, then left, initially following signs to Farndon marina. Then ignore the 2nd right to Farndon marina and follow signs to The Waterfront. Sandy ramp. Lovely.

North Muskham

Down Ferry Lane to the Muskham Ferry pub, and swim off the slipway. Slightly muddy, but nothing to trouble a wild swimmer.

  

Cromwell

A farm track, signed as a footpath, from Cromwell village, crosses the A1 as a single track road to the lock. Plenty of parking at the sign which says “no parking or boat launching at the lock”. Upstream of the lock, by two brick barbeques, a ramp leads to a pontoon with steps into the water at each end. Perfect.

           

Carlton-on-Trent

Head for the Church, and Ferry Lane. The road to the river, Perry Lane, is full of “no access to river” signs so I parked back up in the village. In fact there is parking. Two possible swim spots. Upstream of the commercial wharf, access looks easy via stony muddy banks, but I was nervous of a metal detectorist on the opposite bank.

The wharf itself has a ladder down to the water, but it’s high and muddy and my courage failed again. About 1/4 mile downstream is best. Stony and a bit muddy, but a good gap in the nettles. The opposite bank also looked inviting.

Carlton is downstream of Cromwell weir, so right at the tidal limit. But it’s on the outside of the bend so you’re straight into fast flow. I kept station, but only just. If you got carried downstream, you’d end up clambering out through nettle beds.

   

I’ve never swum below Carlton. There must be good spots but I doubt they beat the ones above.

Jim Thornton

Footnote

  1.  One of the annoyances of river swimming is people banging on about the risks. Learn to swim and avoid the river in spate or near weirs. Weil’s disease is rare; only about 30 recreational cases, and less than one death, per year in the UK. Given the number of people coming into contact with river water, the drive to the riverbank is probably more risky, but avoid swimming with an open cut. Gastroenteritis is less of a risk for older swimmers who don’t wear wet suits; we don’t stay in so long, have developed antibodies and are wise enough not to swallow.

Covid-19 pregnancy news reports – 101 onwards

May 17, 2020

In roughly reverse order. Updated regularly. Click here for the first hundred news reports. Click here for ripe-tomato.org’s Covid-19 in pregnancy navigation page.

29 September update

231. Thirty four pregnant women with Covid-19 have given birth in Mohali Civil Hospital, Sahibzada Ajit Singh Nagar, India (click here). Report 17 September.

230. Three hundred & seventeen women with SARS-CoV-2 have given birth at Lok Nayak Jai Prakash Narayan (LNJP), the biggest Covid-19 hospital in Delhi, India (click here). 143 were by Caesarean. Only 3 or 4 newborns were infected. Report 28 September.

27 September update

229. Santosh University Hospital, Ghaziabad, India has treated about 50 women with Covid-19 in pregnancy (click here). Some details are given about three infected women with pseudonyms who were delivered by Caesarean at term, and one who had birth induced at 28 weeks gestation. Report 21 September.

26 September update

228. An unnamed pregnant doctor from Indore, India, is reported to have developed Covid-19 twice duiring her pregnancy (click here). She first tested positive on June 19 and recovered. She tested positive again on September 19. She has mild disease, is being treated at home and the pregnancy is ongoing. Report 21 September.

227. Dr Pratiksha Waldekar (age 32), a pathologist from Amravati, died of Covid-19 at a private hospital in Nagpur, India,on September 20th (click here). She was 7 months pregnant. Her baby had died five days earlier. Report 22 September

226. Mrs Celine Ng-Chan contracted Covid-19 at 10 weeks gestation (click here). The pregnancy continued and she is due to give birth next month in Singapore. Report 26 September

14 September update

225. Sarah Curtis from Distington, Cumbria, UK, contracted Covid-19 shortly before giving birth to twins at 30 weeks (click here and here). Both babies were infected but survived. The pregnancy had been complicated by twin-to-twin tranfusion syndrome, and treated with laser ablation of the placental vessels.  Report 14 September.

13 September update

224. An unnamed woman tested positive and gave birth at 36 weeks in Taipei, Taiwan (click here). The baby tested negative. Report 12 September.

223. An unnamed woman with conflicting SARS-CoV-2 test results gave birth in a private hospital in Mohali, a suburb of Chandigarh, India (click here). Report 13 September.

9 September update

222. Ke’Lin Dillard, age 29, from Baton Rouge Louisiana, contracted Covid-19 and was delivered by Caesarean section in late July (click here). The baby tested negative and survived, but the mother remained on a ventilator and died on August 17. Report 7 Sept

221. An unnamed 23-year-old pregnant woman, with Covid-19 and other complications gave birth by Caesarean section at Government Rajaji Hospital (GRH) in Madurai, India, on August 11th (click here). Her age and clinical details differ from the woman in report 210. Report 8 Sept.

220. Maike Zwalf, from Queensland Australia, a transgender man, who also had cystic fibrosis, contracted Covid-19 at term and gave birth normally (click here). Report 8 Sept.

219. Patricia Alvarez from Baytown, near Houston, Texas, contracted Covid-19 in pregnancy, self-isolated at home and gave birth normally at term (click here). Report 9 Sept.

1 September update

218. An unnamed woman with Covid-19 gave birth at Victoria Hospital in Bangaluru, Karnataka, India on 26 August (click here). The baby died. Report 27 August.

217. An unnamed 39-year-old woman with Covid-19, from Lucban town in Quezon province in the Philippines, gave birth at the government run Quezon Medical Center (QMC) in Lucena city on 25 August (click here). The birth was normal. According to Dr. Belen Garana, head OB-GYN at QMC there has been a rise in pregnant women testing positive over the prevuious two weeks. Most were asymptomatic. Report 28 August.

216. Paropakar Maternity and Women’s Hospital in Kathmandu, Nepal, is opening an isolation facility with 200 beds for suspected and confirmed cases of Covid-19 (click here). So far 100 women have been suspected and one tested positive.. Report 25 August.

215. Blanca Rodriguez contracted Covid-19 at 28 weeks gestation (click here). She required prolonged ventilation, and her baby was delivered by C-section at Loma Linda University Medical Center in California. Both survived. Report 28 August.

214. In Los Angeles County 1,200 pregnant women have tested positive for the virus and two have died. Of 193 babies tested, eight were positive (click here). Report 26 August.

213. In the Indian state of Meghalaya, 877 babies and 61 pregnant women died over the four month COVID-19 pandemic (click here). Only 10 people in the state had died due to COVID-19 directly. According to Director of Health Services, Dr Aman War the maternal and perinatal mortality rate is a sharp rise above normal, largely due to women avoiding normal care and dying of other causes. Report 29 August.

212. Camila Graciano, from Anapolis, in the central Brazilian state of Goias, contracted Covid-19 at 32 weeks gestation (click here). Birth was induced, but she died. The baby survived. Report 26 August.

21 August update

211. An unnamed woman died from Covid-19 on 20th August, seven days after giving birth in Olongapo City in the Philippines (click here). Report 21 August.

20 August update

210. An unnamed woman with surgically corrected mitral valve disease and Covid-19 gave birth at the Rajaji Hospital in Madurai, India on August 13 (click here). Report 20 August.

209. A one-day-old baby born on August 16, at Assam Medical College & Hospital (AMCH) in Dibrugarh, India, tested positive for SARS-CoV-2 (click here). His mother was also positive, but it is not clear whether her test was during or after the pregnancy. Report 20 August.

19 August update

208. Belma Soljanin, age 37, died from Covid-19, 3 days after giving birth at Podhrastovi hospital in Sarajevo. She was head of the institute for mother and child. The baby tested negative and has no symptoms (click here). Report 10 August.  HT Dr Branka Firulovic

18 August update

207. About 28 women have tested positive for SARS-CoV-2 at some point in the pregnancy among those cared for at the National Maternity Hospital in Holles Street, Dublin (click here). Report 17 August.

206. Out of 170 Covid-19 births at Parklands Hospital Dallas, five babies tested positive (click here).  Among them, 28-year-old Yuri Matamoros was seriously ill. She recovered and gave birth to a son Jesus, who tested negative. Note the minor inconsistency with report 200. Report 17 August.

17 August update

205. An unnamed 37-year-old woman, with asymptomatic SARS-CoV-2 gave birth by Caesarean at 47 weeks gestation to a healthy boy at the “Attikon” General Hospital in Athens on 16 August. The baby weighed 2,630g, was in excellent health and was isolated (click here). Report 16 August.

16 August update

204. Eighty eight pregnant women with Covid-19 have delivered in the Indian State of Odisha, of whom 32 gave birth in a dedicated Covid hospital in Ganjam, and 15 in the city of Blasore (click here). All mothers recovered. One baby was infected. Report 15 August.

15 August update

203. Zully, from Stamford Connecticut, contracted severe Covid-19 in April at 8 months gestation. She required ventilation, but both her and the baby survived (click here). Report 11 August.

202. María Alvarez age 24 had SARS-CoV-2 while pregnant but was asymptomatic. She gave birth on July 29th at Peru’s National Perinatal and Maternal Institute, in Lima (click here). Mother & baby were fine. According to the report over 2,000 pregnant women with SARS-CoV-2 gave birth in that hospital between April and the start of August. 120 newborns were reported to have tested positive. Report 12 August.

14 August update

201.  Only one unnamed pregnant woman was diagnosed with Covid-19 in Buenos Aires, Argentina between March 20 and May 5th. She gave birth at Sardá Maternity Hospital. Mother & baby were discharged on April 29 (click here). Over the same period there were 2,200 deliveries in the the 33 public hospitals in Buenos Aires. Report 5th May.

13 August update

200. Wendy Figueroa contracted Covid-19 at 34 weeks and gave birth vaginally at Parkland Hospital in Texas (click here). Her baby Alexa was isolated and tested positive. The case was reported in Study 186 here. This newspaper report also notes that six babies have tested positive at Parkland Hospital out of 128 mothers with SARS-CoV-2 at some point during their pregnancy. Report 13 August.

12 August update (Thank you to Dr Christoph Brezinke & Dr Branka Firulovic for alerting me to reports 195-199 from Serbia and Romania)

199. An unnamed 31-year-old woman with Covid-19 died at 22 weeks gestation in Baia Mare hospital on 30 July (click here). The same day a 39-year-old with Covid-19 died at 28 weeks gestation during ambulance transfer between Arad and Timisioara. Report 30 July.

198. On August 8th an unnamed 33-year-old woman with Covid-19 died at 25 weeks gestation in Alba Iulia hopsital, Romania (click here). Report 8 August.

197. This report (click here) describes the two patients below (R195 & R196), and mentions a further pregnant woman from Vranje who was admitted to the Nis Clinical Center on July 3rd with symptoms of the corona virus, but testing negative, who has been on artificial ventilation since July 18. Report 29 July.

196. On 28 July 2020 an unnamed 34-year-old woman with severe Covid-19 pneumonia died after cesarean at 26 weeks gestation in Nis hospital, Serbia (click here). The baby is in neonatal intensive care. Report 28 July.

195. On 21 July 2020 an unnamed 27-year-old woman died from Covid-19 (click here). Her baby had been stillborn the previous day. Both were cared for at Nis hospital, Serbia. Report 21 July.

11 August update

194. Belma Soljanin contracted Covid-19 at 35 weeks (click here). She was delivered by Caesarean on 6 August at the Clinical Centre University Sarajevo Gynecology and Obstetrics Clinic. The baby tested negative and survived, but she died on August 9th in Podhrastovi ward in Sarajevo. Report 9 August.

193. Brittany Lance, from Rockford Illinois, contracted Covid-19 at 28 weeks. She required ventilation and spent 40 days in ICU (click here). Her baby was born prematurely by Caesarean. Report 5 August.

192. Sonam Sreekant contracted mild Covid-19 during her pregnancy (click here). She was nursed at home and recovered. The pregnancy is ongoing. Report 11 August.

191. Nadu Morgan contracted Covid-19 at between 12 and 16 weeks gestation (click here). She was initially treated at Nkhoma Hospital and later transferred to Kamuzu Central Hospital in Lilongwe, Malawi. She recovered. The pregnancy is ongoing.  Report 4 August.

190. Haley Peterson contracted Covid-19 at 19 weeks gestation (click here). Her symptoms were mild and the pregnancy is ongoing. Report 5 August.

189. Ebony Brown-Olaseinde contracted Covid-19 at 27 week gestation with twins. She required ventilation and delivery by Caesarean at 28 weeks at Saint Barnabas Medical Center in Livingston, New .Jersey (click here). Mother & babies survived. Report 6 August.

188. Brittany Hartwell, from Brevard county, Florida, contracted Covid-19 while pregnant. Her baby was born by Caesarean at AdventHealth at 27 weeks (click here). Both recovered, but the baby had a grade 4 intra-ventricular bleed. Report 7 August.

187. An unnamed woman died after childbirth at the Manati Hospital in Puerto Rico on 18 July (click here). Report 22 July.

186. A newborn baby in Basildon tested positive two days after birth on May 11 (click here). The mother, Presley Dowdall, had pre-eclampsia and obstetric cholestasis, but tested negative. Both recovered. Report 30 July.

185. An unnamed 24-year-old woman with COVID-19, gave birth to a healthy daughter at Regional Institute of Medical Sciences, Imphal, India, on August 10th (click here). Report August 10th.

184. Molly Grantham, from North Carolina, contracted Covid-19 postnatally. She developed pneumonia but recovered. Her baby remain uninfected (click here). Report 7 August.

31 July update

183. 19-year-old Janete Vasconcelos da Silva, contracted Covid-19 at 8 months gestation and was cared for at a hospital in Santarem, Para State, Brazil on July 17, 2020 (click here). Report 21 July.

182. There have been 2,842 infections among pregnant and post partum women in Mexico, and 83 deaths (click here). Report 13 July.

181. Three mothers tested positive at the Pumwani maternity hospital in Nairobi, Kenya (click here). No babies were affected. Report 14 July.

180. Amandine tested positive for SARS-CoV-2 and gave birth to Mahaut by Caesarean at CHIREC Delta Hospital in Brussels, Belgium April 25, 2020 (click here). Both mother and baby were doing well. Report 26 April.

30 July update

179. Essence Townsend from Scottsdale, Arizona contracted Covid-19 at about 32 weeks (click here). The pregnancy is ongoing. Report 27 July.

178. Three pregnant women with Covid-19 have been turned away by hospitals in Kolkota, West Bengal (click here). The outcomes appear to have been good. Report 28 July.

177. Kia Anderson, from Memphis, Tennessee, contracted Covid-19 at 23 weeks (click here). She self-isolated at home and recovered. The pregnancy is ongoing. Report 27 July

176. 54 pregnant women have been diagnosed with Covid-19 in El Paso, Texas (click here). No newborns have tested positive. Report 28 July.

175. An unnamed woman gave birth at term at the end of May in Sassoon hospital, Pune, India (click here). She had no symptoms but had SARS-CoV-2 antibodies. The baby had fever, lethargy and signs of severe Covid-19, tested positive and recovered. Report 28 July.

174. Veronica Markley contracted Covid 19 at 27 weeks gestation (click here). She was cared for at Presbyterian St. Lukes hospital in Denver, Colorado, and required ventilation for some days. She recovered and gave birth at term. She tested positive again on the day of the birth. The baby was fine. Report 29 July.

27 July update

173. An unnamed woman with Covid-19 gave birth on 22 July at Govind Ballabh Pant Hospital in Agartala, in Tripura, NE India (click here). Both “mother and child are safe”. Report 23 July.

172. An unnamed woman with Covid-19 gave birth at Diphu Medical College & Hospital (DMCH) in Karbi Anglong district in Assam, India (click here). Both mother & child are in a ‘stable’ condition. Earlier Runjun Mahanta and Kankana Barman, who both had Covid-19, gave birth to healthy babies in Kokrajhar, Assam. Report 27 July.

25 July update

171. Kaillee Dyke contracted Covid-19 at 27 weeks gestatiowith twins, and required ventilation in the intensive care unit at Royal Melbourne Hospital, Australia (click here). At the time of the report she remained on the ventilator, the pregnancy was ongoing and the babies were undelivered. Report 19 July.

170. Marzanne Lennox contracted Covid-19 at 30 weeks gestation and required 2 weeks ventilation at Life Wilgers Hospital in Pretoria, South Africa (click here). She survived. The baby was stillborn and delivered by Caesarean. Report 16 July.

20 July update

169. One hundred women with Covid-19 have given birth at Vani Vilas Hospital in Bengaluru, India (click here). The hospital has treated up to 350 pregnant women with Covid-19. Report 17 July.

168. A woman with Covid-19 gave birth by Caesarean at the All India Institute of Medical Sciences (AIIMS)-Patna on 19 July (click here). The baby has not yet been tested. Report 20 July.

167. Ten women with Covid-19 gave birth in Gauhati Medical College and Hospital in Assam, India (click here). Report 19 July.

18 July update

166. Sarah Green from San Antonio in Texas is pregnant and contracted COVID-19 (click here). She is self isolating at home and the pregnancy is ongoing. Report 18 July.

165. Rocio Casalduc from New Hampshire contracted Covid-19 during her pregnancy and was anaeshetised. presumably ventilated, and her baby delivered (click here). Both survived. Report 18 July

15 July update

164. Diana Angola, 36, contracted Covid-19 at 26 weeks. She required ventilation and Caesarean section, at the Versaille clinic in Cali, Colombia (click here). She recovered. Her son Jefferson tested negative and remains in hospital. Report 29 June.

163. Sarah Scully, age 35, from Birmingham UK contracted Covid-19 at a late stage of her prengancy (click here). She was delivered by Caesarean section at Birmingham Women’s Hospital on 12 April. After a month of intensive care she died on May 12. The baby survived. Report 20 June.

162. Aurora Chacon Esparza, age 35, from Minnesota, contracted Covid-19 at 30 weeks gestation. She required ventilation and was delivered by Caesarean at North Memorial Hospital in Brooklyn Minneapolis. The baby survived, but she remains critically ill on a ventilator (click here). Report 11 July. Update 11 August. She died on 18 July (click here).

161. Larissa Blanco was pregnant with twins. She had flu like symptoms and tested positive for SARS- CoV-2 on June 12. The Covid-19 was reported to have been mild. The twins were born at a private hospital in Botucatu, Sao Paulo on June 27, but she died soon after from bleeding (click here). The twins survived. Report 2 July.

160. Dora Nginza Hospital in port Elizbeth S Africa has treated 19 pregnant patients who have tested positive for Covid-19 (click here). The hospital treated its first case in pregnancy on 30 March (click here). Reports 9 April & 24 June.

14 July update

159. Esbeidy Reyes contracted Covid-19 at about 28 weeks, and was admitted to the ICU at Memorial Hermann Hospital in the Texas Medical Center. She was treated with immune plasma from someone who had recovered from the virus (click here). She recovered. The pregnancy is ongoing. Report 28 June.

158. The Institute of Obstetrics & Gynaecology (IOG) & Government Hospital for Women and Children, Egmore, in Chennai, has treated 294 women who tested positive for SARS-CoV-2. None have died.  Kasturba Gandhi Hospital (KGH) for Women and Children, Triplicane has cared for 229 positive women of whom 187 have been discharged, but no further details are available (click here). The Government Kilpauk Medical College Hospital has 30 COVID-19 positive pregnant women. At least 10% of babies are reported to have tested positive. No details were available for Chennai’s largest maternity hospital, Government RSRM Lying-in Hospital, Royapuram. Report 20 June.

157. Morgan Brink, from Johannesburg South Africa, tested positive for SARS-CoV-2 at 22 weeks gestation. She recovered and her son was born by Caesarean at 35 weeks on 11 July. He is recovering (click here). Report 14 July.

13 July update

156. Rocio Martinez contracted Covid-19 at 20 weeks (click here). She recovered, and the pregnancy is ongoing. Report July 8.

155. An unnamed woman from Hesperia, California died from Covid-19 on 26 June (click here). The baby survived and tested negative. According to the report she was the 2nd pregnant woman to die from the disease in California. At the time of the report 72 pregnant women in San Bernardino County had contracted COVID-19. Report 10 July.

154. Maggie Sillero was 28 weeks pregnant with triplets when she tested positive for SARS-CoV-2 (click here). She remained asymptomatic and was delivered by Caesarean at the Woman’s Hospital of Texas in Houston at 32 weeks. The babies all did well. Report 9 July.

153. The wife of professional tennis player Viktor Troicki is pregnant and has tested positive for SARS-CoV-2 (click here). Report 23 June.

26 June update

152. An unnamed 40-year-old woman, with SARS-CoV-2, gave birth to a baby girl at Lagos University Teaching Hospital, Nigeria (click here). Both mother and the baby “are doing fine.” Report 27 April.

24 June update

151. An unnamed 24-year-old woman with Covid-19 and an ectopic pregnancy died in the Gautam Budh Nagar district of Uttar Pradesh, India, on 19 June (click here). Report 20 June.

150. Five pregnant girls have contracted Covid-19 at a state-run children’s shelter in Uttar Pradesh’s Kanpur districy (click here). They are being treated at Kanpur Medical College. No further details. Report 22 June.

149. An unnamed woman with Covid-19 was delivered by Caesarean section at 31 weeks in the Semmelweis Hospital in Budapest (click here). The baby tested negative. Report 23 June.

23 June update

R 20 update. Karen Mannering (report 20 here) gave birth to a healthy baby on 16 June (click here). Report 22 June.

148. A unnamed asymptomatic woman with SARS-Cov2 gave birth to triplets in Mexico on May 8th. (click here). The babies tested positive on the day of birth but are reportedly “not in danger”.  Report 23 June.

147. An unnamed 20-year-old woman who tested positive for coronavirus on June 14 gave birth on June 15 in a COVID care centre in Amravati in Maharashtra. Both mother and baby recovered. Another unnamed woman with COVID-19, from Rohankheda village in Morshi tehsil, gave birth to a boy on June 19 (click here). Both also recovered. Report 22 June.

146. Kate Foxall, 36, from Charminster contracted Covid-19 at 38 weeks, and gave birth to Ostara at St Mary’s Maternity Unit in Poole on May 15 (click here). Ostara’s coronovirus status was not reported but she was fine. Report 22 June.

145. An unnamed  29-year-old woman from Sombrerete in Mexico gave birth to triplets prematurely by Caesarean section on May 6th at Zacatecas Women’s Hospital (click here). She tested positive postnatally. The babies all tested negative. Two died from prematurity. Report 14 May

18 June update

144. Monica V. Garcia from Elizabeth, New Jersey contracted Covid-19 during pregnancy (click here). She recovered without special treatment. The baby is due August 3. Report 22 May.

143. Three pregnant women with Covid-19 in the Cayman Islands recovered with no special treatment (click here). No further details. Report 15 June.

15 June update

142. The Nair hospital in Mumbai successfully completed 302 deliveries of Covid-19 positive women. Doctors said none of the babies born in last two months had tested positive at the time of birth (click here). Report 15 June.

141. An unnamed woman with Covid-19 from Old Dhaka gave birth to a baby boy at Dhaka Medical College Hospital in Bangladesh (click here). Both recovered. Report 17 May.

140. An unnamed woman in late pregnancy tested positive in Meghalaya, Bangladesh (click here). No further details given. Report 10 June.

14 June update

139. Liberian nurse Sedia Marwolo, aged 38, was 32 weeks gestation when she contracted Covid-19 (click here). She recovered and later had a healthy baby. Report 23 May.

Update (click here) of report 17 from Baton Rouge (click here). The mother, who had required ventilation but laboured spontanously at 21+6 days, and whose baby had died soon after birth, is named as Kenna Allen. She recovered. Report 10 June.

138. An unnamed women contracted Covid-19 at 28 weeks gestation, and required delivery at 29 weeks at Dubai’s King’s College Hospital London (click here). The baby was not infected and both recovered. Two other women with less severe disease in the same hospital also recovered and their babies were not infected. Report 11 June.

137. Danielle Wood, age 32, contracted Covid-19  at 32 weeks gestation (click here). She self-isolated at home. Her baby born at 38 weeks was not infected. Report 12 June.

8 June update

136. A woman, identified only as Ilse, developed Covid-19 at 31 weeks gestation (click here). She required ventilation at Rodolfo de Mucha Macías hospital in Mexico City. At 34 weeks she was delivered by Caesarean. The baby tested negative and both recovered. The hospital has cared for four other women with Covid-19. Three recovered and their pregnancies are ongoing. No details were given of the fourth. Report 3rd june.

135. Rusia Goes, aged 42, from Rio de Janeiro developed Covid-19 at 8 months gestion (click here). She required ventilation and delivery by caesarean. The baby tested negative and was isolated from her. She eventually recovered. Report 26 May.

7 June update

134. An unnamed 20 year old woman died after giving birth at 7 months gestation to a stillborn baby in Vellore Medical College and Hospital (click here). The birth was by Caesarean section and the cause of death was reported as complications of pregnancy-induced hypertension. She had tested positive for Sars-Cov2. Report 6 June.

133. 79 pregnant women have tested positive for COVID-19 in Kashmir (click here). Mainly from the Anantnag district. No further details. Report 6 June.

132. Neelam Kumari, age 30, from Ghaziabad in Uttar Pradesh, died in the eighth month of her pregnancy of Covid-19 (click here). Report 7 June.

131. Abi Atkin, aged 34, from Sheffield contracted mild Covid-19 at 34 weeks (click here). She recovered without treatment and gave birth normally at term. Report 6 June.

5 June update

130. An unnamed 22-year-old woman from Padarayanapura, Bengaluru, India, contracted Covid-19 at 8 months gestation (click here). No further details. Report 5th June.

2 June update

129. Michelle Hunter contracted Covid-19 at term (click here). Her son, Hank, was delivered by Caesarean section at an unnamed Vernon, British Columbia hospital. He tested negative. Report 30 May.

1 June update

128. Wafa Boudissa, age 28, died of the coronavirus at 8 months gestation (click here). She was a doctor working in the Intensive Care unit of Ras El Oued hospital in eastern Algeria. Report May 18.

127. A unnamed 28-year-old woman, who was six months pregnant, died in Kalsekar hospital, Mumbra, India after three private hospitals refused to admit her because of suspected Covid-19 (click here). Her death certificate says she died of Acute Respiratory Distress Syndrome (ARDS) with suspected Covid. HT @DeepakNModi. Report 29 May.

31 May update 

126. Vegan lifestyle vlogger Rachel Ama contracted Covid-19 at 11 weeks gestation (click here). She recovered and the pregnancy is continuing. Report 30 May.

30 May update

125. Hilda Garson, age 28, from Manitoba, tested positive for SARS-Cov2 in March (click here). She self isolated, is now 21 weeks, and the pregnancy is ongoing. Three other pregnant women in Manitoba are reported to have tested positive. Report 28 May.

124. Rashmi Kapoor tested positive at term and delivered in Lok Nayak Jai Prakash Narayan Hospital in New Delhi (click here). Report 27 May.

123. Amanda Joyce, from Boston, Massachusetts, contracted Covid-19 on March 19th at about 21 weeks gestation (click here). She self-isolated at home and the pregnancy is ongoing. Report May 29.

28 May update Reports 121 and 122 added.

122. A belated addition. An anonymous woman with Covid-19 in Wuhan (click here) gives birth to an infected baby. Report 5 Feb.

121. Candice Bowie contracted Covid-19 in April in prison in Louisiana at 8 months gestation. On May 4th she was released and went to an unnamed hospital where she was scheduled to deliver by Caesarean (click here). Report 18 May.

26 May update Reports 115-120 added.

120. Diamond, a pseudonym, developed mild Covid 19 at term and delivered at Toronto’s Michael Garron Hospital (click here). Mother and baby survived. Report 21 May.

119. Tasnim Shaheen developed severe Covid-19 at about 28 weeks gestation. She required ventilation and Caesarean at Jamaica Hospital in Queens, New York (click here). Mother and baby are still in hospital but recovering. Report 11 May.

118. An unnamed 20-year-old coronavirus positive woman from Medchal has given birth to twins by Caesarean section at Gandhi Hospital in Hyderabad (click here). The mother was asymptomatic. The twins are awaiting testing. Report 26 May.

117. Lisseth Hernandez developed Covid-19 at 29 weeks gestation with twins. She required ventilation and was delivered at 30 weeks by Caesarean (click here). She recovered. The babies were isolated and did well. Report 19 May.

116. There are 2,561 pregnant women in Russia with coronavirus infection. 2,035 tested positive for SARS-Cov2. Presumably the rest are clinical diagnoses (click here).  There are 816 pregnant women with the coronavirus infection in Moscow alone. Report 25 May.

115. Katie Miller, the spokeswoman for US Vice President Mike Pence, is pregnant and has tested positive for SARS.Cov2 (click here). She has recovered and is back at work. The pregnancy is continuing. Report 26 May.

21 May update Reports 111-114 added.

114. Claire Trusson, age 37, developed Covid-19 at 34 weeks (click here). It was an IVF pregnancy. She gave birth at St Helier Hospital in Carshalton. Both recovered. Report 29 April.

113. Shaquilla James, of Summerton, South Carolina developed Covid-19 at 38 weeks gestation (click here). She gave birth the same day at McLeod Regional Medical Center in Florence, SC, but later was put on a ventilator. Mother & baby both recovered. Report 20 May.

112. Alicia Kappers, age 40, was 31 weeks when she developed Covid-19 on March 24 (click here). She was cared for at the TriHealth Good Samaritan Hospital in Cincinnati, Ohio, where she required prolonged ventilation and a tracheostomy. She went into pre-term labour at 32 weeks and was delivered by Caesarean. The baby tested negative. Both are recovering at home. Report 17 May

111. There have been 115 babies born to Covid-19 infected mothers at the Lokmanya Tilak Municipal General Hospital – also called Sion Hospital – in Mumbai (click here). Three babies were infected, but recovered. Two mothers died, one of whom was aged 28 and died after giving birth.  Report 21 May. (HT Francis Githae Murithi)

18 May update – report 109 added.

110. An unnamed woman with Covid-10 gave birth in the North Ossetia city of Beslan (click here). Both mother and baby are now home. The head of the unnamed hospital’s maternity unit, Hassan Tagaiev, said that 17 of 35 women who were about to give birth there had tested positive for Covid-19.  Report 18 May.

109. Kimberly Phillips, age 44, who had Covid 19, gave birth on May 2nd, at 40 weeks gestation, at the Princess of Wales hospital in Bridgend (click here & here). Her baby, Coolio Carl Justin Morgan, died age 3 days. The primary cause of death was hypoxic ischemic encephalopathy, secondary cause maternal Covid-19. Kimberley is reported to have needed intensive care but has now been discharged. Reports 13, 14 May

17 May update reports 107 & 108 added

108. An unnamed 29-year-old from Sindhupalchowk district in Nepal gave birth on May 6, and died of COVID-19 on May 16, in Kathmandu (click here). Report 17 May

107. An unnamed 27-year-old, from Dharavi slum in Maharashtra, tested positive for coronavirus in Belagavi city on 14 May (click here). She was 7 months gestation. Dharavi is in Mumbai . Belagavi is 500 km to the south. Report 15 May

16 May update – reports 105 & 106 added

106. Ten pregnant women with Covid-19 have been were treated at Sheba Medical Center at Tel Hashomer Hospital in Tel Aviv (click here). Four have given birth, one of whom was in critical condition and was transferred to ICU. Report 15 May.

105. An unnamed woman with SARS-COV-2 gave birth at 39 weeks gestation in Indraprastha Apollo Hospital, New Delhi  (click here). The baby was not infected. Report 15 May.

13 May update – reports 103 and 104 added.

104. Mili América Antelo, age 40, was pregnant with twins at when she developed severe Covid-19 at 28 weeks gestation (click here). She required Caesarean section and spent 11 days in intensive care (7 on a ventilator) at Vall d’Hebron hospital in Barcelona. The twins both tested negative. Mili has now been discharged. Report 11 May.

103. The Los Angles Times reports that roughly 134 pregnant women have tested positive, in LA county (click here). Over 82% of them were symptomatic. There have been 29 live births, and one stillbirth. Twenty-four infants were tested at birth, including one set of twins, and none tested positive. The virus has not been detected in amniotic fluid, breast milk or other “maternal samples”. Report 11 May.

10 May update – cases 97-102 added

102. Six women with COVID-19 have given birth in a government hospital in Peru. Five babies were healthy and have been discharged. The sixth woman remains in a serious condition in the intensive care unit. Her baby was born prematurely and remains hospitalized. None of the babies tested positive for COVID-19 (click here). Report 9 May.

101. Jessa Yager, from Grand island, Nebraska, developed Covid-19 while pregnant  (click here). She is recovering and the pregnancy is ongoing at 36 weeks. Report 7 May.

Jim Thornton

Covid-19 in pregnancy 101 onwards

May 15, 2020

Primary sources. Updated 28th September

In roughly reverse order. Updated regularly. Click here for studies 1-100. Click here for ripe-tomato.org’s Covid-19 in pregnancy navigation page.

28 September update – study 291 added

Study 291 – Spanish registry of Covid-19 screening in asymptomatic pregnant women

By May 31st 2020, of 16,308 pregnant women screened, 338 (2.1%) had tested positive (click here or RS94C_202009092). Testing was done in 100 maternity hospitals listed in Table 2. This is a different registry from study 264b, which only covered 45 hospitals. However the hospitals, time period and presumably cases overlap.  Spanish with English abstract. Citation: Encinas Pardilla MB, Caño Aguilar Á, Marcos Puig B, Sanz Lorenzana A, Rodríguez de la Torre I, Hernando López de la Manzanara P, Fernández Bernardo A, Martínez Pérez Ó. Registro español de cribado de Covid-19 en gestantes asintomáticas. Rev Esp Salud Pública. 2020; 94: 18 de septiembre e202009092

27 September update – studies 284-290 added. I’ve also noticed ten duplicate numbers, studies 257 to 266 & renumbered the later ones as 257b to 266b

Study 290 – 25 symptomatic women in St Louis, Missouri

25/532 (4.7%) women admitted for an obstetric procedure were asymptomatic but positive for SARS-CoV-2 at Barnes-Jewish Hospital in St Louis, Missouri from May 28 – July 22 (click here or PIIS0002937820311029). This series will not include the severely ill woman in study 69, but probably includes some in study 259. Citation: KELLY JC, RAGHURAMAN N, PALANISAMY A, STOUT MJ, CARTER EB, Pre-procedural asymptomatic COVID-19 in obstetric and surgical units, American Journal of Obstetrics and Gynecology (2020), doi: https://doi.org/10.1016/j.ajog.2020.09.023.

Study 289 – seroprevalence during labour at 7 hospitals in New York State

269/1671 (16%) women were seropositive in labour (click here or Haizler-Cohen PIIS0002937820311017). They delivered in the Northwell Health system so probably were included in studies 162 and 179. Citation: HAIZLER-COHEN L, DAVIDOV A, BLITZ MJ, FRUHMAN G, SARS-CoV-2 Antibodies in Pregnant Women Admitted to Labor and Delivery, American Journal of Obstetrics and Gynecology (2020), doi: https://doi.org/10.1016/j.ajog.2020.09.022.

Study 288 – serological testing among pregnant women in Estonia

The SARS-CoV-2 seroprevalemce was reported to be nearly five time higher than the rate of PCR positivity, and also 10 times lower than the rate of seropositivity in the general population of Spain (click here or aogs.13995) Citation: Veerus, P., Salumets, A., Naaber, P., Krjutškov, K., Tilk, K., Laanpere, M. and Uusküla, A. (2020), Seroprevalence of SARS‐CoV‐2 antibodies among pregnant women in Estonia: a call for epidemiological studies. Acta Obstetricia et Gynecologica Scandinavica. Accepted Author Manuscript. doi:10.1111/aogs.13995

Study 287 – 2 cases from Tehran, Iran

A woman with severe Covid-19 at 31 weeks was delivered by Caesarean and died in Shariati hospital, Tehran. Her baby was seriously ill with complications of prematurity and neonatal Covid-19. He recovered, albeit with hydrocephalus (click here or s13052-020-00897-2). A second women had milder disease diagnosed clinically. Her baby also had complications of prematurity and neonatal Covid-19 and recoverd. The mothers may have been included in studies 66, 67 and 218. The babies may have been reported in study 250. Citation: Sagheb, S., Lamsehchi, A., Jafary, M. et al. Two seriously ill neonates born to mothers with COVID-19 pneumonia- a case report. Ital J Pediatr 46, 137 (2020). https://doi.org/10.1186/s13052-020-00897-2

Study 286 – 52 cases from Turkey

27 women with Covid-99 in pregnancy confirmed on PCR, and 25 diagnosed clinically (click here or Alay jog.14493 (1)). From author affiliations the unnamed tertiary referral hospital is probably Dr. Sadi Konuk Education and Training Hospital, Istanbul, which has not previously reported cases on its own behalf. They may be included in other Istanbul series such as study 244. It also appears to be a different hospital from Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital which is nearby, and reported cases in studies 144 and 210. Citation: Alay, I., Yildiz, S., Kaya, C., Yasar, K.K., Aydin, O.A., Karaosmanoglu, H.K., Aydeniz, B., Salihoglu, O., Yaşar, L. and Ekin, M. (2020), The clinical findings and outcomes of symptomatic pregnant women diagnosed with or suspected of having coronavirus disease 2019 in a tertiary pandemic hospital in Istanbul, Turkey. J. Obstet. Gynaecol. Res.. doi:10.1111/jog.14493

Study 285 – 61 cases from New Jersey, USA

A case control study including 61 women with confirmed COVID-19 in pregnancy (click here or Brandt PIIS0002937820311340). The women were cared for at the Robert Wood Johnson University Hospital, in New Brunswick, which also reported cases in study 86. Citation: BRANDT JS, HILL J, REDDY A, SCHUSTER M, PATRICK HS, ROSEN T, SAUER MV, BOYLE C, ANANTH CV, Epidemiology of COVID-19 in Pregnancy: Risk Factors and Associations with Adverse Maternal and Neonatal Outcomes American Journal of Obstetrics and Gynecology (2020), doi: https://doi.org/10.1016/j.ajog.2020.09.043.

Study 284 – 70 cases from the Republic of Ireland’s Covid-19 register

70 women tested positive for SARS-CoV-2 during pregnancy in March and April 2020 (click here). There were no maternal deaths (pers comm Keelin O’Donoghue). The first report from the Republic of Ireland. Citation: ROI COVID-19 Study https://www.ucc.ie/en/npec/roicovid-19study/ Accessed 27 Sept 2020

24th September update – study 283 added

Study 283 – 321 cases from Maharashtra state, India

This first report from the Indian PregCOVID registry reports 141 pregnant women testing positive for SARS-CoV-2 in 15 hospitals in Maharashtra state (click here or PIIS0301211520306084). To these are added a further 180 cases from Topiwala National Medical College & BYL Nair Charitable Hospital, grid.413161.0, a dedicated Covid-19 hospital in Mumbai. The registry hospitals are listed and appear to have not previously reported cases. Note Lokmanya Tilak Municipal General Hospital and Lokmanya Tilak Municipal Medical College, in Mumbai grid.415652.1, study 245, does not appear to be part of the registry. The Nair hospital cases may overlap with those in study 225. Citation: Waghmare R, Gajbhiye R, Mahajan N, Modi D, Mukherjee S, Mahale S, Universal screening identifies asymptomatic carriers of SARS-CoV-2 among pregnant women in India, European Journal of Obstetrics and amp; Gynecology and Reproductive Biology (2020), doi: https://doi.org/10.1016/j.ejogrb.2020.09.030

23 September update – study 282 added

Study 282 – 156 cases from Stockholm, Sweden

Of 156 pregant women seen at the Karolinska Hospital in Stockoholm who tested positive for SARS-CoV-2, 65% were asymptomatic (click here). There was one stillbirth. Maternal deaths were not reported. Compared with a control group matched on various factors there was an increase in pre-eclampsia but no increase in preterm birth. This is the first report from this hospital. The cases don’t overlap with those reported in studies 20 or 259, but likely overlap with some in study 88. Citation: Ahlberg M, Neovius M, Saltvedt S, et al. Association of SARS-CoV-2 Test Status and Pregnancy Outcomes. JAMA. Published online September 23, 2020. doi:10.1001/jama.2020.19124

21 September update – study 281 added

Study 281 – First report from the US PRIORITY Study 

The PRIORITY study collected self-reported cases of Covid-19 in pregnancy. In this report they describe the outcomes of 179 infants born to mothers who had tested positive and 84 who tested negative. 82% of the former group and 63% of the latter had symptoms (click here or ciaa1411). 44 babies were admitted to NICU, and two were infected. Although not explicitly stated there appear to have been no stillbirths or neonatal deaths. Births occurred at over 100 hospitals across the US so it is likely that many will have been included in other US reports. Citation: Valerie J Flaherman, MD, MPH, Yalda Afshar, MD, PHD, John Boscardin, PHD, Roberta L Keller, MD, Anne Mardy, MD, Mary K Prahl, MD, Carolyn Phillips, MD, Ifeyinwa V Asiodu, RN, PHD, W Vincenzo Berghella, MD, Brittany D Chambers, PHD, Joia Crear-Perry, MD, Denise J Jamieson, MD, MPH, Vanessa L Jacoby, MD, MAS, Stephanie L Gaw, MD, PHD, Infant Outcomes Following Maternal Infection with SARS-CoV-2: First Report from the PRIORITY Study, Clinical Infectious Diseases, ciaa1411, https://doi.org/10.1093/cid/ciaa1411

20 September update – study 274 belatedly added (we’d missed it on 8 June). Studies 275 to 280 also added

Study 280 – Case report from Wuhan, China

A woman with Covid-19 gave birth on March 6th. The baby was not infected (click here or 5f3fc192e7305c00087df995). The hospital was Wuhan Central Hospital grid.440160.7 which presumably reported this case in study 39. Citation: Gao WDeng ZZeng LYang YGong HLiu JXiao H. A newborn with normal IgM and elevated IgG antibodies born to an asymptomatic infection mother with COVID-19. Aging (Albany NY). 2020; 12:16672-16674. https://doi.org/10.18632/aging.103346

Study 279 – The first case of Covid-19 in pregnancy in the United States

A woman with Covid-19 presented to New York City Health and Hospitals/Lincoln in New York City on March 12, 2020 (click here or 9795-IN PRESS-52450-5-10-20200908). She had mild disease, was treated as an outpatient and recovered. She was delivered by Caesarean at 37 weeks and the baby was not infected. The authors claim this was the first case of Covid-19 in pregnancy in the US. They may be correct. However the paper title is misleading because it was not a case of intrauterine transmission. Citation: Elkafrawi D, Joseph J, Schiattarella A, Rodriguez B, Sisti G. Intrauterine transmission of COVID-19 in Pregnancy: case report and review of literature. Acta Bio Med [Internet]. 2020Sep.7 [cited 2020Sep.20];91(3):e2020041. Available from: https://www.mattioli1885journals.com/index.php/actabiomedica/article/view/9795

Study 278 – 388 mothers testing positive for SARS-COV-2 from 22 countries.

The World Association of Perinatal Medicine Covid-19 working group has collected 388 women, pregnant with singletons, and diagnosed with SARS-CoV-19 between February 1 and April 30, 2020, from 73 centers in 22 countries (Argentina, Australia, Belgium, Brazil, Colombia, Czech Republic, Finland, Germany, Greece, Israel, Italy, North Macedonia, Peru, Portugal, Republic of
Kosovo, Romania, Russia, Serbia, Slovenia, Spain, Turkey, and United States (click here or uog.23107). Three mothers died. Of 266 completed pregnancies there were 6 miscarriages, 3 pregnancy terminations, and 6 stillbirths. Of 251 livebirths, 5 neonates died. The centres are listed in the supplement here uog23107-sup-0001-supinfo and many appear to have not previously reported cases. However the number of cases per centre is not reported and there is no explicit statement about previous reports. Citation: Di Mascio, D. and the WAPM (The World Association of Perinatal Medicine) working group on COVID‐19 (2020), Maternal and Perinatal Outcomes of Pregnant Women with SARS‐COV‐2 infection. Ultrasound Obstet Gynecol. Accepted Author Manuscript. doi:10.1002/uog.23107

Study 277 – 37 Neonates with community acquired Covid-19 in Turkey

This series of 37 neonates with Covid-91 acquired in the community were collected from 24 neonatal intensive care units around Turkey (click here or A_Multicentered_Study_on_Epidemiologic_and.2). Those born to mothers with SARS-CoV-2 during pregnancy were excluded. One with Down’s syndrome died. Citation: Kanburoglu, Mehmet Kenan; Tayman, Cuneyt; Oncel, Mehmet Yekta; Akin, Ilke Mungan; Can, Emrah; Demir, Nihat; Arayici, Sema; Baser, Demet Orhan; Caner, Ibrahim; Memisoglu, Asli; Uygun, Saime Sundus; Akar, Selahattin; Akin, Mustafa Ali; Ataoglu, Emel; Bezirganoglu, Handan; Bilgin, Leyla; Bozdag, Senol; Comert, Serdar; Gurpinar, Resat; Imamoglu, Ebru Yalin; Imdadoglu, Timucin; Narter, Fatma; Ozdemir, Ramazan; Toptan, Handan Hakyemez; Yalinbas, Emine Esin; Yaman, Akan; Erdeve, Omer; Koc, Esin. A Multicentered Study on Epidemiologic and Clinical Characteristics of 37 Neonates With Community-acquired COVID-19, The Pediatric Infectious Disease Journal: October 2020 – Volume 39 – Issue 10 – p e297-e302
doi: 10.1097/INF.0000000000002862 

Study 276 – a case treated with Remdesivir from New York Presbyterian

A woman with severe Covid-19 requiring supplemental oxygen but not invasive ventilation was treated with hydroxychloroquine and remdesivir (click here or ofaa345). She recovered and later gave birth vaginally. She was a health care worker caring for COVID-19 patients. From author affiliations this was NewYork-Presbyterian Hospital, Weill Cornell Medical Center, so she may have been included in studies 99, 230, 234 and 270 and possibly other New York series.  Citation: Grace A Maldarelli, MD, PhD, Megan Savage, MD, Shawn Mazur, PharmD, Corrina Oxford-Horrey, MD, Mirella Salvatore, MD, Kristen M Marks, MD, Remdesivir treatment for severe COVID-19 in third-trimester pregnancy: Case report and management discussion, Open Forum Infectious Diseases, , ofaa345, https://doi.org/10.1093/ofid/ofaa345

Study 275 – 20 women infected with SARS-CoV-2 and pre-eclampsia from Peru

20 women with SARS-CoV-2 also developed pre-eclampsia (click here or PIIS0301211520305959). Two babies died. One baby tested positive. One woman require hysterectomy for placenta accreata. Patients were cared for at Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru and, as acknowledged by the authors, they overlap with those reported in study 274. Citation: Coronado-Arroyo JC, Concepcion-Zavaleta MJ, Zavaleta-Gutierrez FE, Concepcion-Urteaga LA, Is COVID-19 a risk factor for severe preeclampsia? Hospital experience in a developing country, European Journal of Obstetrics and amp; Gynecology and Reproductive Biology (2020), doi: https://doi.org/10.1016/j.ejogrb.2020.09.020 

Study 274 – 41 patients from Peru

Of 41 women with Covid-19 in pregnancy, treated  between March 24 & May 7, 2020, none died although two required non invasive ventilation. Report in Spanish (click here). English translation (available here or 2245-6876-2-PB). From author affiliations the patients were cared for in Edgardo Rebagliati Martins National Hospital, Lima, Peru. One baby was infected. This is a different hospital from the case in study 51. Citation: Huerta Saenz IH, Elías Estrada JC, Campos Del Castillo K, Muñoz Taya R, Cristina Coronado J. Maternal and perinatal characteristics of pregnant women with COVID-19 in a national hospital in Lima, Peru. Rev Peru Ginecol Obstet. 2020;66(2). DOI: https://doi.org/10.31403/rpgo.v66i2245 

16 September update – studies 272 & 273 added.

Study 273 – 598 cases from US COVID-NET hospitals

598 hospitalized women with COVID-19, cared for in the COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) were pregnant (click here or mm6938e1-H). 44 mothers were admitted to ICU, 23 required invasive mechanical ventilation, and two died. COVID-NET covers 99 counties in 14 US states, which amounts to about 10% of the US population. The cases likely overlap with those in previous COVID-NET reports, studies 171 and 173. Citation: Delahoy MJ, Whitaker M, O’Halloran A, et al. Characteristics and Maternal and Birth Outcomes of Hospitalized Pregnant Women with Laboratory-Confirmed COVID-19 — COVID-NET, 13 States, March 1–August 22, 2020. MMWR Morb Mortal Wkly Rep. ePub: 16 September 2020. DOI: http://dx.doi.org/10.15585/mmwr.mm6938e1

Study 272 – 105 cases from eight US hospitals participating in vaccine surveillance

Among 105 pregnant women admitted with SARS-CoV-2 infection to eight hospitals participating in a Vaccine Safety Datalink (VSD) surveillance project, over half were admitted for obstetric reasons (click here or mm6938e2-H). The participating hospitals are listed here. Citation: Panagiotakopoulos L, Myers TR, Gee J, et al. SARS-CoV-2 Infection Among Hospitalized Pregnant Women: Reasons for Admission and Pregnancy Characteristics — Eight U.S. Health Care Centers, March 1–May 30, 2020. MMWR Morb Mortal Wkly Rep. ePub: 16 September 2020. DOI: http://dx.doi.org/10.15585/mmwr.mm6938e2external icon

14 September update – study 270 added

Study 271 – 86 “extra” maternal deaths during pandemic in Mexico

These authors used publicly available goverment statisitics (click here) to estimate the excess maternal deaths from Covid-19 in Mexico in 2020 (click here or Excess_Maternal_Deaths_Associated_With_Coronavirus.97254). The predicted maternal mortality ratio was 29.5 per 100,000 live births, and so far in 2020 the actual ratio is 42.4. The excess was entirely confined to respiratory disease. Overall 86 “extra” deaths have ocurred. In comparison the 168 deaths officially reported as due to respiratory disease are made up of 109 deaths due to confirmed COVID-19, 34 for which COVID-19 needs to be confirmed, and 25 due to other respiratory diseases. Citation: Lumbreras-Marquez, Mario I. MBBS, MMSc; Campos-Zamora, Melissa MBBS, MMSc; Seifert, Sara M. MD; Kim, Jimin MD, MSc; Lumbreras-Marquez, Jesus MBBS; Vazquez-Alaniz, Fernando PhD; Fields, Kara G. MS; Farber, Michaela K. MD, MS Excess Maternal Deaths Associated With Coronavirus Disease 2019 (COVID-19) in Mexico, Obstetrics & Gynecology: September 09, 2020 – Volume Publish Ahead of Print – Issue – doi: 10.1097/AOG.0000000000004140 

13 September update – studies 267-270 added

Study 270 – more from New York Presbyterian

Not clear from abstract if this includes original data (click here or ). Citation: Dayal, A. K., Razavi, A. S., Jaffer, A. K., Prasad, N., & Skupski, D. W. (2020). COVID-19 in obstetrics 2020: the experience at a New York City medical center, Journal of Perinatal Medicine (published online ahead of print 2020), 000010151520200365. doi: https://doi.org/10.1515/jpm-2020-0365

Study 269 – Case report from Baltimore

A woman with Covid-19 ruptured her membranes at 19 weeks, and delivered vaginally at 29 weeks (click here or Haiti 8847859 (1)). The baby tested negative but suffered complications of prematurity and remains on ICU. From author affiliations the hospital was probably University of Maryland Medical Center, which has not previously repoted cases. Citation: Mary E. Burgoyne, Emad A. Elsamadicy, Liviu Cojocaru, Andrea Desai, “COVID-19 Barriers to Care for Pregnant Patients in Prolonged Isolation”, Case Reports in Obstetrics and Gynecology, vol. 2020, Article ID 8847859, 4 pages, 2020. https://doi.org/10.1155/2020/8847859

Study 268 – 14 cases from Tongi, Wuhan

Further details on 14 cases which have probably been described before (click here or 1-s2.0-S2052297520301049-main). Citation: Gao X, Wang S, Zeng W, Chen S, Wu J, Lin X, Liu Y, Sun Z, Feng L, Clinical and immunological features among COVID-19 affected mother-infant pairs: antibodies to SARS- CoV- 2 detected in breast milk, New Microbes and New Infections,  https://doi.org/10.1016/j.nmni.2020.100752.

Study 267 – Case from Izmir, Turkey

Mild Covid-19 delivered by Caesarean, both well (click here or ozer pdf_TPD_1941). From Dokuz Eylul University Hospital, Izmir, which has not previously reported cases. Citation: Ozer E, Cagliyan E, Yuzuguldu RI, Cevizci MC, Duman N. Villitis of Unknown Etiology in the Placenta of a Pregnancy Complicated by COVID-19 [published online ahead of print, 2020 Sep 8]. Villitis of Unknown Etiology in the Placenta of a Pregnancy Complicated by COVID-19 [published online ahead of print, 2020 Sep 8]. Turk Patoloji Derg. 2020;10.5146/tjpath.2020.01506. doi:10.5146/tjpath.2020.01506

11 September update – study 266 added

Study 266b – United States, Centres for Disease Control update

The latest CDC tracking data, updated 10th September, shows 20,798 pregnant women with Covid-19 in the United States, of whom 44 (0.21%) have died (click here). Among those  for which data were available 205/5,339 (4.7%) were admitted to ICU, and 77/4,674 (1.6%) required mechanical ventialtion. Citation: Centres for Disease Control. Weekly COVID-19 Pregnancy Data updated September 10, 2020, Accessed 11 Sept 2020.

10th September update – studies 264 & 265 added

Study 265b – 71 cases from Houston, Texas

The authors report 71 women who tested positive for SARS-CoV-2 at delivery, four who had tested positive earlier in the pregnancy and two postnatally (click here or PIIS0301211520305807). One mother with severe disease recovered. Another required ECMO and remains on ventilatory support at a tertiary centre three months following delivery at 30 weeks. All neonates were isolated, and one tested positive but was asymptomatic. No babies died. All authors were affiliated with McGovern Medical School at The University of Texas. Houston but the acknowledgment suggests that the unnamed community hospital was Memorial Hermann Southwest Hospital. There have been no previous reports from Houston. Citation: Pineles BL, Alamo IC, Farooq N, Green J, Blackwell SC, Sibai BM, Parchem JG, Racial-Ethnic Disparities and Pregnancy Outcomes in SARS-CoV-2 Infection in a Universally-Tested Cohort in Houston, Texas, European Journal of Obstetrics & Gynecology & Reproductive Biology (2020), doi: https://doi.org/10.1016/j.ejogrb.2020.09.012

Study 264b – 246 cases from Spain

246 women with SARS-CoV-2 and 763 control women are reported in this Medxiv preprint (click here or 2020.09.05.20188458v1.full). Five women were admitted to ICU, but none died. Three babies were stillborn. This is the first report from the Spanish “Obs Covid registry” which includes 77 hospitals in Spain. The patients are therefore likely to include some from previous Spanish series, namely studies 53, 125, 151, 158, 165, 185, 191, 196, 235, and 266. Note that study 196, authored by the Neo-COVID-19 Research Group, which includes 14 hospitals in Spain, reported 42 cases and included one maternal death, so presumably does not completely overlap. Citation: SPANISH OBSTETRIC EMERGENCY GROUP, Oscar Martinez Perez, et al. The association between COVID-19 and preterm delivery: A cohort study with a multivariate analysis. medRxiv 2020.09.05.20188458; doi: https://doi.org/10.1101/2020.09.05.20188458

8 September update – studies 261-263 added

Study 263b – 66 cases (plus one maternal death) from Tehran, Iran

Of 66 women with Covid-19 treated between March 1 to Sep 1, 2020, four were admitted to ICU but none required ventilation (click here or taaa158). Two women aborted, 43 delivered, and 21 pregnancies are ongoing. No baby outcomes are reported directly, although one baby tested positive. No women in the series died. However in the discusssion section it is mentioned that in February 2020, a 22-year-old pregnant woman with COVID-19 at 37 weeks had died in the same hospital. It is not clear if she had been included in studies 23, 66 or 67. The women were cared for in Arash Women’s Hospital, which has also reported a set of triplets of which one was infected with SARS-CoV-2 and survived, and the other two who were negative died, (case 5 in study 250). Those triplets seem not to be included in the present series although it is not clear why. Citation: Pirjani R, Hosseini R, Soori T, et al. Maternal and neonatal outcomes in COVID-19 infected pregnancies: a prospective cohort study [published online ahead of print, 2020 Sep 5]. J Travel Med. 2020;taaa158. doi:10.1093/jtm/taaa158

Study 262b – case report from Wuhan

A woman with Covid-19 gave birth normally on Feb 22nd at 38 weeks gestation (click here or Antibodies in the breast milk of a maternal woman with COVID 19). Her baby was isolated and tested negative. IgG and IgA were both detected in breast milk, but no virus. The hospital of birth is unnamed but the mother was later transferred Guanggu Branch of Hubei Maternal and Child Health Hospital, a designated hospital for COVID-19 treatment in Wuhan city. This is not listed on GRID.ac but has reported cases many times. The case has probably been included in studies 8, 17, 30, 38, 54, and 55, and perhaps others. Citation: Yunzhu Dong, Xiangyang Chi, Huang Hai, Liangliang Sun, Mengyao Zhang, Wei-Fen Xie & Wei Chen (2020) Antibodies in the breast milk of a maternal woman with COVID-19, Emerging Microbes & Infections, 9:1, 1467-1469, DOI: 10.1080/22221751.2020.1780952 

Study 261b – Case report from Al Ahssa, Saudi Arabia

A woman with mild Covid-19 was delivered by Caesarean at 38 weeks and the baby isolated from the mother (click here or cureus-0012-00000010035). The baby did not become infected although 1/29 health care workers involved contracted SARS-CoV-2. This is the first reported case from Saudi Arabia. Citation: AlOmran A, Almatawah Y, Al Sharit B, Alsadah Z, Mousa O. Infection Prevention and Control Challenges With First Pregnant Woman Diagnosed With COVID-19: A Case Report in Al Ahssa, Saudi Arabia. Cureus. 2020;12(8):e10035. Published 2020 Aug 26. doi:10.7759/cureus.10035

7 September update – studies 258-260 added

Study 260b – Case report from Leicester, UK

A woman with Covid-19 at 28 weeks recovered and delivered at term (click here or e237007.full). The baby was unaffected. From author affiliations the hospital was part of University Hospitals of Leicester NHS Trust, which runs two maternity hospitals, Leicester Royal Infirmary and Leicester General Hospital. Neither has previously reported cases, although the patient was probably included in the UKOSS report, Study 92. Citation: Anness ASiddiqui F. COVID-19 complicated by hepatic dysfunction in a 28-week pregnant woman. 

Study 259b – Case report from Malmo, Sweden

A woman with severe Covid-19 and coagulopathy at 32 weeks required Caesarean delivery (click here or 1-s2.0-S1876034120304391-main). Mother and baby recovered. The baby tested negative. The hospital was Skåne University Hospital in Malmö which has not previously reported cases. Citation: Ronnje, L., Länsberg, J., Vikhareva, O. et al. Complicated COVID-19 in pregnancy: a case report with severe liver and coagulation dysfunction promptly improved by delivery. BMC Pregnancy Childbirth 20, 511 (2020). https://doi.org/10.1186/s12884-020-03172-8

Study 258b – Case of successful ECMO from France

A woman with Covid 19 required ventilation and Caesarean at 31 weeks. Following delivery her condition worsened and she was treated with ECMO for 7 days (click here or PIIS105307702030793X (002)). She recovered with moderate residual shortness of breath. The baby tested negtive and also recovered. From author affiliations the unnamed ECMO hospital was probably Hôpital Henri-Mondor in Creteil, a southeastern suburb of Paris. The patient may have been previously included in studies 150 & 184. Citation: Fiore A, Piscitelli M, Adodo DK, et al. Successful use of Extracorporeal Membrane Oxygenation (ECMO) in postpartum as rescue therapy in a woman with Covid-19: ECMO postpartum in COVID-19 patient [published online ahead of print, 2020 Aug 6]. J Cardiothorac Vasc Anesth. 2020;doi:10.1053/j.jvca.2020.07.088

3rd September update

Study 257b – Case report from Suzhou, China

A woman with Covid-19 was delivered by Caesarean on February 6, 2020 (click here or main (1)). The baby and other placental/amniotic samples tested negative. Both mother and baby survived. She was cared for in the 5th People’s Hospital of Suzhou grid.490559.4 (click here) which has not previously reported cases. Citation: Lv Y, Gu B, Chen Y, et al. No intrauterine vertical transmission in pregnancy with COVID-19: A case report [published online ahead of print, 2020 Aug 5]. J Infect Chemother. 2020;S1341-321X(20)30266-X. doi:10.1016/j.jiac.2020.07.015

Study 266 – Two cases from Alcazar de San Juan, Spain

Two pregnant woman with Covid-19 at 12 and 20 weeks respectively had amniocenteis negative for SARS-CoV-2 (click here or 10.1080@14767058.2020.1811669). From author affiliations the unnamed hospital was probably Hospital La Mancha Centro, in Alcazar de San Juan, Spain which has not previously reported cases. Citation: Ana M. Rubio Lorente, Maria Pola Guillén, Nuria López Jimenez, Maria Moreno-Cid Garcia-Suelto, Eduardo Rodriguez Rodriguez & Ana Pascual Pedreño (2020) Study of amniotic fluid in pregnant women infected with SARS-CoV-2 in first and second trimester. Is there evidence of vertical transmission?, The Journal of Maternal-Fetal & Neonatal Medicine, DOI: 10.1080/14767058.2020.1811669

2nd September update

Study 265 – Pregnant v non-pregnant disease severity using smartphone apps

The authors of this Medxiv preprint (click here or 2020.08.17.20161760v1.full) used a smartphone app (400K women – click here) and the Facebook/Carnegie Mellon COVID-19 survey (1.8M women – click here) to record Covid-19 symptoms and outcomes prospectively. Pregnant women with SARS-CoV-2 infection had the same disease severity as the non-pregnant. Citation: Erika Molteni, Christina M Astley, Wenjie Ma, Carole Helene Sudre, Laura A Magee, Benjamin Murray, Tove Fall, Maria F Gomez, Neli Tsereteli, Paul W Franks, John S Brownstein, Richard Davies, Jonathan Wolf, Timothy Spector, Sebastien Ourselin, Claire Steves, Andrew T Chan, Marc Modat SARS-CoV-2 (COVID-19) infection in pregnant women: characterization of symptoms and syndromes predictive of disease and severity through real-time, remote participatory epidemiology. medRxiv 2020.08.17.20161760; doi: https://doi.org/10.1101/2020.08.17.20161760

1st September update – studies 257 to 264 added

Study 264 – SARS-CoV-2 cell entry gene expression in placenta

Placental expression of the SARS-CoV-2 cell entry genes, ACE2 and TMPRSS2 in pre-pandemic stored samples from the Research Centre for Women’s and Infants’ Health BioBank, and the Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, both in Toronto, Ontario (click here or Bloise AJOG 1-s2.0-S000293782030884X-main). Citation: Bloise E, Zhang J, Nakpu J, Hamada H, Dunk CE, Li S, Imperio GE, Nadeem L, Kibschull M, Lye P, Matthews SG, Lye SJ, Expression of SARS-CoV-2 cell entry genes, ACE2 and TMPRSS2, in the placenta across gestation and at the maternal-fetal interface in pregnancies complicated by preterm birth or preeclampsia, American Journal of Obstetrics and Gynecology (2020), doi: https://doi.org/10.1016/j.ajog.2020.08.055.

Study 263 – Case report from The Netherlands

A pregnant woman with Covid-19 developed coagulopathy at 31 weeks, and CTG abnormalities at 32 weeks, necessitating Caesarean birth (click here or Mongula uog.22189). From author affiliations the unnamed hospital was probably Máxima Medical Centre, in Einthoven. Apart from NethOSS reports, the case has not been previously reported. Citation: Mongula, J.E., Frenken, M.W.E., van Lijnschoten, G., Arents, N.L.A., de Wit‐Zuurendonk, L.D., Schimmel‐de Kok, A.P.A., van Runnard Heimel, P.J., Porath, M.M. and Goossens, S.M.T.A. (2020), COVID‐19 during pregnancy: non‐reassuring fetal heart rate, placental pathology and coagulopathy. Ultrasound Obstet Gynecol. Accepted Author Manuscript. doi:10.1002/uog.22189

Study 262 – COVID-19 perinatal biorepository in Massachussetts

100 women and 78 newborns enrolled in the Massachussets General Hospital COVID-19 biorepository (click here or s12874-020-01102-y). No clinical outcomes reported. Citation: Shook, L.L., Shui, J.E., Boatin, A.A. et al. Rapid establishment of a COVID-19 perinatal biorepository: early lessons from the first 100 women enrolled. BMC Med Res Methodol 20, 215 (2020). https://doi.org/10.1186/s12874-020-01102-y

Study 261- Cardiac abnomalities with, but not caused by, SARS-CoV-2. New York

Six babies with congenital heart disease and one with congenital diaphragmatic hernia born to women with SARS-CoV-2, and cared for in the cardiac unit of New York Presbyterian’s Morgan Stanley Children’s Hospital and Columbia University Irving Medical Center (click here or Goldshtrom 2150135120950256). No babies had symptoms and none tested positive. Four babies were inborn, & two transferred in. Some of the pregnancies and births have probably been described elsewhere. Citation: Goldshtrom, N., Vargas, D., Vasquez, A., Kim, F., Desai, K., Turner, M. E., … Krishnamurthy, G. (2020). Neonates With Complex Cardiac Malformation and Congenital Diaphragmatic Hernia Born to SARS-CoV-2 Positive Women—A Single Center Experience. World Journal for Pediatric and Congenital Heart Surgery. https://doi.org/10.1177/2150135120950256

Study 260 – 2 patients from Vercelli in Italy

Two women with positive SARS-CoV-2 serology also had anti SARS-CoV-2 IgG antibodies in their baby’s cord blood (click here or vendola EJOG PIIS0301211520305352). One birth was vaginal and one by Caesarean. From author affilitations the unnamed hospital was probably Ospedale Sant’Andrea in Vercelli in Piedmont, which has not previously reported caes. Both mothers and babies were healthy.  Citation: Vendola Nicoletta, Stampini Viviana, Amadori, Roberta, Gerbino Martina, Curatolo Annalisa, Surico Daniela, et al. Vertical transmission of antibodies in infants born from mothers with positive serology to COVID-19 pneumonia’ European Journal of Obstetrics & Gynecology & Reproductive Biology, Accepted article online.

Study 259 – Test uptake druing hospital birth in St Louis, Missouri

Of 270 women offered SARS-CoV-2 testing on admission in labour, 13 had symptomatic disease, 3 had tested positive earlier in the pregnancy, and 223 accepted testing. Uptake rose after a range of methods to encourage testing (click here or Kernberg Universal_SARS.97256). Time period May 28th to June 25th No clinical details or test results reported. Barnes Jewish Hospital in St. Louis, Missouri has not previously reported cases. However the case reported in study 69 may have been cared for in the same hospital. Citation: Kernberg A, Kelly J, Nazeer S, et al. Universal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2) Testing Uptake in the Labor and Delivery Unit: Implications for Health Equity [published online ahead of print, 2020 Aug 26]. Obstet Gynecol. 2020;10.1097/AOG.0000000000004127

Study 258 – Environmental sampling during 4 births in Oregon

A range of samples were collected from the room during two vaginal and two Ceasarean births of asymptomatic women with SARS-CoV-2 (click here or Hermesch SARSCoronavirus_2.97258). No other clinical details. The unnamed university hospital is difficult to identify from author affiliations. Citation: Hermesch, Amy C. MD, PhD; Horve, Patrick F. BS; Edelman, Alison MD, MPH; Dietz, Leslie PhD; Constant, David PhD; Fretz, Mark DDS, MArch; Messer, William B. MD, PhD; Martindale, Robert MD; Van Den Wymelenberg, Kevin PhD Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Environmental Contamination and Childbirth, Obstetrics & Gynecology: August 19, 2020 – Volume Publish Ahead of Print – Issue – doi: 10.1097/AOG.0000000000004112

Study 257 – 6 cases treated with nitric oxide from Massachusetts

Six pregnant women with severe Covid-19 were treated with nitric oxide (click here or FAKHR High_Concentrations_of_Nitric_Oxide_Inhalation.97257). Three women delivered four babies, and three pregnancies are ongoing. No mothers or babies died. The patients were treated at Massachusetts General Hospital from April to June 2020, and probably overlap with those reported in studies 142 & 231. Citation: Safaee Fakhr B, Wiegand SB, Pinciroli R, et al. High Concentrations of Nitric Oxide Inhalation Therapy in Pregnant Patients With Severe Coronavirus Disease 2019 (COVID-19) [published online ahead of print, 2020 Aug 26]. Obstet Gynecol. 2020; 10.1097/AOG.0000000000004128. 

21st August update – studies 255 & 256 added

Study 256 – Case report from Norway

In Norweigan. Following from Google translate. A woman with twins developed mild Covid-19 during the process of labour induction at 38 weeks (click here or 59551-fødende-risikopasient-med-covid-19). Both babies were delivered vaginally. She recovered and the twins were healthy. Baby test results not reported. 14 hospital employees were quarantined due to patient contact, but none diagnosed with infection. From author affiliations the unnamed hospital was Sørlandet Hospital, Kristiansand, which has not previously reported cases.  Citation: Ane Cecilie Munk, Linda Reme Sagedal, Turid Stavseth Krogedal, Ida McFadzean, Hanna Oommen. Fødende risikopasient med covid-19 (Maternity risk patient with covid-19) Tidsskrift for Den norske legeforening. Published: July 16, 2020 Issue 11, August 18, 2020 Tidsskr Nor Legeforen 2020 doi: 10.4045 / tidsskr.20.0425

Study 255 – 16 maternal deaths in the UK

Ten women died with SARS-CoV-2 between 01/03/2020 and 31/05/2020, seven directly due to Covid-19, one cause not determined, and two due to unrelated causes (click here or Ref.-201-MBRRACE-UK-maternal-COVID-19-Report-FINAL (002)).  Six further women died by suicide or domestic violence, conceivably related to lockdown, over the same period. They overlap with those in studies 29, 52, 68, 92, 107, 126 & 200. Citation: Knight M, Bunch K, Cairns A, Cantwell R, Cox P, Kenyon S, Kotnis R, Lucas DN, Lucas S, Marshall L, Nelson-Piercy C, Page L, Rodger A, Shakespeare J, Tuffnell D, Kurinczuk JJ on behalf of MBRRACE-UK. Saving Lives, Improving Mothers’ Care Rapid Report: Learning from SARS-CoV-2-related and associated maternal deaths in the UK March – May 2020 Oxford: National Perinatal Epidemiology Unit, University of Oxford 2020.

20 August update – study 254 added

Study 254 – Breast milk testing in 18 affected women from the United States

Eighteen women with SARS-CoV-2, 17 symptomatic, had multiple breast milk samples tested (click here or jama_chambers_2020_ld_200087_1597789061.40481). One sample had detectable SARS-CoV-2 RNA, but no replication-competent virus was detectable in any sample, including the sample that tested positive for viral RNA. The samples were collected from woman anywhere in the United States so may include cases previously reported. Citation: Chambers C, Krogstad P, Bertrand K, et al. Evaluation for SARS-CoV-2 in Breast Milk From 18 Infected Women. JAMA. Published online August 19, 2020. doi:10.1001/jama.2020.15580

19 August update – Studies 251 to 253 added.

Study 253 – Case report from Chongqing, China

A woman with Covid-19 was delivered at 35 weeks gestation by caesarean section (click here or 1-s2.0-S1876034120304391-main). The baby was not infected. From author affiliations the unnamed hospital was probably Chongqing Three Gorges Central Hospital (grid.477128.f) which has not previously reported cases. Citation: Zhoujie Peng, Jianhui Wang, Yunbo Mo, Wei Duan, Guangjun Xiang, Ming Yi, Lei Bao, Yuan Shi. Unlikely SARS-CoV-2 vertical transmission from mother to child: A case report. Journal of Infection and Public Health, Volume 13, Issue 5, 2020, Pages 818-820, ISSN 1876-0341, https://doi.org/10.1016/j.jiph.2020.04.004.

Study 252a – Case report from Genoa, Italy

An asymptomatic woman with SARS-CoV-2 underwent Caesarean for breech at 38 weeks gestation (click here or medicina-56-00306-v2). The baby was asymptomatic and tested negative. Swabs from the amniotic surface of the placenta were positive. The hospital was IRCCS Ospedale Policlinico San Martino, Genoa, which has not previously reported cases. Citation: Ferraiolo, A.; Barra, F.; Kratochwila, C.; Paudice, M.; Vellone, V.G.; Godano, E.; Varesano, S.; Noberasco, G.; Ferrero, S.; Arioni, C. Report of Positive Placental Swabs for SARS-CoV-2 in an Asymptomatic Pregnant Woman with COVID-19. Medicina 2020, 56, 306.

Study 252 – 49 new cases from Lombardy, Italy

These 49 women with SARS-CoV-2 in pregnancy were collected between 10–26 April (click here or 10.1080@14767058.2020.1788532).  No outcomes reported. The unnamed hospitals in Milan and the six provinces of Lombardy (Brescia, Como, Lecco, Monza, Pavia, and Sondrio) were probably Sacco (Milan), Mangiagalli (Milan), S. Gerardo MBBM Foundation (Monza), Papa Giovanni XXIII (Bergamo), and San Matteo (Pavia) and the hospitals of Padua, Florence, Lecco, Trento, Modena, Seriate and Piacenza. However the recruitment period was later than that in studies 33, 64 & 117, so these patients have not been previously reported. Citation: Enrico Ferrazzi, Paolo Beretta, Stefano Bianchi, Irene Cetin, Paolo Guarnerio, Anna Locatelli, Anna Maria Marconi, Mario Giuseppe Meroni, Giulia Pavone, Armando Pintucci, Federico Prefumo, Valeria Savasi, Arsenio Spinillo, Beatrice Tassis, Patrizia Vergani, Michele Vignali, Fabio Parazzini & Carlo La Vecchia. (2020): SARS-CoV-2 infection testing at delivery: a clinical and epidemiological priority. Journal of Maternal-Fetal & Neonatal Medicine, DOI: 10.1080/14767058.2020.1788532

Study 251 – 101 cases from Chicago

Risk factors for 101 pregnant women testing positive for SARS-CoV-2 were compared with 1,317 controls (click here or 1-s2.0-S2589933320301543-main). No outcome data. The women were cared for at Northwestern Memorial Hospital March 19 to May 31 2020. They likely include cases in studies 116 & 124Citation: SAKOWICZ A, AYALA AE, UKEJE CC, WITTING CS, GROBMAN WA, MILLER ES, Risk Factors for SARS-CoV2 Infection in Pregnant Women, American Journal of Obstetrics & Gynecology MFM (2020), doi: https://doi.org/10.1016/j.ajogmf.2020.100198.

18 August update – belated addition of study 246, ItOSS registry, (HT Aris Papageorghiou), & studies 247 to 250.

Study 250 – 19 infected babies from Iran

19 newborns (incl. one set of triplets) infected with SARS-CoV-2 (click here or 10.1080@14767058.2020.1797672). One mother and four babies died. Dates of birth preceded paper receptin 20 June. The hospitals were Imam Khomeini Hospital, Orumiyeh, West Azerbaijan Province; Shariati Hospital, Tehran (the mother of this case died); Torbat-e Jām Hospital in Torbat-e Jām, Razavi Khorasan Province; Taleghani Hospital in Tehran, Arash Women’s Hospital in Tehran (triplets – 2 died, 1 survived); Boo-Ali Sina Hospital in Sari, Mazandaran Province; Qods Hospital in Qazvin; Ayatollah Mousavi Hospital in Zanjan; Mustafa Khomeini Hospital in Ilam; Allameh Bohluli Hospital in Gonabad, Razavi Khorasan Province; Imam Reza Hospital in Mashhad, Khorasan-e Razavi Province; Imam Sajad Hospital in Shahriar, Tehran Province; Day General Hospital in Tehran; Taleghani Hospital in Gorgan, Golestan Province (baby died); Hakim Jorjani Hospital in Gorgan, Golestan Province (baby died); and Hamedan Besat Hospital in Hamedan. The cases may overlap with those in studies 66, 67 & 218. They probably differ from those reported in studies 23 & 70. Citation: David A. Schwartz, Parisa Mohagheghi, Babak Beigi, Nazanin Zafaranloo, Fereshteh Moshfegh, Anita Yazdani. Spectrum of neonatal COVID-19 in Iran: 19 infants with SARS-CoV-2 perinatal infections with varying test results, clinical findings and outcomes. J Mat Fetal & Neonatal Med 2020, AHEAD-OF-PRINT, 1-10 https://doi.org/10.1080/14767058.2020.1797672

Study 249 – 669 cases with respiratory problems from Brazil

Another report of women with Covid-19 in pregnancy identified through the Brazilian Acute Respiratory Distress Syndrome Surveillance System (click here or oup-accepted-manuscript-2020). Overlap with studies 66, 138, 282, 194, 201, 203 & 248. Citation: Debora de Souza Santos, RN, PhD, Mariane de Oliveira Menezes, CM, MSc, Carla Betina Andreucci, MD, PhD, Marcos Nakamura-Pereira, MD, PhD, Roxana Knobel, MD, PhD, Leila Katz, MD, PhD, Heloisa de Oliveira Salgado, MSc, PhD, Melania Maria Ramos de Amorim, MD, PhD, Maira L S Takemoto, CNM, PhD, Disproportionate impact of COVID-19 among pregnant and postpartum Black Women in Brazil through structural racism lens, Clinical Infectious Diseases, , ciaa1066, https://doi.org/10.1093/cid/ciaa1066

Study 248 – 978 cases with respiratory problems from Brazil

Of 978 pregnant or postpartum women with COVID-19 and Acute Respiratory Distress Syndrome (ARDS), 124 died (click here or 1471-0528.16470). These appear to be the same cases as reported in study 182, albeit in more detail. They probably also overlap with studies 66, 138, 194, 201, & 203. Citation: Takemoto, M.L., Menezes, M.O., Andreucci, C.B., Knobel, R., Sousa, L.A., Katz, L., Fonseca, E.B., Nakamura‐Pereira, M., Magalhães, C.G., Diniz, C.S., Melo, A.S., Amorim, M.M. and Menezes, M.O. (2020), Clinical characteristics and risk factors for mortality in obstetric patients with severe COVID‐19 in Brazil: a surveillance database analysis. BJOG: Int J Obstet Gy. Accepted Author Manuscript. doi:10.1111/1471-0528.16470

Study 247 – 6 placentas from 5 women, Turin, Italy

This preprint reports the histology of 6 placentas from 5 pregnancies (one set of twins) complicated by Covid-19 (click here or Placenta in SARS-CoV-2 Bertero). All mothers and babies survived and all babies tested negative. They were cared for in S. Anna Hospital, Turin from March 22, to April 23, 2020, so are probably included in study 246. Citation: Luca Bertero, Fulvio Borella, Giovanni Botta, Andrea Carosso, Stefano Cosma, Marialuisa Bovetti, Marco Carosso, Giancarlo Abbona, Mauro Papotti, Paola Cassoni. Placenta in SARS-CoV-2 infection: a new target for inflammatory and thrombotic events. Research Square. Maternal Fetal Medicine. 2020. DOI: 10.21203/rs.3.rs-30412/v1

Study 246 – 146 cases from Italy (ItOSS)

This Medxiv preprint (not yet published as a peer reviewed paper) reports 146 women with Covid-19 in pregnancy up to April 22nd and collected by the Italian Obstetric Surveillance System, ItOSS (click here or 2020.06.11.20128652v1.full). 142 were positive for SARS-CoV-2 and 4 diagnosed clinically via CXR. Seven mothers were admitted to ITU, and 2 intubated, but none died. Two babies were stillborn and five tested positive. There were no neonatal deaths. These patients likely overlap with those in studies 32, 64, 76, 79, 109, 114, 188 and 197. They probably do not overlap with those in study 195. Citation: Alice Maraschini, Edoardo Corsi, Michele Antonio Salvatore, Serena Donati. Coronavirus and birth in Italy: results of a national population-based cohort study. medRxiv 2020.06.11.20128652; doi: https://doi.org/10.1101/2020.06.11.20128652

17th August update – studies 238 to 245 added

Study 245 – 141 cases from Mumbai, India

Out of 141 women with Covid-19 in pregnancy there were 3 abortions, one ectopic pregnancy and 3 maternal deaths (click here or Nayak 13224_2020_Article_1335). There were 3 stillbirths and 3 babies tested positive. From the description and author affiliations, the unnamed hospital is almost certainly Lokmanya Tilak Municipal General Hospital, grid.415652.1, which has not previously reported cases. Citation: Nayak, A.H., Kapote, D.S., Fonseca, M. et al. Impact of the Coronavirus Infection in Pregnancy: A Preliminary Study of 141 Patients. J Obstet Gynecol India 70, 256–261 (2020). https://doi.org/10.1007/s13224-020-01335-3

Study 244 – 125 cases from Turkey

Of 125 pregnant women with Covid-19 (click here or Oncel2020_Article), 7 mothers required ventilation and 5 died. Four babies tested positive and one (who tested negative) died. The babies were cared for in 34 unnamed neonatal intensive care units. From author affiliations these probably include İzmir (3 centres), İstanbul (6 centres), Rize (1 centre), Ankara (4 centres) and Kocaeli (1 centre). Some of these cases probably overlap with those reported in studies 31, 145, 146, 203, 210 & 223. Citation: Oncel, M.Y., Akın, I.M., Kanburoglu, M.K. et al. A multicenter study on epidemiological and clinical characteristics of 125 newborns born to women infected with COVID-19 by Turkish Neonatal Society. Eur J Pediatr (2020). https://doi.org/10.1007/s00431-020-03767-5

Studies 238 to 243 – 6 case reports, from Portugal, France, US, India, UK & Nigeria

S 238 (facial palsy) from Porto, Portugal (click here or figuerdo), Citation: Figueiredo R, Falcão V, Pinto MJ, et al. BMJ Case Rep 2020;13:e237146. doi:10.1136/bcr-2020-237146S 239 (severe case) from Paris, France (click here or federici). Citation: Federici L, Picone O, Dreyfuss D, et al. BMJ Case Rep 2020;13:e237511. doi:10.1136/bcr-2020-237511S 240 (serial cord antibody levels) from Mount Sinai, New York (click here or Toner). Citation: Toner et al. Passive Immunity in COVID Positive Pregnant Patient. Am J Perinatol. 21 July 2020. https://doi.org/10.1055/s-0040-1715643.  S 241 (mild case) from New Delhi, India (click here or Chhabra IndianJAnaesth6414141-6060246_165002). Citation: Chhabra A, Rao TN, Kumar M, Singh Y, Subramaniam R. Anaesthetic management of a COVID‑19 parturient for caesarean section ‑ Case report and lessons learnt. Indian J Anaesth 2020;64:S141-3. S 242 (HELLP) from Birmingham, UK (click here or Ahmed e237521.full) Citation: Ahmed I, Eltaweel N, Antoun L, et al. BMJ Case Rep 2020;13:e237521. doi:10.1136/bcr-2020-237521.  S 243 (Caesarean) from Lagos, Nigeria (click here or Makwe). Citation: Christian Chigozie Makwe et al. Caesarean delivery of first prediagnosed COVID-19 pregnancy in Nigeria. Pan African Medical Journal. 2020;36:100. [doi: 10.11604/pamj.2020.36.100.23892]

13 August update – studies 236 & 237 added

Study 237 – Effect of lockdown on hospital births in Nepal

Birth numbers halved, stillbirths increased by 50% and neonatal mortality nearly fourfold, during lockdown in nine Nepal hospitals (click here PIIS2214109X20303454). No women or babies were tested for Covid-19. Citation: Ashish KC, Rejina Gurung, Mary V Kinney, Avinash K Sunny, Md Moinuddin, Omkar Basnet, Prajwal Paudel, Pratiksha Bhattarai, Kalpana Subedi, Mahendra Prasad Shrestha, Joy E Lawn, Mats Målqvist. Effect of the COVID-19 pandemic response on intrapartum care, stillbirth, and neonatal mortality outcomes in Nepal: a prospective observational study. Lancet Global Health. August 10, 2020 DOI: https://doi.org/10.1016/S2214-109X(20)30345-4

Study 236 – 45 cases from New York

45 babies were born to SARS-CoV-2 positive mothers, 30 were vaginal births, 33 co-located with their mothers and 31 were breast fed (click here or s41372-020-0765-30). 27 of the mothers were asymptomatic. No other maternal details were reported. All 45 new borns were tested & 3 were positive. The patients were cared for at Elmhurst Hospital Center in New York which has not previously reported cases.  Citation: Patil, U.P., Maru, S., Krishnan, P. et al. Newborns of COVID-19 mothers: short-term outcomes of colocating and breastfeeding from the pandemic’s epicenter. J Perinatol (2020). https://doi.org/10.1038/s41372-020-0765-3

11 August update – study 235 added

Study 235 – 125 anti-SARS-CoV-2 sero-positive women from Barcelona, Spain

Of 874 pregnant women attending first trimester screening (n=372) or delivery (n=502) from April 14 to May 5, 2020, 125 were positive for anti-SARS-CoV-2 IgG, IgM, or IgA. 54/372 in first trimester, and 71/502 in 3rd trimester (click here or PIIS0140673620317141 & supplementary material mmc1). Three women required oxygen therapy, but none critical care. No baby outcomes reported. Women were cared for in Hospital Sant Joan de Déu, Hospital Clínic, and Sant Pau all in Barcelona. They probably overlap with cases reported in studies 185 and 191, but probably not with those in studies 53, 125, 151, 158, 165, or 196. Citation: Francesca Crovetto, Fàtima Crispi, Elisa Llurba, Francesc Figueras, María Dolores Gómez-Roig, Eduard Gratacós. Seroprevalence and presentation of SARS-CoV-2 in pregnancy.  Lancet. Published Online August 6, 2020 https://doi.org/10.1016/S0140-6736(20)31714-1

10 August update – study 234 added

Study 234 – 70 cases from New York

Of 675 pregnant women admitted for delivery and tested for SARS-CoV-2, 70 were positive, of whom 55 were asymptomatic on presentation (click here or 1471-0528.16403). Three mothers were hypoxic, one was admitted to ITU but none required ventilation. No mothers died. There was one stillbirth to a mother with asymptomatic Covid-19 and other pathology. 73 babies were born, 71 were tested and all were negative. The three hospitals, all affiliated with New York Presbyterian were Weill Cornell Medical Center, Queens, and Lower Manhattan Hospital. The cases may therefore also have been included in studies 160, 216 and 230. However, they were probably not included in the other NY Presbyterian series namely studies 14, 27, 41, 95, 96 and 136. Citation: Prabhu, M., Cagino, K., Matthews, K.C., Friedlander, R.L., Glynn, S.M., Kubiak, J.M., Yang, Y.J., Zhao, Z., Baergen, R.N., DiPace, J.I., Razavi, A.S., Skupski, D.W., Snyder, J.R., Singh, H.K., Kalish, R.B., Oxford, C.M. and Riley, L.E. (2020), Pregnancy and postpartum outcomes in a universally tested population for SARS‐CoV‐2 in New York City: A prospective cohort study. BJOG: Int J Obstet Gy. Accepted Author Manuscript. doi:10.1111/1471-0528.16403

9 August update – studies 230 to 233 added

Study 233 – case report from Marrakech, Morocco

A woman contracted Covid-19 at 31 weeks gestation, required oxygen therapy and went into premature labour. A Caesarean was performed for fetal distress (click here or 8852816). The mother recovered. The baby tested negative but had severe birth asphyxia and died age 5 days. The mother was cared for at University Hospital of Mohammed VI, Marrakech, which has not previously reported cases. This is the first report from Morocco. Citation: Yassamine Abourida, Houssam Rebahi, Imane Oussayeh, Hajar Chichou, Bouchra Fakhir, Abderraouf Soummani, Hicham Jalal, Fatiha Bennaoui, Nadia El Idrissi Slitine, Fadl Mrabih Rabou Maoulainine, Ahmed Rhassane El Adib, and Mohamed Abdenacer Samkaoui. Management of Severe COVID-19 in Pregnancy. Case Reports in Obstetrics and Gynecology Volume 2020, Article ID 8852816, 5 pages https://doi.org/10.1155/2020/8852816

Study 232 – 44 cases from Boston, Massachusetts

Of 44 pregnant or recently postpartum women with COVID-19, 5 had severe disease and 2 required ventilation (click here or ijgo.13333). All mothers survived. Of 11 babies born, 9 tested negative and 2 declined testing. All survived. 31 pregnancies are ongoing. The majority of patients belonged to racial [sic] or ethnic minority groups. From author affiliations the unnamed hospital was probably Brigham and Women’s Hospital, Boston. Some cases may therefore have been reported in study 231, but probably differ from those in studies 129 & 142. Citation: Onwuzurike, C., Diouf, K., Meadows, A.R. and Nour, N.M. (2020), Racial and ethnic disparities in severity of COVID‐19 disease in pregnancy in the United States. Int J Gynecol Obstet. Accepted Author Manuscript. doi:10.1002/ijgo.13333

Study 231 – 19 placentas from Boston, Massachusetts

2/19 placentas of affected pregnancies tested positive for SARS-CoV-2 by in-situ hybrization (click here or s41379-020-0639-4). There were no specific pathologic features compared with 262 control placentas. One fetus was stillborn at 22 weeks and not tested. There were two sets of twins. All liveborn babies survived, and only one tested positive. From the case codes in Table 2 it appears that 10 pregnancies had been cared for at Massachusetts General Hospital, 4 at Brigham and Women’s Hospital & 5 at Beth Israel Deaconess Medical Center. Some have therefore probably been reported in studies 129 & 142Citation: Hecht, J.L., Quade, B., Deshpande, V. et al. SARS-CoV-2 can infect the placenta and is not associated with specific placental histopathology: a series of 19 placentas from COVID-19-positive mothers. Mod Pathol (2020). https://doi.org/10.1038/s41379-020-0639-4

Study 230 – Placental features of 74 cases from New York

2/53 placentas from affected pregnancies contained a SARS-CoV-2 viral signal by in-situ hybridization (click here or Zhang, Placenta, AJOGMFM). One baby tested positive, the other negative. Both were asymptomatic. There were no specific histological differences between 74 placentas from SARS-CoV-2 positive pregnancies and 290 controls. The authors are affiliated with the New York Presbyterian, Brooklyn Methodist, Weill Cornell group of hospitals so the clinical aspects of the cases have probably been reported before.  Citation: Zhang P, Heyman T, Salafia C, Dygulska B, Lederman S, Detection of SARS-CoV-2 in placentas with pathology and vertical transmission, American Journal of Obstetrics & Gynecology MFM (2020), doi:  https://doi.org/10.1016/j.ajogmf.2020.100197.

8 August update – studies 225 to 229 added

Study 229 – Some assisted reproduction pregnancies during the pandemic in France.

The authors report 88, or possibly 104, women (numbers are unclear) who conceived by assisted reproduction between December 2019 & March 2020, and were still pregnant after the first reported case of Covid-19 in France on 12th February. Ten had symptoms related to Covid-19, none severe or requiring intensive care (click here or PIIS0301211520304929). Five of the ten were tested and two were positive. 15 women miscarried although their Covid-19 status was not reported. From author affiliations the unnamed centre was probably the Reproductive Biology UnitAntoine Béclère Hospital, Clamart, France. These cases may therefore feature in studies 150, 157, 184 & 217. The pregnancies were unlikely to have been sufficiently far advanced to have featured in studies 48 & 187. Citation: Mayeur A, Binois O, Gallot V, Hesters L, Benoit A, Oppenheimer A, Presse M, Zeghari F, Benguigi J, Grynberg M, Frydman N, Sonigo C, First follow-up of art pregnancies in the context of the COVID-19 outbreak, European Journal of Obstetrics & Gynecology and Reproductive Biology (2020), doi: https://doi.org/10.1016/j.ejogrb.2020.07.050

Study 228 – case report from Stockton, California

A pregnant woman contracted severe Covid-19 requiring ventilation at 32 weeks (click here or Ching Case Rep RespMed). She was delivered by Caesarean section for suspected placenta praevia and recovered. The baby required intubation and ventilation for 48 hours but tested negative. The ultimate baby outcome is not reported. The hospital is unnamed but the authors’ affiliation with San Joaquin Critical Care Medical Group, suggests that it was San Joaquin General Hospital in Stockton, California which has not previously reported cases. Citation: Josebelo Chong, Siraj Ahmed, Kyle Hill. Acute Respiratory Distress Syndrome in a pregnant patient with COVID-19 improved after delivery: A case report and brief review. Respiratory Medicine Case Reports. Volume 31, 2020, 101171, ISSN 2213-0071, https://doi.org/10.1016/j.rmcr.2020.101171.

Study 227 – case report from Columbia, Missouri, USA

A woman with mild Covid-19 gave birth to a male infant vaginally at term (click here or HSU jmv.26386). She recovered. The baby breast fed, tested negative and was fine. The virus was demonstrated in the placenta by immuno-histochemistry using a  SARS-CoV-2 nucleocapsid-specific monoclonal antibody. Mother and baby were cared for at University of Missouri Women and Children’s Hospital which has not previously reported cases. The clinical details of case 69 differ. Citation: Hsu, A.L., Guan, M., Johannesen, E., Stephens, A.J., Khaleel, N., Kagan, N., Tuhlei, B.C. and Wan, X.‐F. (2020), Placental SARS‐CoV‐2 in a Pregnant Woman with Mild COVID‐19 Disease. J Med Virol. Accepted Author Manuscript. doi:10.1002/jmv.26386

Study 226 – 3 cases treated with remdesivir from Stanford

Three pregnant women with Covid-19 were treated with remdesivir outside a clinical trial (click here or PIIS0002937820308292). One developed “transaminitis” – I think the authors mean raised liver transaminase. The pre-print is missing a table – which the authors attributed to the remdesivir. That woman later developed intrahepatic cholestasis of pregnancy and delivered normally. The other pregnancies are ongoing. The acknowledgements suggest that the unnamed hospital is Lucile Packard Children’s Hospital at Stanford. Although one author is shared with study 115 from another unnamed Stanford hospital, the clinical details differ. These cases have probably not previously been reported. Citation: Igbinosa I, Miller S, Bianco K, Nelson J, Kappagoda S, Blackburn BG, Grant P, Subramanian A, Lyell D, El-Sayed Y, Aziz N, Use of Remdesivir for Pregnant Patients with Severe Novel 2019 Coronavirus Disease, American Journal of Obstetrics and Gynecology (2020), doi: https://doi.org/10.1016/j.ajog.2020.08.001.

Study 225 – over 600 cases (412 births) in Nair Hospital, Mumbai

Nair hospital, Mumbai, India, a dedicated Covid-19 facility, has cared for over 600 pregnant women with the disease (click here or ijgo.13338). There have been 412 births including seven pairs of twins and one set of triplets. No mothers died of Covid-19 directly, although four died of other causes. No baby outcomes reported. The first two cases had originally been cared for elsewhere, and also previously denied admission at four private hospitals, the latter a feature of news reports from India (click here). Two health care workers contracted COVID-19. Nair Hospital has not previously reported cases. The case reported in study 58 was from New Delhi. Citation: Mahajan, N.N., Pednekar, R., Patil, S.R., Subramanyam, A.A., Rathi, S., Malik, S., Mohite, S.C., Shinde, G., Joshi, M., Kumbhar, P., Tilve, A., Lokhande, P.D. and Srivastava, S.A. (2020), Preparedness, administrative challenges for establishing obstetric services, and experience of delivering over 400 women at a tertiary care COVID‐19 hospital in India. Int J Gynecol Obstet. Accepted Author Manuscript. doi:10.1002/ijgo.13338

31 July update – studies 221 to 224 added

Study 224 – 6 cases from Sri lanka

This paper primarily reports the mental health of pregnant women without Covid-19 during the pandemic in Sri Lanka (click here or ijgo.13335). The authors mention six cases of COVID-19 positive pregnant women in the country. Although no further details are given, and the link given (ref 8) to the Live Situational Analysis Dashboard of Sri Lanka (click here) does not cite pregnancy cases, this is the first scientific report of Covid-19 in pregnancy from Sri Lanka. Citation: Patabendige, M., Gamage, M.M., Weerasinghe, M. and Jayawardane, A. (2020), Psychological impact of the COVID‐19 pandemic among pregnant women in Sri Lanka. Int J Gynecol Obstet. Accepted Author Manuscript. doi:10.1002/ijgo.13335

Study 223 – 3 cases from Ankara

Three pregnant women tested postive for SARS-CoV-2 in Ankara City Hospital (click here or PIIS0301211520304930). All three had co-morbidities but mild disease and were delivered by Caesarean. Baby outcomes not reported. Citation: Tanacan A, Erol SA, Turgay B, Anuk AT, Secen EI, Yegin GF, Ozyer S, Kirca F, Dinc B, Unlu S, Yapar Eyi EG, Keskin HL, Sahin D, Surel AA, Tekin OM, The Rate of SARS-CoV-2 Positivity in Asymptomatic Pregnant Women Admitted to Hospital for Delivery: Experience of A Pandemic Center in Turkey, European Journal of Obstetrics and amp; Gynecology and Reproductive Biology (2020), doi: https://doi.org/10.1016/j.ejogrb.2020.07.051

Study 222 – Case report from California

A 22-year-old woman with placenta previa and a past medical history of tuberous sclerosis and multiple associated comorbidities contracted Covid-19 at 23 weeks + 6 days gestation (click here or 2324709620946621). She required intubation and ventilation and was delivered by caesarean at 25+5. The baby tested negative. Both mother and baby survived. The hospital is unnamed but from author affiliations is probably Los Angeles County+USC Medical Center, which has not previously reported cases. Citation: Easterlin, M. C., De Beritto, T., Yeh, A. M., Wertheimer, F. B., & Ramanathan, R. (2020). Extremely Preterm Infant Born to a Mother With Severe COVID-19 Pneumonia. Journal of Investigative Medicine High Impact Case Reports. https://doi.org/10.1177/2324709620946621

Study 221 – SARS-CoV-2 serological testing of 1,293 parturient women

1,293 parturient women tested fro SARS-CoV-2 antbodies in two hospitals in Philadelphia, 80 were positive (click here or eabd5709.full), Percentages in results table 1 are given by row rather than column making comparisons difficult. The hospitals are unnamed. A preprint of this paper in MedXiv was study 202. Citation: D. D. Flannery et al., Sci. Immunol. 10.1126/sciimmunol.abd5709 (2020)

30 July update – study 220 added

Study 220 – 29 cases from Wuhan

29 women with Covid-19 between January 30 and March 10, 2020, gave birth to 30 neonates (1 set of twins) (click here or journal.pmed.1003195). The hospitals were Renmin Hospital, Wuhan University, and Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology. These cases have surely been published before. Citation: Wu Y-T, Liu J, Xu J-J, Chen Y-F, Yang W, Chen Y, et al. (2020) Neonatal outcome in 29 pregnant women with COVID-19: A retrospective study in Wuhan, China. PLoS Med 17(7): e1003195. https://doi.org/10.1371/journal.pmed.1003195

28 July update – studies 217 to 219 added

Study 219 – 3 cases from New Jersey, USA

Three women with Covid-19 in pregnancy required ventilation and delivery by Caesarean (click here or Douedi AM J Cas Rep NJ). All three mothers and babies survived, and all babies tested negative. The hospital is unnamed, but from author affiliations is probably Jersey Shore University Medical Center. The cases were probably therefore also reported in study 149. Citation: Steven Douedi, Asseel Albayati, Nasam Alfraji, Usman Mazahir, Eric Costanzo Steven Douedi, Asseel Albayati, Nasam Alfraji, Usman Mazahir, Eric Costanzo. Am J Case Rep 2020; 21:e925513 DOI: 10.12659/AJCR.925513

Study 218 – Case report from Tehran, Iran

A 30 year old woman contracted Covid-19 at 21 weeks gestion (click here or Soleimani JMFM). She received methyprednisolone, Lopinivir, Azithromycin, Hydrocortisone and immune plasma and survived. The pregnancy is ongoing. The hospital is unnamed and only identifiable as being in Tehran from author affiliations. The case in study 101 was from a different city, and the details differ from those of the two survivors is study 67. Citation: Zahra Soleimani & Azam Soleimani (2020): ADRS due to COVID-19 in midterm pregnancy: successful management with plasma transfusion and corticosteroids, The Journal of Maternal-Fetal & Neonatal Medicine, DOI: 10.1080/14767058.2020.1797669

Study 217 – 83 cases from France & Belgium

83 pregnant women with Covid-19 were compared with a group of non-pregnant affected control women (click here or Badr AJOG PIIS0002937820307766). No raw data and no pregnancy outcomes provided. The hospitals were Antoine Béclère, Clamart, Paris, Bicêtre Hospital, Le Kremlin-Bicêtre, Centre Hospitalier Sud Francilien, Corbeil-Essones, and University Hospital Brugmann, Brussels. These cases have probably been already reported. Citation: Badr DA, Mattern J, Carlin A, Cordier A-G, Maillart E, El Hachem L, El Kenz H, Andronikof M, De Bels D, Damoisel C, Preseau T, Vignes D, Cannie MM, Vauloup-Fellous C, Fils J-F, Benachi A, Jani JC, Vivanti AJ, Are clinical outcomes worse for pregnant women ≥ 20 weeks’ gestation infected with COVID-19? A multicenter case-control study with propensity score matching, American Journal of Obstetrics and Gynecology (2020), doi: https://doi.org/10.1016/j.ajog.2020.07.045.

27 July update – study 216 added

Study 216 – 120 babies born to SARS-CoV-2 positive mothers from New York

120 neonates born to 116 mothers who had tested positive for SARS-CoV-2 in pregnancy, were were tested at 24 hours of life. Of them, 79 were also tested at 5-7 days, and 72 at 14 days. All tested negative at all time points and none had symptoms of COVID-19 (click here or  1-s2.0-S2352464220302352-main). The mothers and babies were cared for at three unnamed New York Presbyterian Hospitals. From author affiations these were probably Weill Cornell Presbyterian Komansky, Presbyterian Queens, and Presbyterian Lower Manhattan hospitals. These hospital names are not found among previous reports from New York despite many previous reports from the New York Presbyterian network. Citation: Christine M Salvatore, Jin-Young Han, Karen P Acker, Priyanka Tiwari, Jenny Jin, Michael Brandler, Carla Cangemi, Laurie Gordon, Aimee Parow, Jennifer DiPace, Patricia DeLaMora. Neonatal management and outcomes during the COVID-19 pandemic: an observation cohort study, The Lancet Child & Adolescent Health, 2020, ISSN 2352-4642, https://doi.org/10.1016/S2352-4642(20)30235-2.

25 July update – studies 212 to 215 added

Study 215 – Case report from Tacoma, Washington State, USA

A woman with Covid-19 in pregnancy continued to test positive for SARS-CoV-2 for 100 days (click here or Prolonged_Detection_of_Severe_Acute_Respiratory.97292). Mother and baby survived. All viral tests on baby, placenta and breast milk were negative. The cord blood was positive for IgG antibodies to SARS-CoV-2. From author affiliations the hospital was MultiCare Tacoma General Hospital, which has not previously reported cases. Citation: Molina, Loren P. MD; Chow, Siu-Kei PhD; Nickel, Adam DO; Love, Jason E. MD Prolonged Detection of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) RNA in an Obstetric Patient With Antibody Seroconversion, Obstetrics & Gynecology: July 21, 2020 – Volume Publish Ahead of Print – Issue – doi: 10.1097/AOG.0000000000004086

Study 214 – 100 cases from New York

The authors report the Race [sic] and Ethnicity of 100 cases of Covid-19 in pregnancy from New York (click here or Influence_of_Race_and_Ethnicity_on_Severe_Acute.97290). These cases have likely been reported before. Citation: Emeruwa, Ukachi N. MD, MPH; Spiegelman, Jessica MD; Ona, Samsiya MD; Kahe, Ka MD, ScD; Miller, Russell S. MD; Fuchs, Karin M. MD, MHA; Aubey, Janice J. MD, MPH; Booker, Whitney MD; D’Alton, Mary E. MD; Friedman, Alexander M. MD, MPH; Aziz, Aleha MD, MPH; Sutton, Desmond MD; Purisch, Stephanie E. MD; Goffman, Dena MD; Melamed, Alexander MD, MPH; Gyamfi-Bannerman, Cynthia MD, MSc Influence of Race and Ethnicity on Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection Rates and Clinical Outcomes in Pregnancy, Obstetrics & Gynecology: July 21, 2020 – Volume Publish Ahead of Print – Issue – doi: 10.1097/AOG.0000000000004088

Study 213 – 89 cases from Sao Paolo, Brazil

Of 89 women with Covid-19 cared for in a single institution between March 12 & May 25, 2020, the details of five who experienced a fetal death are reported (click here or 1-s2.0-S2214911220300734-main). No details of the other cases, and no explicit maternal outcomes are reported, but enough details are given for it to be implied that the mothers survived. From author affiliations the unnamed hospital is probably Hospital e Maternidade Santa Joana, São Paulo. Apart from study 194 which was from a different city, all previous reports of Covid-19 in pregnancy from Brazil (studies 66, 138, 182 & 201) have been of maternal deaths. These cases have therefore probably not previously been reported. Citation: Rosana Richtmann, Maria Regina Torloni, Andre Ricardo Oyamada Otani, Jose Eduardo Levi, Mariana Crema Tobara, Camila de Almeida Silva, Lívio Dias, Lisia Miglioli-Galvão, Pollyanna Martins Silva, Mario Macoto Kondo, Fetal deaths in pregnancies with SARS-CoV-2 infection in Brazil: A case series, Case Reports in Women’s Health,  Volume 27, 2020, e00243, ISSN 2214-9112,
https://doi.org/10.1016/j.crwh.2020.e00243.

Study 212 – 2 cases from Yichang city, in Hubei province, China

There were only two pregnant women with Covid-19 in Yichang city between January 20 & April 9, 2020 (click here or Coronavirus_disease_2019__COVID_19__in_pregnancy_.126). Both mothers and both babies survived. Neither baby was infected. The hospital was Yichang Central People’s Hospital. On GRID.ac this disambiguates as Peking University People’s Hospital grid.411634.5 which is probably an error. Yichang city is in Western Hubei province about 200 km west of Wuhan, and about 1000 km south of Peking/Beijing. Yichang city was a centre in study 57, so these two cases were probably included in that series, Citation: Zheng, Tingting; Guo, Jianqiang; He, Wencong; Wang, Hao; Yu, Huiling; Ye, Hong. Coronavirus disease 2019 (COVID-19) in pregnancy: 2 case reports on maternal and neonatal outcomes in Yichang city, Hubei Province, China, Medicine: July 17, 2020 – Volume 99 – Issue 29 – p e21334 doi: 10.1097/MD.0000000000021334

24 July update – studies 208 to 211 added

Study 211 – 21 cases from Wuhan, China

21 term pregnancies with Covid-19 (click here or Chen-Bai2020_Article_MaternalAndInfantOutcomesOfFul). No mothers or babies died. All babies tested negative. The patients were cared for in Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology. They probably overlap with those in studies 2, 8, 11, 15, 39, 55, 57, 59, 73, and 108Citation: Chen, Y., Bai, J. Maternal and infant outcomes of full-term pregnancy combined with COVID-2019 in Wuhan, China: retrospective case series. Arch Gynecol Obstet (2020). https://doi.org/10.1007/s00404-020-05573-8

Study 210 – 23 cases from Istanbul, Turkey

23/296 pregnant women tested positive for SARS-CoV-2 infection during one month’s screening from 27 April, in a “Coronavirus Pandemic Hospital” in Istanbul (click here or 10.1080@14767058.2020.1798398). Another 15 referral cases were treated over the same period. No pregnancy outcomes were reported. From author affiliations the unnamed hospital is probably Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital. If so, these cases probably include those reported in study 146. Citation: Murat Yassa, Cihangir Yirmibes, Gul Cavusoglu, Hazal Eksi, Cevdet Dogu, Canberk Usta, Memis Ali Mutlu, Pinar Birol, Cagri Gulumser & Niyazi Tug. (2020). Outcomes of universal SARS-CoV-2 testing program in pregnant women admitted to hospital and the adjuvant role of lung ultrasound in screening: A prospective cohort study. The Journal of Maternal-Fetal & Neonatal Medicine, DOI: 10.1080/14767058.2020.1798398

Study 209 – 51 placentas from infected pregnancies in New York

All 51 placentas from SARS-CoV-2 affected pregnancies were negative for SARS-Cov-2 by in situ hybridization and immunohistochemistry (click here or his.14215), Citation: Smithgall, M.C., Liu‐Jarin, X., Hamele‐Bena, D., Cimic, A., Mourad, M., Debelenko, L. and Chen, X. (2020), Third Trimester Placentas of SARS‐CoV‐2‐Positive Women: Histomorphology, including Viral Immunohistochemistry and in Situ Hybridization. Histopathology. Accepted Author Manuscript. doi:10.1111/his.14215

Study 208 – Ten cases from Porto, Portugal

Ten pregnant women with Covid-19 were cared for at Centro Hospitalar Universitario, Sao Joao, Porto, Portugal (click here or Perinatal management of SARS CoV 2 infection in a level III University Hospital). One women was admitted to intensive care but all mothers and babies survived. No babies tested positive. This hospital has not previously reported cases. Citation: Susana Pissarra, Marta Rosário, Marina Moucho & Henrique Soares (2020) Perinatal management of SARS-CoV-2 infection in a level III University Hospital, The Journal of Maternal-Fetal & Neonatal Medicine. DOI: 10.1080/14767058.2020.1786526

2 July update – studies 205 to 207 added

Study 207 – Mental health of 14 cases from London

Fourteen women with Covid-19 in pregnancy recorded their levels of anxiety & depression (click here or PIIS0301211520304796). No clinical outcomes reported. The hospital is not named but the authors note that this is an extension of the series in study 206 so must be North Middlesex. The patients are therefore also included in study 93. Citation: Kotabagi P, Nauta M, Fortune L, Yoong W, COVID-19 positive mothers are not more anxious or depressed than non COVID pregnant women during the pandemic: a pilot case-control comparison. European Journal of Obstetrics and Gynecology and Reproductive Biology (2020). doi: https://doi.org/10.1016/j.ejogrb.2020.07.037

Study 206 – Mental health of 11 cases from London

Eleven women with Covid-19 in pregnancy recorded their levels of anxiety & depression (click here or aogs.13928). No clinical outcomes reported. The authors note that these patients were treated at North Middlesex Hospital and included those in study 93. Citation: Kotabagi, P., Fortune, L., Essien, S., Nauta, M. and Yoong, W. (2020), Anxiety and depression levels among pregnant women with COVID‐19. Acta Obstet Gynecol Scand, 99: 953-954. doi:10.1111/aogs.13928

Study 205 – 91 cases from Madrid

Of 91 pregnant women with Covid-19 treated in Hospital Universitario “12 de Octubre”, 4 required ventilation, but none died (click here or 10.1080@14767058.2020.1793320). 38 babies delivered, all testing negative immediately after birth, although one developed mild Covid-19 and tested positive at 6 days. These cases likely overlap with those in studies 151, 165 & 196. Citation: Patricia Barbero, Laura Mugüerza, Ignacio Herraiz, Antonio García Burguillo, Rafael San Juan, Laura Forcén, Inmaculada Mejía, Emma Batllori, María Dolores Montañez, Paloma Vallejo, Olga Villar, Diana García Alcazar & Alberto Galindo (2020) SARS-CoV-2 in pregnancy: characteristics and outcomes of hospitalized and non-hospitalized women due to COVID-19. The Journal of Maternal-Fetal & Neonatal Medicine. DOI: 10.1080/14767058.2020.1793320

21 July update – study 204 added

Study 204 – 7 screen positives from Newham, London

Seven pregnant women tested positive for SARS-CoV-2 out of 189 screened over a two week period 22nd April to 5th May, 2020 at Newham University Hospital  in East London (click here or PIIS0301211520304772). Only one was symptomatic. No outcomes reported. Citation: Abeysuriya S, Wasif S, Counihan C, Shah N, Iliodromiti S, Cutino-Moguel M-Teresa, Saeed F, Velauthar L, Universal Screening for SARS-CoV-2 in Pregnant Women at Term Admitted to an East London Maternity Unit, European Journal of Obstetrics & Gynecology and Reproductive Biology (2020), doi: https://doi.org/10.1016/j.ejogrb.2020.07.035

19 July update – study 203 added.

Study 203 – 37 cases from Turkey

Of 100 pregnant women with possible Covid-19, 29 had the diagnosis confirmed by RT‐PCR, and a further eight were clinically high suspicious (click here or ijgo.13318). None died or were admitted to ITU. No babies died or tested positive. Patients were cared for at the Ministry of Health Ankara City Hospital which has not previously reported cases. The only previous Ankara case (study 31) was from a different hospital and the clinical details differ. Citation: Sahin, D., Tanacan, A., Erol, S.A., Anuk, A.T., Eyi, E.G., Ozgu‐ Erdinc, A.S., Yucel, A., Keskin, H.L., Tayman, C., Unlu, S., Kirca, F., Dinc, B., San, I., Parpucu, Ü.M., Surel, A.A. and Moraloglu, O.T. (2020). A pandemic center’s experience of managing pregnant women with COVID‐19 infection in Turkey: A prospective cohort study. Int J Gynecol Obstet. Accepted Author Manuscript. doi:10.1002/ijgo.13318

18 July update – studies 198 to 202 added

Study 202 – 80 cases from Pennsylvania

This preprint from reports 80 pregnant women who tested positive for IgG and/or IgM SARS-CoV-2-specific antibodies in two centers in Philadelphia (click here or Flannery 2020.07.08.20149179v1.full).  46 of the 72 who were tested also had a SARS-CoV-2 positive PCR result. 79 women delivered a liveborn infant. The outcome of the 80th woman was not reported. The hospitals are not named. The cases may overlap with studies 65 & 175 and possibly also with study 86.  Citation:Dustin D. Flannery, Sigrid Gouma, Miren B. Dhudasia, Sagori Mukhopadhyay, Madeline R. Pfeifer, Emily C. Woodford, Jeffrey S. Gerber, Claudia P. Arevalo, Marcus J. Bolton, Madison E. Weirick, Eileen C. Goodwin, Elizabeth M. Anderson, Allison R. Greenplate, Justin Kim, Nicholas Han, Ajinkya Pattekar, Jeanette Dougherty, Olivia Kuthuru, Divij Mathew, Amy. Baxter, Laura. Vella, JoEllen Weaver, Anurag Verma, Rita Leite, Jeffrey S. Morris, Daniel J. Rader, Michal A. Elovitz, E. John Wherry, Karen M. Puopolo, Scott E. Hensley. SARS-CoV-2 Seroprevalence Among Parturient Women medRxiv 2020.07.08.20149179; doi: https://doi.org/10.1101/2020.07.08.20149179

Study 201 – 20 maternal deaths from Brazil

Twenty COVID-19 related maternal deaths were identified from the Brazilian Ministry of Health surveillance system (click here or Takemoto Maternal mortality and COVID 19). Ten were in the Northeast region, and nine in the Southeast (5 in São Paulo). They probably overlap with those in studies 138, 182 & 194Citation: Maira L. S. Takemoto , Mariane O. Menezes , Carla B. Andreucci , Roxana Knobel , Liduína A. R. Sousa , Leila Katz , Eduardo B. Fonseca , Claudia G. Magalhães, Wanderson K. Oliveira , Jorge Rezende-Filho , Adriana S. O. Melo & Melania M. R. Amorim (2020): Maternal mortality and COVID-19, The Journal of Maternal-Fetal & Neonatal Medicine, DOI: 10.1080/14767058.2020.1786056

Study 200 – 23 cases from Birmingham, UK

Of 23 pregnant women with COVID-19, four were admitted to ITU and one died from basilar artery thrombosis, pulmonary embolism, and diabetic ketoacidosis (click here or Antoun EJOG 1-s2.0-S0301211520304486-main). 20 babies were delivered, incl. one set of twins. All survived. Seven babies were tested for SARS-CoV-2 and all were negative. The hospital is unnamed but from its size and author affiliations is likely to be Birmingham Women’s Hospital which has not previously reported cases. However, they will have been included in the UKOSS report study 92. The clinical details of the maternal death suggest this is the same patient as reported in study 107 as having been delivered at Birmingham Heartlands Hospital. Citation: Antoun L, Taweel NE, Ahmed I, Patni S, Honest H, Maternal COVID-19 infection, clinical characteristics, pregnancy, and neonatal outcome A prospective cohort study, European Journal of Obstetrics and amp; Gynecology and Reproductive Biology (2020), doi: https://doi.org/10.1016/j.ejogrb.2020.07.008

Study 199 – case report of a miscarriage from France

A woman with Covid-19 miscarried at 20 weeks (click here or Hachem EJOG 1-s2.0-S0301211520304668-main). The hospital is unnamed but from author affiliation is René Dubos Hospital, Cergy-Pontoise, a northern suburb of Paris. No authors with this affiliation were included in the GROG series, study 150, so this case has probably not been reported before. Citation: Hachem R, Markou G, Veluppillai C, Poncelet C, Late miscarriage as a presenting manifestation of COVID-19, European Journal of Obstetrics and Gynecology and Reproductive Biology (2020), doi: https://doi.org/10.1016/j.ejogrb.2020.07.024

Study 198 – 10 cases from Cleveland ohio

Ten pregnant women tested positive for SARS-CoV-2, of whom three were symptomatic (click here or Berkowitz AJOG PIIS0002937820307298). None required medical treatment beyond standard obstetric care. They were cared for at various hospitals managed by the Cleveland Clinic Foundation in Ohio, which appear to be all based around the town of Cleveland itself. If so they have not previously been reported. Citation: Berkowitz KM, Goje O, Eaton J. Implementation of universal testing for SARS-CoV-2 in pregnant women with intended admission for delivery. American Journal of Obstetrics and Gynecology (2020), doi: https://doi.org/10.1016/j.ajog.2020.07.011.

17 July update – studies 192 to 196 added

Study 197 – A case report from Mantova, Italy

A pregnant woman with Covid-19 at 24 weeks gestation was treated with convalescent plasma (click here or Grisolia AJOG MFM 1-s2.0-S258993332030118X-main). The following day her condition worsened, and she was transferred to ICU where she received non-invasive ventilation. After a 2nd dose of convalescent plasma she recovered. The pregnancy is ongoing.  The hospital is not named but from author affiliations was Carlo Poma Hospital, Mantova. Mantova is in Lombardy so this case was probably included in studies 32 & 64. Citation: Grisolia G, Franchini M, Glingani C, Inglese F, Garuti M, Beccaria M, Capuzzo M, Pinto A, Pavan G, Righetto L, Perotti C, Zampriolo P, De Donno G, Convalescent plasma for COVID-19 in pregnancy: a case report and review, American Journal of Obstetrics & Gynecology MFM (2020), doi: https://doi.org/10.1016/j.ajogmf.2020.100174.

Study 196 – 42 cases from Spain

42 women with COVID-19 in the third trimester of pregnancy from 14 hospitals in Spain delivered 42 babies (click here or Gabriel apa.15474). One mother died. 3/37 babies tested positive. No babies died. The authors wrote on behalf of the Neo-COVID-19 Research Group. The hospitals were, 12 de Octubre, Clínico San Carlos, Fuenlabrada, Fundación Jiménez Díaz, Getafe, Josep Trueta, La Paz, Hospitales-Madrid Group, Príncipe de Asturias, Puerta de Hierro-Majadahonda, Rey Juan Carlos, Río Hortega, Santiago de Compostela, Sant Joan, Severo Ochoa Leganés, Vall d’Hebrón and the European Institute of Perinatal Mental Health. The cases probably overlap with those in studies 151, 158, 165, 185 &  191. Citation: Marín Gabriel, M.A., Cuadrado, I., Álvarez Fernández, B., González Carrasco, E., Alonso Díaz, C., Llana Martín, I., Sánchez, L., Olivas, C., de las Heras, S., Criado, E. and (2020), Multi‐centre Spanish study found no incidences of viral transmission in infants born to mothers with COVID‐19. Acta Paediatr. Accepted Author Manuscript. doi:10.1111/apa.15474

Study 195 – 14 first trimester cases from Turin

14 women tested positive for SARS-CoV-2 in the first trimester (click here or cosma turin jmv.26267). No outcomes reported. They were cared for at Sant’ Anna Hospital, Turin, Italy, so are likely included in the 23 first trimester cases in study 167. Citation: Cosma, S., Borella, F., Carosso, A., Sciarrone, A., Cusato, J., Corcione, S., Mengozzi, G., Preti, M., Katsaros, D., Di Perri, G. and Benedetto, C. (2020), The “scar” of a pandemic: cumulative incidence of COVID‐19 during the first trimester of pregnancy. J Med Virol. Accepted Author Manuscript. doi:10.1002/jmv.26267

Study 194 – Three cases from Vitoria, Espirito Santo State. Brazil.

Two women with severe Covid-19 in pregnancy, and one with severe disease postnatally, required prologed ICU admission and ventilation (click here or dos Reis Case Rep Brazil). One mother died. All three babies tested negative and survived. This is the first scientific report from this city. However, the woman who died may be included in studies 66, 138 & 182. Citation: Reis Helena Lucia Barroso dos, Boldrini Neide Aparecida Tosato, Caldas João Victor Jacomele, Paz Ana Paula Calazans da, Ferrugini Carolina Loyola Prest, Miranda Angelica Espinosa. Severe coronavirus infection in pregnancy: challenging cases report. Rev. Inst. Med. trop. S. Paulo [Internet]. 2020 [cited 2020 July 17] ; 62: e49. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46652020000100513&lng=en. Epub July 13, 2020. https://doi.org/10.1590/s1678-9946202062049.

Study 193 – Case report from Belgium

A pregnant woman with twins developed mild Covid-19 at 22 weeks gestion (click here or Pulinx 10096_2020_Article_3964). She was nursed at home, but at 24 weeks went into spontanous labour. One twin was stillborn and the other died soon after birth. Amniotic fluid and placental tissue tested positive for SARS-CoV-2. From author affiliations this was probably Sint-Trudo Hospital in Sint-Truiden, which has not previous reported cases. Citation: Pulinx, B., Kieffer, D., Michiels, I. et al. Vertical transmission of SARS-CoV-2 infection and preterm birth. Eur J Clin Microbiol Infect Dis (2020). https://doi.org/10.1007/s10096-020-03964-y

Study 192 – Case report from Zhongshan, in Guangdong Province, China.

A mother with Covid-19 at 35 weeks gestation suffered from a cytokine storm, and required both ventilation and ECMO (click here or Wang 1-s2.0-S0002937820307286-main). She survived, but the baby died. As the authors note this case was included in Study 3. The hospital, mother’s age, gestational age and baby outcome all suggest she is also the same woman as in studies 57 and 81. Citation:  Wang X, Wang D, He S, The role of a cytokine storm in severe COVID-19 disease in pregnancy, American Journal of Obstetrics and Gynecology (2020), doi: https://doi.org/10.1016/j.ajog.2020.07.010.

16 July update – studies 188 – 191 added

Study 191 – 27 cases from Barcelona, Spain

This preprint reports 27 pregnant women with COVID-19 of whom seven developed some features of HELLP syndrome (click here or 2020.07.10.20133801v1.full). The details are difficult to interpret but I think 12 delivered, 5 by Caesarean, and no mothers or babies died. The patients were cared for in two unnamed hospitals which from author affiliations were probably Hospital de la Santa Creu i Sant Pau and Hospital Sant Joan de Deu, both in Barcelona. These hospitals have not previously reported cases under their own names. However, the patients may have been included in the Spanish Covi-Preg registry study 151. Citation: Francesc Figueras, Elisa LLurba, Raigam Martinez-Portilla, Josefina Mora, Fatima Crispi, Eduard Gratacos. COVID-19 causing HELLP-like syndrome in pregnancy and role of angiogenic factors for differential diagnosis. medRxiv 2020.07.10.20133801; doi: https://doi.org/10.1101/2020.07.10.20133801

Study 190 – Two cases from Bergamo, Italy

Two pregant women with diabetes contracted Covid -19. Clinical details are given for only one who recovered (click here or ijgo.13306). Both were cared for in Papa Giovanni XXIII Hospital in Bergamo between Feb 22 & May 17, 2020 so have probably been reported in studies 32, 64, 114 & 117. Citation: Dodesini, A.R., Galliani, S., Ciriello, E., Bellante, R. and Trevisan, R. (2020), Pre‐gestational diabetes during the COVID‐19 pandemic in Bergamo, Italy. Int J Gynecol Obstet. Accepted Author Manuscript. doi:10.1002/ijgo.13306

Study 189 – 185 cases from Kuwait

This preprint reports 185 pregnant women with Covid-19 treated in New-Jahra Hospital, where all pregnant women with Covid-19 in Kuwait are treated, between March 15th & May 31st 2020 (click here or 2020.07.10.20150623v1.full). No mothers died or required ECMO, although two required ventilation. Three women miscarried, and 41 babies delivered. Two babies tested positive but none died.  Citation: Amal Ayed, Alia Embaireeg, Asmaa Benawadth, Wadha Al-Fouzan, Majeda Hammoud, Monif Alhathal, Abeer Alzaydai, Mariam Ayed. Maternal and perinatal characteristics and outcomes of pregnancies complicated with COVID-19 in Kuwait. medRxiv 2020.07.10.20150623; doi: https://doi.org/10.1101/2020.07.10.20150623

Study 188 – Four, possibly five, cases from Bergamo, Italy

Four pregnant women with Covid-19 and a further woman who had possible pneumonia one day after delivering twins and two months later had SARS-CoV-2 IgG antibodies, are reported (click here or 10.1080@14767058.2020.1791817) All mothers and babies survived although one of the four definite Covid-19 mothers developed Guillain-Barré syndrome and remains in hospital. All patients were cared for Bolognini Hospital which is a “spoke center” for COVID 19 in pregnancy in Seriate, Bergamo in Lombardy. It is thus likely that they were included in studies 32, 64 & 117. Citation: Paola Algeri, Valentina Stagnati, Maria Donata Spazzini, Cristina Bellan, Alessandro Montanelli, Gianluigi Patelli & Massimo Ciammella (2020) Considerations on COVID-19 pregnancy: a cases series during outbreak in Bergamo Province, North Italy, The Journal of Maternal-Fetal & Neonatal Medicine, DOI: 10.1080/14767058.2020.1791817

15 July update – study 187 added

Study 187 – Case report of neonatal infection from Paris

A woman contracted Covid-19 at 35 weeks, required Caesarean for fetal distress, and recovered with supportive treatment (click here or s41467-020-17436-6). The baby was initially well but developed neurological symptoms on day 3. Maternal nasopharynx (NP), blood, placental, vaginal and amniotic samples were all positive for SARS-CoV-2. Baby blood and rectal samples, as well as NP samples on days 1, 3 and 18, were also positive. The baby recovered with supportive treatment. From author affiliations the hospital was Antoine Béclère, Paris. Although not cited, this is case two in study 48. The papers share two authors, Alexandra J Vivanti & Alexandra Benachi, from the same hospital, and all reported maternal and baby characteristics, as well as all the mother’s blood values on the day of birth, are identical. Citation: Vivanti, A.J., Vauloup-Fellous, C., Prevot, S. et al. Transplacental transmission of SARS-CoV-2 infection. Nat Commun 11, 3572 (2020). https://doi.org/10.1038/s41467-020-17436-6

13 July update – study 186 added

Study 186 – Case report from Dallas, Texas

A woman with Covid-19 gave birth vaginally at 34 weeks (click here or INTRAUTERINE_TRANSMISSION_OF_SARS_COV_2_INFECTION.96099). Despite isolation from the mother, the baby was infected SARS-CoV-2. Mother and baby were cared for at Parkland Health & Hospital System, Dallas, Texas which has not previously reported cases. Citation: Sisman, Julide; Jaleel, Mambarambath A; Moreno, Wilmer; Rajaram, Veena; Collins, Rebecca R.J; Savani, Rashmin; Rakheja, Dinesh; Evans, Amanda S. INTRAUTERINE TRANSMISSION OF SARS-COV-2 INFECTION IN A PRETERM INFANT, The Pediatric Infectious Disease Journal: July 10, 2020 – Volume Online First – Issue – doi: 10.1097/INF.0000000000002815

12 July update – studies 183 to 185 added

Study 185 – Two cases from Spain

The fetuses of two pregnant women with Covid-19 developed transient skin oedema at 21 and 25 weeks gestation (click here or Fetal_Transient_Skin_Edema_in_Two_Pregnant_Women.97307). One mother, cared for at Vall d’Hebron University Hospital in Barcelona, had severe disease requiring ventilation. The other, hospital not stated, had mild disease only. Amniotic fluid was negative for SARS-CoV-2 in both cases. Both resolved and the pregnancies are ongoing. The Barcelona case at least was probably included in study 140. Citation: Garcia-Manau P, Garcia-Ruiz I, Rodo C, et al. Fetal Transient Skin Edema in Two Pregnant Women With Coronavirus Disease 2019 (COVID-19) [published online ahead of print, 2020 Jul 7]. Obstet Gynecol. 2020;10.1097/AOG.0000000000004059. doi:10.1097/AOG.0000000000004059

Study 184 – 100 cases from Paris

One hundred pregnant women with Covid-19 were treated in four Paris hospitals between March 12 & April 13, 2020 (click here). Ten were admitted to ICU of whom 9 required intubation. There were no stillbirths or miscarriages, but one neonatal death due to prematurity. All neonates were tested for SARS-CoV-2. One was positive but did not show signs of respiratory illness. The hospitals were Antoine Béclère, Clamart; Bicêtre Hospital, Le Kremlin Bicêtre; Louis-Mourier, Colombes; and Centre Hospitalier Sud Francilien, Evry. They therefore include one of the cases in study 48, are included in study 150 and probably also overlap with those in study 157. Citation: Vivanti AJ, Mattern J, Vauloup-Fellous C, Jani J, Rigonnot L, El Hachem L, Le Gouez A, Desconclois C, Ben M’Barek I, Sibiude J, Benachi A, Picone O, Cordier AG. Retrospective Description of Pregnant Women Infected with Severe Acute Respiratory Syndrome Coronavirus 2, France. Emerg Infect Dis. 2020 Jul 6;26(9). doi: 10.3201/eid2609.202144. Online ahead of print.

Study 183 – 18 cases from Renmin hospital in Wuhan

Between Jan 30, & Mar 1, 2020, 10 clinically diagnosed and 8 swab positive pregnant women with COVID-19 were treated at Renmin Hospital of Wuhan University (click here or s12884-020-03026-3). These cases probably overlap with studies 10, 36, 37, 40, and 80. They are also likely to be included in studies 55 & 57. Citation: Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection during late pregnancy: a report of 18 patients from Wuhan, China. Zhang L, Dong L, Ming L, Wei M, Li J, Hu R, Yang J. BMC Pregnancy Childbirth. 2020 Jul 8;20(1):394. doi: 10.1186/s12884-020-03026-3.

11 July update study 181 & 182  added. Latter HT Fred Peret.

Study 182 – 124 maternal deaths from Covid-19 in Brazil

Between Feb 26 & June 18, 978 pregnant and postpartum women with COVID-19 were registered with the Brazilian Ministry of Health’s Acute Respiratory Distress Syndrome (ARDS) Surveillance System, of whom 124 died (click here or IJOGfinal (1)). They probably include five cases from study 66Citation: Takemoto, M.L.S., Menezes, M.O., Andreucci, C.B., Nakamura‐Pereira, M., Amorim, M.M.R., Katz, L. and Knobel, R. (2020), The tragedy of COVID‐19 in Brazil: 124 maternal deaths and counting. Int J Gynecol Obstet. Accepted Author Manuscript. doi:10.1002/ijgo.13300

Study 181 – Rise in stillbirths during pandemic in London

Nineteen women with Covid-19 were cared for at St Georges Hospital in London during the period February 1 to June 14, 2020. None experienced stillbirth. However the overall stillbirth rate in the hospital was significantly higher than in the pre-pandemic period (click here or jama_khalil_2020_ld_200076). Included in study 92. Citation: Khalil A, von Dadelszen P, Draycott T, Ugwumadu A, O’Brien P, Magee L. Change in the Incidence of Stillbirth and Preterm Delivery During the COVID-19 Pandemic. JAMA. Published online July 10, 2020. doi:10.1001/jama.2020.12746

4th July update – studies 178 -180 added.

Study 180 – case report of postnatal Covid-19 from Monza

A mother developed pyrexia on day two after a normal birth, and both her and her baby tested positive (click here or e20201121.full). The baby was cared for in Fondazione Monza e Brianza per il Bambino e la sua Mamma and Azienda Socio Sanitaria Territoriale-Monza. Monza is in Lombardy so this case may be included in studies 32, 64, 109 & 114. However as a postnatal case it may not. We’re keeping an open mind.  Citation: Sinelli M, Paterlini G, Citterio M, et al. Early Neonatal SARS-CoV-2 Infection Manifesting With Hypoxemia Requiring Respiratory Support. Pediatrics. 2020;146(1):e20201121

Study 179 – 67 cases from New York

67 women with SARS-CoV-2 infection from March 13 to April 24, (click here or s-0040-1713851). Patients cared for in seven hospitals within the Northwell Health system in New York: North Shore University Hospital, Long Island Jewish Medical Center, Long Island Jewish Forest Hills, Huntington Hospital, Southside Hospital, Lenox Hill Hospital, and Staten Island University Hospital. The patients probably overlap with those reported in studies 49, 83, 113,118,134 & 162. Citation: Moti Gulersen, Matthew J. Blitz, Burton Rochelson, Michael Nimaroff, Weiwei Shan, Eran Bornstein Clinical Implications of SARS-CoV-2 Infection in the Viable Preterm Period. Am J Perinatol DOI: 10.1055/s-0040-1713851

Study 178 – Ten cases from Wuhan

Ten pregnant women with COVID-19, treated in the Zhongnan Hospital of Wuhan University (grid.413247.7) from Jan 20 to Feb 6 (click here or 10.1371@journal.pone.0235134). These women are probably also included in studies 1, 13, 55 & 57, and may also overlap with study 75. Citation: Gong X, Song L, Li H, Li L, Jin W, Yu K, et al. (2020) CT characteristics and diagnostic value of COVID-19 in pregnancy. PLoS ONE 15(7): e0235134. https://doi.org/10.1371/journal.pone.0235134

3rd July update – study 177 added. Study 176 removed. Duplicate of study 89.  Jim’s mistake. HT Keelin.

Study 177 – CTG changes in 12 Covid-19 pregnancies

Intrapartum electronic fetal cardiotocograms (CTGs) from 11 women with Covid-19 and one antepartum CTG at 28 weeks, were evaluated using a physiological system (click here or PIIS0301211520304243). All eleven delivered babies had normal Apgar scores and cord pH. No details of maternal severity, mode of delivery or other baby details were given. Some patients had been cared for in Puerta de Hierro hospital, Madrid, which also included cases in studies 125 and 151.  Others came from Germans Trias i Pujol Hospital, Badalona, a northern suberb of Barcelona, which has not previously reported cases. Citation: Gracia-Perez-Bonfils A, Martinez-Perez O, Llurba E, Chandraharan E, Fetal heart rate changes on the cardiotocograph trace secondary to maternal COVID-19 infection, European Journal of Obstetrics and amp; Gynecology and Reproductive Biology (2020), doi: https://doi.org/10.1016/j.ejogrb.2020.06.049

1 July update – study 176 added.

Study 176 – Case report from San Francisco. Deleted 3 July duplicate of study 89

A 34 year old woman contracted Covid-19 at 28 weeks gestation (click here or Acute_Respiratory_Distress_Syndrome_in_a_Preterm.11). She required ventilation and was delivered by Caesarean section. The baby tested negative. Both recovered. The hospital is not named but authors are all affiliated with University of California, San Francisco. Citation: Blauvelt, Christine A. MD; Chiu, Catherine MD; Donovan, Anne L. MD; Prahl, Mary MD; Shimotake, Thomas K. MD; George, Ronald B. MD, FRCPC; Schwartz, Brian S. MD; Farooqi, Naghma A. MD; Ali, Syed S. MD; Cassidy, Arianna MD; Gonzalez, Juan M. MD, PhD; Gaw, Stephanie L. MD, PhD Acute Respiratory Distress Syndrome in a Preterm Pregnant Patient With Coronavirus Disease 2019 (COVID-19), Obstetrics & Gynecology: July 2020 – Volume 136 – Issue 1 – p 46-51 doi: 10.1097/AOG.0000000000003949

30 June update – study 175 added

Study 175 – 5 cases from Philadelphia, Pennsylvania, US

Five pregnant women with Covid-19 were treated with remdesivir (click here or mccoy remdesevir ajogmfm). Three were ventilated, four delivered and all recovered. One pregnancy is ongoing.  All neonates tested negative. From author affiliations these cases may overlap with studies 65 and 86. Citation: Mccoy JA, Short WR, Srinivas SK, Levine LD, Hirshberg A, Compassionate use remdesivir for treatment of severe COVID-19 in pregnant women at a United States academic center, American Journal of Obstetrics & Gynecology MFM (2020), doi: https://doi.org/10.1016/j.ajogmf.2020.100164.

26 June update –  study 174 added

Study 174 – US CDC Covid-19 & pregnancy weekly tracking data

The US Centers for Disease Control (CDC) are now publishing weekly COVID-19 in pregnancy tracking data. The June 25th update (click here) duplicates that in study 172. Citation: US CDC Weekly COVID-19 Pregnancy Data; Pregnant women with COVID-19, United States [January 22-June 23, 2020] https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/special-populations/pregnancy-data-on-covid-19.html Accessed 26 June 2020.

25 June update – studies 171 to 173 added. (Study 173 belatedly).

Study 173 – 33 cases from Covid-Net

An April 6th MMWR, which we had previously missed, of SARS-CoV-2 hospitalisations reported to COVID-NET, a network of hospitals representing about 10% of the United States, included 33 pregnant women of whom 3 (9%) had been hospitalised (click here or mm6915e3-H). These cases overlap with studies 171 and 172. Citation: Garg S, Kim L, Whitaker M, et al. Hospitalization Rates and Characteristics of Patients Hospitalized with Laboratory-Confirmed Coronavirus Disease 2019 — COVID-NET, 14 States, March 1–30, 2020. MMWR Morb Mortal Wkly Rep 2020;69:458–464. DOI: http://dx.doi.org/10.15585/mmwr.mm6915e3external icon

Study 172 – 8,207 pregnant woman with SARS-CoV-2 from CDC

Of 8,207 pregnant women who tested positive for SARS-CoV-2 and were reported to the US Centers For Disease Control by 7th June, 2,587 (31.5%) were hospitalised, 120 (1.5%) admitted to ICU, 42 (0.5%) ventilated, and 16 (0.2%) died. Comparative figures for 83,205 non-pregnant women in the same age group were; 4,840 (5.8) hospitalised, 757 (0.9%) admitted to ICU, 225 (0.3%) ventilated, 208 (0.2%) died (click here or mm6925a1-H). Citation: Ellington S, Strid P, Tong VT, et al. Characteristics of Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status — United States, January 22–June 7, 2020. MMWR Morb Mortal Wkly Rep 2020;69:769–775. DOI: http://dx.doi.org/10.15585/mmwr.mm6925a1external icon

Study 171 – 36 cases from Covid-Net 

In this MedRxiv preprint, of 2,491 adults hospitalised with Covid-19, in the US Covid-Net database (154 acute hospitals in 13 states), 26 were pregnant. This represent 12.9% of the 279 women of childbearing age (15–49 years) in the cohort (click here or 2020.05.18.20103390v1.full). [Comment – see table 1. The percentage seems to be wrong.] Citation: Lindsay Kim, Shikha Garg, Alissa O’Halloran, Michael Whitaker, Huong Pham, Evan J. Anderson, Isaac Armistead, Nancy M. Bennett, Laurie Billing, Kathryn Como-Sabetti, Mary Hill, Sue Kim, Maya L. Monroe, Alison Muse, Arthur Reingold, William Schaffner, Melissa Sutton, H. Keipp Talbot, Salina M. Torres, Kimberly Yousey-Hindes, Rachel A Holstein, Charisse Cummings, Lynette Brammer, Aron Hall, Alicia Fry, Gayle E. Langley. Interim Analysis of Risk Factors for Severe Outcomes among a Cohort of Hospitalized Adults Identified through the U.S. Coronavirus Disease 2019 (COVID-19)-Associated Hospitalization Surveillance Network (COVID-NET) medRxiv 2020.05.18.20103390; doi: https://doi.org/10.1101/2020.05.18.20103390

24 June update – studies 165 to 170 added

Study 170 – 241 cases from the Netherlands

The 19th June update of NethOSS (click here), accessed 24 June 2020, contains the following. 6/224 women with brief additional details were admitted to intensive care. One mother died. 69 women have given birth, 26 by Caesarean. 152 pregnancies are ongoing. No baby has died. No babies were infected. Citation: See Studies 42, 46, 120, 141, & 147. Available here. Accessed 24 June 2020.

Study 169 – 19 June ICNARC report

The 19th June ICNARC update (click here or ICNARC COVID-19 report 2020-06-19.pdf) contains 26 currently, and 37 recently, pregnant women critically ill with Covid-19.  Of these 10 are currently, and 24 have in the past,  received advanced respiratory support. NOTE – ICNARC has recently started reporting pregnancy data subdivided by white/non white ethnicity.

Study 168 – The PRIORITY study 24 June 2020

The PRIORITY (Pregnancy Coronavirus Outcomes Registry) study (click here) has issued no formal reports yet. However the dashboard (click here accessed 24 June 2020) shows 882 participants, by age group, gestational age band, ethnic group and US state of residence. Citation: University of California San Francisco. PRIORITY Study dashboard https://priority.ucsf.edu/dashboard. Accessed 24 June 2020.

Study 167 – 23 women in the first trimester from Turin

Of 23 women in this preprint from Medxiv, testing positive for SARS-Cov2 in the first trimester, 11 miscarried and 12 had ongoing prgnancies (click here or 2020.06.19.20135749v1.full). This was a case control study comparing SARS-Cov2 rates between women experiencing miscarriage and matched women with ongoing pregnancy. The rates did not differ significantly. The patients were cared for at S. Anna Hospital, Turin, which has not previously reported cases in the first trimester. Citation: Stefano Cosma, Andrea Carosso, Jessica Cusato, Fulvio Borella, Marco Carosso, Marialuisa Bovetti, Claudia Filippini, Antonio D’Avolio, Valeria Ghisetti, Giovanni Di Perri, Chiara Benedetto. COVID-19 and first trimester spontaneous abortion: a case-control study of 225 pregnant patients. medRxiv 2020.06.19.20135749; doi: https://doi.org/10.1101/2020.06.19.20135749

Study 166 – 3 cases from Hubei, China

Three pregnant woman with Covid-19 were all delivered by Caesarean (click here or E603.full).  The babies all tested negative. The mothers came from a cohort of 166 pregnant women testing positive for SARS-Cov19 in a predefined administrative region containing 12 hospitals, including the Xiangyang First People’s Hospital in Hubei, China. This hospital is not found on GRID.ac. Citation: Peng An, Bradford J. Wood, Wei Li, Min Zhang, Yingjian Ye. Postpartum exacerbation of antenatal COVID-19 pneumonia in 3 women. CMAJ Jun 2020, 192 (22) E603-E606; DOI: 10.1503/cmaj.200553

Study 165 – 65 cases from Madrid

Of 65 women with Covid-19, 13 were diagnosed postnatally. Of the 52 antenatal cases, 32 developed pneumonia and two required ICU admission (click here or PIIS2589537020301516. No mother died.  6/32 women with pneumonia had delivered and no babies were infected. Patients were cared for at University Hospital “12 de Octubre”. They therefore probably overlap with those reported in study 151 but differ from those in study 125. Citation: R. San-Juan et al., Incidence and clinical profiles of COVID-19 pneumonia in pregnant women: A single-centre cohort study from Spain, EClinicalMedicine (2020), https://doi.org/10.1016/j.eclinm.2020.100407

23 June update – studies 163 & 164 added

Study 164 – Two cases from New York

One woman with severe Covid-19 miscarried at 22 weeks. At the time of writing she remained ventilated. Another woman required Caesarean birth at 29 weeks and recovered. Her baby required intubation and tested positive for SARS-Cov2 at 6 days (click here or Futterman NY s-0040-1712978).  The hospital is not named. Author affiliations are Dept. OBGYN, New York Medical College, Valhalla, New York, which is affiliated with multiple clinical sites. These cases may therefor have been previously reported. Citation: Itamar Futterman, Miriam Toaff, Liel Navi, Camille A. Clare. COVID-19 and HELLP: Overlapping Clinical Pictures in Two Gravid Patients. Am J Perinatol Rep 2020;10:e179–e182.

Study 163 – 9 cases with placental histology from Milan

Of 9 women with SARS-CoV2 infection delivered between March and April 2020 at Fondazione IRCCS Ca’ Granda – Ospedale Maggiore Policlinico (Milan), all mothers recovered and all babies tested negative (click here or Cribiu Eur JOG IIS0301211520304164). Placental histology is reported. Although the hospital name differs these cases are probably included in studies 32 & 64. Citation: Cribi `u FM, Croci GA, Gobbo AD, Rizzuti T, Iurlaro E, Tondo M, Viscardi A, Bosari S, Ferrero S, HISTOLOGICAL CHARACTERIZATION OF PLACENTA IN COVID19 PREGNANT WOMEN, European Journal of Obstetrics and amp; Gynecology and Reproductive Biology (2020), doi: https://doi.org/10.1016/j.ejogrb.2020.06.041

21 June update – studies 161 & 162 added

Study 162 – 462 cases (70 severe) from New York

Of 462 pregnant women with Covid-19, 70 had severe disease, 14 were admitted to ICU, and two died (click here or PIIS0002937820306360). The patients were cared for in the Northwell Hospital network which includes Maimonides Medical Centre. The paper includes a statement about severe case overlap with studies 113, 118 & 134. Shared authorship suggests overlap with studies 49 and 83 as well. Citation: Blitz MJ, Rochelson B, Minkoff H, Meirowitz N, Prasannan L, London V, Rafael TJ, Chakravarthy S, Bracero LA, Wasden SW, Pachtman Shetty SL, Santandreu O, Chervenak FA, Schwartz BM, Nimaroff M, Maternal Mortality Among Women with COVID-19 Admitted to the Intensive Care Unit, American Journal of Obstetrics and Gynecology (2020), doi: https://doi.org/10.1016/j.ajog.2020.06.020.

Study 161 – 54 cases from Strasbourg

Of 54 pregnant women with confirmed (n=38) or suspected (n=16) COVID-19 in pregnancy treated at Strasbourg University Hospital (France) from March 1 to April 3, there was one miscarriage, 21 live births (12 vaginal, 9 cesarean), and 32 ongoing pregnancies (click here or PIIS0002937820306396). Five women were admitted to ICU, three required mechanical ventilation and one ECMO. No mothers died, although at the time of writing the woman on ECMO remained on it. All babies tested negative & none died. Strasbourg doctors co-authored the GROG report, so these cases are probably included in study 150. Citation: Sentilhes L, De Marcillac F, Jouffrieau C, Kuhn P, Thuet V, Hansmann Y, Ruch Y, Fafi-Kremer S, Deruelle P, COVID-19 in pregnancy was associated with maternal morbidity and preterm birth, American Journal of Obstetrics and Gynecology (2020), doi: https://doi.org/10.1016/j.ajog.2020.06.022.

18 June update – studies 157-160 added

Study 160 – 241 cases from New York

Of 241 pregnant women with laboratory-confirmed SARSCoV-2 infection who gave birth between March 13 & April 12, there were 245 live births to 241 women (6 sets of twins), & 2 stillbirths (click here or Characteristics_and_Outcomes_of_241_Births_to.97310). 17 women were admitted to ITU and 9 intubated. No mothers died, although one woman remained intubated at time of writing. 27% of neonates were admitted to NICU. Of liveborns with SARS-CoV-2 test results 236/230 tested negative. No further neonatal outcomes reported. The five hospitals were “Montefiore Medical Center; Mount Sinai Health System, including Mount Sinai Hospital and Mount Sinai West; its affiliate, NYC Health and Hospitals- Elmhurst Hospital; NewYork-Presbyterian Hospital- Columbia University; and New York University Langone Health, including NYU Langone Hospitals, Manhattan campus, and NYU Langone Hospitals-Brooklyn”. These cases therefore likely overlap with studies 14, 27, 41, 49, 83, 85, 86, 95, 95, 119, 135, 136, & 152. They probably do not overlap with women in studies 61, 113, 118, 122 & 134, which included women cared for in different New York centres. Women in Study 99 are unclear. Citation: Khoury, Rasha MD, MPH; Bernstein, Peter S. MD; Debolt, Chelsea MD; Stone, Joanne MD; Sutton, Desmond M. MD; Simpson, Lynn L. MD; Limaye, Meghana A. MD; Roman, Ashley S. MD; Fazzari, Melissa PhD; Penfield, Christina A. MD; Ferrara, Lauren MD; Lambert, Calvin MD; Nathan, Lisa MD; Wright, Rodney MD; Bianco, Angela MD; Wagner, Brian MD; Goffman, Dena MD; Gyamfi-Bannerman, Cynthia MD; Schweizer, William E. MD; Avila, Karina MPH; Khaksari, Bijan MPH; Proehl, Meghan MPH; Heitor, Fabiano MD; Monro, Johanna BS; Keefe, David L. MD; D’Alton, Mary E. MD; Brodman, Michael MD; Makhija, Sharmila K. MD; Dolan, Siobhan M. MD Characteristics and Outcomes of 241 Births to Women With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection at Five New York City Medical Centers, Obstetrics & Gynecology: June 16, 2020 – Volume Publish Ahead of Print – Issue – doi: 10.1097/AOG.0000000000004025

Study 159 – Three severe cases from New Jersey

Three pregnant women with Covid-19 required ventilation (click here or s-0040-1713664). All three recovered and their pregnancies are ongoing. They were cared for in Morristown Medical Center and St. Peter’s University Medical Center in central New Jersey, neither of which have previously reported cases. Citation: Lucarelli E, Behn C, Lashley S, Smok D, Benito C, Oyelese Y. Mechanical Ventilation in Pregnancy Due to COVID-19: A Cohort of Three Cases [published online ahead of print, 2020 Jun 16]. Am J Perinatol. 2020;10.1055/s-0040-1713664. doi:10.1055/s-0040-1713664

Study 158 – Four patients undergoing amniocentesis from Spain.

Four pregnant women with Covid-19 underwent midtrimester amniocentesis for prenatal diangosis of other conditions (click here or 1-s2.0-S0014256520301569-main). No amniotic samples tested positive. The hospital is not named but from author affiliations is probably Hospital Universitario Maternal-Infantil de Jaén, Jaén. This hospital has not previously reported cases, but these cases may be included in study 151 which included registry cases from Spain. Citation: Hijona Elósegui JJ, et al. ¿Existe transmisión materno-fetal del SARS-CoV-2 durante la gestación? Rev Clin Esp. 2020. https://doi.org/10.1016/j.rce.2020.06.001

Study 157 – 88 cases from France

Eighty eight pregnant women with Covid-19 responded to an anonymous internet survey hosted by the French television pregnancy show “la Maison des Maternelles” (click here or PIIS030121152030364X). 6 had been sufficiently severe to require oxygen. 14 had delivered, 5 by Caesarean. Many are probably included in study 150. Citation: J. Cohen, et al., Covid-19 in pregnant women: General data from a French National Survey, Eur J Obstet Gynecol (2020), https://doi.org/10.1016/j.ejogrb.2020.06.002

16 June update study 156 added

Study 156 – Case report of Covid-19, pregnancy & pancreatitis

A 36-year-old woman contracted Covid-19 at 33 weeks (click here or 1-s2.0-S2214911220300588-main). Pancreatitis was diagnosed on the basis of raised lipase, despite normal amylase. She recovered and was later delivered by Caesarean. Both mother & baby discharged  in stable condition. Author affiliations Saint Joseph Hospital, Denver, Colorado. Citation: Sarah R. Rabice, Paulina C. Altshuler, Claire Bovet, Cathlyn Sullivan, Amy J. Gagnon. COVID-19 infection presenting as pancreatitis in a pregnant woman: A case report. Case Reports in Women’s Health. Volume 27, 2020, e00228, ISSN 2214-9112, https://doi.org/10.1016/j.crwh.2020.e00228.

15 June update study 155 added

Study 155 – Case report of placental infection from Yale

This MedRxiv preprint (click here or SARS-CoV-2 infection of the placenta (002)) (click here for published peer reviewed version update 24 June) reports a 35-year-old woman who contracted Covid-19 at 22 weeks gestation. She had coagulopathy and hypertension, and was offered and accepted pregnancy termination, which was performed under GA with extubation on day 1.  SARS-CoV-2 RNA was present at high levels in the placenta, and virions were visible on electron microscopy. The hospital is not named but author affiliations are Yale School of Medicine. The case is therefore probably included in study 132Citation: Hillary Hosier, Shelli Farhadian, Raffaella Morotti, Uma Deshmukh, Alice Lu-Culligan, Katherine Campbell, Yuki Yasumoto, Chantal Vogels, Arnau Casanovas-Massana, Pavithra Vijayakumar, Bertie Geng, Camila Odio, John Fournier, Anderson Brito, Joseph Fauver, Feimei Liu, Tara Alpert, Reshef Tal, Klara Szigeti-Buck, Sudhir Perincheri, Christopher Larsen, Aileen Gariepy, Gabriela Aguilar, Kristen Fardelmann, Malini Harigopal, Hugh Taylor, Christian Pettker, Anne Wyllie, Charles Dela Cruz, Aaron Ring, Nathan Grubaugh, Albert Ko, Tamas Horvath, Akiko Iwasaki, Uma Reddy, Heather Lipkind.  SARS-CoV-2 Infection of the Placenta. medRxiv 2020.04.30.20083907; doi: https://doi.org/10.1101/2020.04.30.20083907

Update 24 June. Peer reviewed citation, [online ahead of print, 2020 Jun 23]. J Clin Invest. 2020;139569. doi:10.1172/JCI139569

11 June update studies 154 & 154 added

Study 154 – Case report from Northwick Park Hospital, London

A 34-year woman with immunologic thrombocytopaenia developed a cough, fever, petechiae and gum bleeding at 20 weeks gestation (click here or Nesr BJH case bjh.16928). She had a low platelet count, swabbed positive for SARS-CoV-2 and recovered. Pregnancy outcome not reported, but by implication ongoing. Case presumably included in study 92.  Citation: Nesr, G., Garnett, C., Bailey, C. and Arami, S. (2020), ITP flare with mild COVID‐19 infection in pregnancy: A case report. Br J Haematol. Accepted Author Manuscript. doi:10.1111/bjh.16928

Study 153 – Case report from Jordan

A 30-year-old woman, contracted mild Covid-19 at 36 weeks gestation (click here or Al Zaghal Case Rep Jordan 1-s2.0-S2214911220300424-main). She delivered by Caesarean. The baby tested negative. Both recovered. The first report from Jordan. Citation: Laila A. AlZaghal, Najwa AlZaghal, Safwan O. Alomari, Nail Obeidat, Basil Obeidat, Wail A. Hayajneh. Multidisciplinary team management and cesarean delivery for a Jordanian woman infected with SARS-COV-2: A case report. Case Reports in Women’s Health 27 (2020) https://doi.org/10.1016/j.crwh.2020.e00212

9 June update – studies 151 & 152 added.

Study 152 – 2 severe cases from New York

Two women with Covid-19 required ventilation and caesarean delivery (click here or Silverstein AmJPerinatol Rep s-0040-1712925). Both neonates tested negative. Both mothers recovered. The hospital(s) are not named but author affiliations suggest either Langone Medical Center or Bellevue Hospital Center. The cases are therefore probably included in studies 85 & 86, and possibly also in studies 49 & 83. Citation: Jenna S. Silverstein, Meghana A. Limaye, Sara G. Brubaker, Ashley S. Roman, Judita Bautista, Judith Chervenak, Adam J. Ratner, Philip M. Sommer, Nicole M. Roselli, Charlisa D. Gibson, David Ellenberg, Christina A. Penfield. Acute Respiratory Decompensation Requiring Intubation in Pregnant Women with SARS-CoV-2 (COVID-19) Am J Perinatol Rep 2020;10:e169–e175.

Study 151 – 82 cases from Spain

Of 82 women with singleton pregnancies and Covid-19, who delivered within 14 days of disease onset, collected from from 96 level 2 or 3 maternity hospitals in Spain, 9 were admitted to ICU and 7 ventilated (click here or jama_martnezperez_2020_ld_200062). Five babies tested positive. No mothers or babies died. The hospitals are not named but author affiliations include Puerta de Hierro University Hospital, 12 Octubre University Hospital, & Gregorio Marañon University Hospital, all three from Madrid. Three other authors are associated with the Covi-Preg registry in Switzerland (click here). The cases probably overlap with those in studies 53125. Citation: Martínez-Perez O, Vouga M, Cruz Melguizo S, et al. Association Between Mode of Delivery Among Pregnant Women With COVID-19 and Maternal and Neonatal Outcomes in Spain. JAMA. Published online June 08, 2020. doi:10.1001/jama.2020.10125

8 June update – study 150 added.

Study 150 – 617 cases from France

Thirty three maternity units from the “Groupe de Recherche en Obstétrique et Gynécologie (GROG)” treated 617 pregnant women with COVID-19 between March 1 & April 14 (click here or GIlles France JOG HR). Eighty three women required nasal oxygen, a further 10 non-invasive ventilation, a further 29 mechanical ventilation and a further six, ECMO.  One woman died. There were 5 miscarriages and 7 stillbirths among the 181 pregnancies which had ended. Among the 190 live births (7 twins & 1 set of triplets) there was one neonatal death. Two babies tested positive. The 33 maternity units (including 24 tertiary referral centers) are not named, although 19 can be guessed from the author affiliations. Citation: Kayem G, Alessandrini V, Azria E, Blanc J, Bohec C, Bornes M, Bretelle F, Ceccaldi P-Franc¸ois, Chalet Y, Chauleur C, Cordier A-Gael, Deruelle P, Desbri`ere R, Doret M, Dreyfus M, Driessen M, Fermaut M, Gallot D, Garab´edian C, Huissoud C, Lecarpentier E, Luton D, Morel O, Perrotin F, Picone O, Rozenberg P, Schmitz T, Sentilhes L, Sroussi J, Vayssi`ere C, Verspyck E, Vivanti AJ, Winer N, A snapshot of the Covid-19 pandemic among pregnant women in France, Journal of Gynecology Obstetrics and Human Reproduction (2020), doi: https://doi.org/10.1016/j.jogoh.2020.101826

6 June update – study 149 added

Study 149 – 73 cases, 8 severe, from New Jersey

Of 73 pregnant women with COVID-19, 31 were admitted, of whom 8 visited ICU. Of these 6 needed intubation, and 1 ECMO (click here or 1-s2.0-S2589933320300951-main). 7 of the 8 ICU cases were delivered by Caesarean and one remains undelivered.  All babies were isolated and fed artificial or donor milk. All tested negative. All mothers were discharged from intensive care. No babies died but four remain in hospital. No details given of the non ICU cases. The “network’s two largest hospitals” in which the patients were treated are not named. The authors are affiliated with three large hospitals in New Jersey  Hackensack University Medical Center, University Hospital (Newark, New Jersey) and Hackensack Meridian Jersey Shore University Medical Center. The patients are therefore probably different from those reported in Studies 86, and 111. Citation: Romagano MP, Guerrero K, Spillane N, Kayaalp E, Smilen SW, Alvarez M, Alvarez-Perez J, Francis Kim A, Aschner J, Al-Khan A, Perinatal outcomes in critically ill pregnant women with COVID-19, American Journal of Obstetrics & Gynecology MFM (2020), doi: https://doi.org/10.1016/j.ajogmf.2020.100151.

5 June update – studies 143 to 148 added.

Study 148 – 29th May ICNARC report

The 29th May ICNARC update (click here or ICNARC COVID-19 report 2020-05-29.pdf) contains 23 currently, and 34 recently, pregnant women critically ill with Covid-19. Of these 10 and 20 respectively had received advanced respiratory support.

Study 147 – 223 cases from the Netherlands

The 5th June  update of NethOSS (click here), accessed 4 June 2020, contains the following. 6/210 women with brief additional details were admitted to intensive care. One mother died. 66 women have given birth, 25 by Caesarean. 142 pregnancies are ongoing. No baby has died. No babies were infected. Citation: See Studies 42, 46, 120, & 141. Available here. Accessed 5 June 2020.

Study 146 – 8 cases from Turkey

Two pregnant women with Covid-19 were delivered by Caesarean at term, one miscarried at 7 weeks and five pregnancies are ongoing (click here or jum.15367).  One delivered baby tested negative. No details are reported of the other. All mothers recovered. The tertiary hospital is not named, but from author affiliations is probably Sehit Prof Dr Ilhan Varank Sancaktepe Training & Research Hospital, Istanbul. These case are therefore unlikely to overlap with those in Studies 31 and 145. Citation: Yassa M, Birol P, Mutlu AM, Tekin AB, Sandal K, Tug N. Lung Ultrasound Can Influence the Clinical Treatment of Pregnant Women With COVID-19 [published online ahead of print, 2020 Jun 1]. J Ultrasound Med. 2020;10.1002/jum.15367. doi:10.1002/jum.15367

Study 145 – Case report from Turkey

A 25 year old woman with Covid-19 was delivered by Caesarean at 38 weeks (click here or 1-s2.0-S0952818020308953-main). The mother recovered and the baby tested negative. The hospital is not named but from author affiliations is likely Necmettin Erbakan University, Meram Faculty of Medicine, Konya, Turkey. The patient is different from the one in study 31Citation: Resul Yilmaz, FatmaKiliç, Şule Arican, Gülçin Hacibeyoğlu, Halime Süslü, Mustafa Koyuncu, Sema Tuncer Uzun. Anesthetic management for cesarean birth in pregnancy with the novel coronavirus (COVID-19). Journal of Clinical Anesthesia. Available online 27 May 2020. https://doi.org/10.1016/j.jclinane.2020.109921

Study 144 – 2 (or 3) cases from Tokyo

Of 52 asymptomatic pregnant women screened for SARS-CoV-2 between April 6 and April 27, two tested positive and one, whose partner had Covid-19, was treated as if she was infected despite a negative test (click here or ijgo.13252). All three were delivered by Caesarean section, and their babies isolated. No babies were infected. Patients were cared for in Keio University Hospital, Tokyo. These are the first cases of Sars-Cov2 from Japan. Citation: Ochiai, D., Kasuga, Y., Iida, M., Ikenoue, S. and Tanaka, M. (2020), Universal screening for SARS‐CoV‐2 in asymptomatic obstetric patients in Tokyo, Japan. Int J Gynecol Obstet. Accepted Author Manuscript. doi:10.1002/ijgo.13252

Study 143 – 12 cases from Korea

Twelve women with COVID-19 were admitted for delivery between February 26th & to April 3rd 2020 (click here or kja-20204). Four birthed vaginally and 8 by Caesarean. Two babies were stillborn. All patients were cared for at Daegu Fatimal Hospital, Korea, (see Study 22 cited in paper). Although there is no explicit statement about whether the patient in Study 22 was included, the clinical details (age and gestation) differ, so it is likely that all 12  have not previously been reported.  Citation: Jeongmin Oh, Eunju Kim, Hyunkyum Kim, Sang-Ah Lee, Kyeong Hee Lee, Mi Hyae Yu, Jihyun An. Infection control of operating room and anesthesia for cesarean section during pandemic Coronavirus disease-19 (COVID-19) outbreak in Daegu, the republic of Korea – 8 cases report. Korean J Anesthesiol DOI: https://doi.org/10.4097/kja.20204 [Epub ahead of print]. Published online June 5, 2020.

4th June update – studies 141 and 142 added

Study 142 – 61 cases from Boston Massachusetts

Of these 61 women with Covid-19 in pregnancy, cared for at a single academic medical centre, 21 were admitted to hospital, of whom 6 went to intensive care, of whom four were intubated (click here or Prevalence_and_Severity_of_Coronavirus_Disease.97338). No mothers died. The hospital is not named, but from author affiliations is likely Massachusetts General Hospital, Boston, Mass. If so, these women probably differ from those reported in Study 129, and have not previously been reported. Citation: Goldfarb, Ilona Telefus MD, MPH; Clapp, Mark A. MD, MPH; Soffer, Marti D. MD, MPH; Shook, Lydia L. MD; Rushfirth, Katherine CNM, MSN; Edlow, Andrea G. MD, MSc; Boatin, Adeline A. MD, MPH; Kaimal, Anjali J. MD, MAS; Barth, William H. Jr MD; Bryant, Allison S. MD, MPH Prevalence and Severity of Coronavirus Disease 2019 (COVID-19) Illness in Symptomatic Pregnant and Postpartum Women Stratified by Hispanic Ethnicity, Obstetrics & Gynecology: June 02, 2020 – Volume Publish Ahead of Print – Issue – doi: 10.1097/AOG.0000000000004005

Study 141 – 201 women from the Netherlands Covid in pregnancy registry

The 22nd May update of NethOSS (click here), accessed 4 June 2020, contains the following. 7/176 women with brief additional details were admitted to intensive care. One mother died after prolonged admission and intubation as a result of pulmonary infection with multiple pulmonary emboli. 49 women have given birth, 16 by Caesarean. 124 pregnancies are ongoing. No baby has died. No babies were infected. Citation: See Studies 42, 46 & 120. Available here. Accessed 4 June 2020.

2nd June update – study 140 added

Study 140 – 42 cases from Barcelona

Forty two pregnant women with Covid-19 between March 13 & April 10 (click here or 1471-0528.16339). Eight required admission to ICU of whom 6 developed some features of pre-eclampsia, 4 requiring Caesarean, one of which was due to HELLP syndrome. No maternal or baby outcomes are reported but it is implied “after recovery from severe pneumonia, hypertensive therapy was no longer required in all cases” that all women recovered. The “tertiary care” hospital is not named but from author affiliations is likely to be Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona. If so, these cases have not been previously reported. Citation: Mendoza, M., Garcia‐Ruiz, I., Maiz, N., Rodo, C., Garcia‐Manau, P., Serrano, B., Lopez‐Martinez, R.M., Balcells, J., Fernandez‐Hidalgo, N., Carreras, E. and Suy, A. (2020). Preeclampsia‐like syndrome induced by severe COVID‐19: a prospective observational study. BJOG. doi:10.1111/1471-0528.16339

1st June update – Studies 138 (HT Frederico Amedee Peret) & 139 added. Study 137 removed.

Study 139 – 13 cases in Washington state

Twelve women with Covid-19 were detected through targeted testing, and one by universal screening (click here or ciaa675). No separate clinical details given for the SARS-Cov2 positive women.  Patients were treated at the University of Washington Montlake Labor and Delivery Unit and Northwest Birth Center. They therefore likely overlap with Study 102. Citation: Sylvia M LaCourse, Alisa Kachikis, Michela Blain, LaVone E Simmons, James A Mays, Amber D Pattison, Carol C Salerno, Stephen A McCartney, Nicole M Kretzer, Rebecca Resnick, Rosemary L Shay, Leah M Savitsky, Anna C Curtin, Emily M Huebner, Kimberly K Ma, Shani Delaney, Carlos Delgado, Adrienne Schippers, Jeff Munson, Paul S Pottinger, Seth Cohen, Santiago Neme, Lori Bourassa, Andrew Bryan, Alex Greninger, Keith R Jerome, Alison C Roxby, Erica Lokken, Edith Cheng, Kristina M Adams Waldorf, Jane Hitti. Low prevalence of SARS-CoV-2 among pregnant and postpartum patients with universal screening in Seattle, Washington. Clinical Infectious Diseases ciaa675, https://doi.org/10.1093/cid/ciaa675

Study 138 – 36 deaths among 484 pregnant women with Covid-19 in Brazil

Bulletin no 17 from the Brazilian Ministry of Health contains a special section on pregnant women with Covid-19 (click here or 2020-05-25—BEE17—Boletim-do-COE). The report is in Portugese. I’ve prepared an English translation of the pregnancy section using google translate Brazil MoH Covid 19 Bulletin 17 translation of pregnancy section. Citation: Ministério da Saúde, Secretaria de Vigilância em Saúde. Boletim Epidemiológico Especial da COVID-19 no Brasil. Número do boletim 17.  25 May 2020.

31 May update – study 137 added.

Study 137 – A patient with Covid-19 & an ectopic pregnancy

A 37-year-old woman tested positive for SARS-Cov2 and presented two days later with an ectopic pregnancy (click here or Ectopic_Pregnancy_During_Coronavirus_Disease_2019.97340). The authors discuss treatment options but give no further clinical details. Although the report is ambiguous, it is conventional in educational medical reports to present real cases unless stated otherwise. From author affiliations the patient was likely cared for in South Dakota or Texas. Citation: Hansen, Keith A; Stovall, Dale W. Ectopic Pregnancy During Coronavirus Disease 2019 (COVID-19), Obstet Gynecol: May 27, 2020 doi: 10.1097/AOG.0000000000003995 Removed 1 June 2020 because the peer review correspondence available here or aog_136_2_2020_05_18_hansen_20-1079_sdc1 makes clear that the case is hypothetical.

30 May update – study 136 added.

Study 136 – 158 cases from New York

Of 158 pregnant women with Covid-19, 34 had moderate or severe disease, 9 received ICU or step down care and 1 required intubation. There were no deaths (click here or Andrikopoulou Green Symptoms_and_Critical_Illness_Among_Obstetric.97341). No baby outcomes reported. Patients were cared for at New York Presbyterian/Columbia University Irving Medical Center, and at
New York-Presbyterian/Allen Hospital. Cases presumably overlap with those in studies 14, 27, 41 & 95. Citation: Andrikopoulou, Maria; Madden, Nigel; Wen, Timothy; Aubey, Janice J; Aziz, Aleha; Baptiste, Caitlin D;  Breslin, Noelle; D’Alton, Mary E; Fuchs, Karin; Goffman Dena; Gyamfi-Bannerman, Cynthia; Matseoane-Peterssen, Dara N; Miller, Russell S; Sheen, Jean-Ju; Simpson, Lynn L; Sutton, Desmond; Zork, Noelia; Friedman, Alexander M. Symptoms and Critical Illness Among Obstetric Patients With Coronavirus Disease 2019 (COVID-19) Infection, Obstet Gynecol May 27, 2020 – doi: 10.1097/AOG.0000000000003996

28 May update – studies 133 to 135 added

Study 135 –  50 cases from New York

Among 307 asymptomatic women tested on admission in labour, 50 were SARS CoV-2 positive (click here or Buckley Mount Sinai AJOGMFM). The women were tested between April 4 & 15, 2020, at two institutions within Mount Sinai Health System in New York. They therefore probably overlap with those in Study 119. Citation: Buckley A, Bianco A, Stone J, Universal testing of patients and their support persons for COVID-19 when presenting for admission to Labor and Delivery within the Mount Sinai Health System, Am J Obstet Gynecol MFM (2020), doi: https://doi.org/10.1016/j.ajogmf.2020.100147.

Study 134 – 125 cases from New York

These authors report further details on 12 pregnant women with severe Covid 19, out of 125 in total (click here or McLaren AJOG PIIS0002937820305676). 7 were delivered by Caesarean, 2 vaginally, and 3 remain undelivered. No mothers died, although one remains in hospital. This is an update on study 113, and again the hospital is presumably Maimonides Medical Center, Brooklyn, NY. Citation: MCLAREN Jr. RA, LONDON V, ATALLAH F, MCCALLA S, HABERMAN S, FISHER N, STEIN JL, MINKOFF HL, Delivery For Respiratory Compromise Among Pregnant Women With COVID-19, Am J Obstet Gynecol (2020), doi: https://doi.org/10.1016/j.ajog.2020.05.035.

Study 133 – 3 cases identified by screening in North Tuscany

By screening 533 women admitted for delivery for SARS-CoV2 between March 26th & April 1st in North Tuscany and Liguria, these authors identified 3 positives, who all gave birth without clinical problems (click here or PIIS0002937820305421). The women birthed in all the 6 hospitals of Azienda USL “Toscana Nord Ovest” (Tuscany), and Gaslini Children’s Hospital (Genoa, Liguria). They have therefore probably not previously been reported. Citation: Gagliardi L, Danieli R, Suriano G, Vaccaro A, Tripodi G, Rusconi F, Ramenghi LA, Universal SARS-CoV-2 testing of pregnant women admitted for delivery in two Italian regions. Am J Obstet Gynecol (2020), doi: https://doi.org/10.1016/j.ajog.2020.05.017.

27 May update – study 132 added (HT @janevandis)

Study 132 – 42 cases from Connecticut

Of 782 women presenting for childbirth between April 2nd & 29th, 2020, 12 had already been diagnosed with Covid-19. Of the remainder 30/770 screened positive, 22 of whom were asymptomatic (click here orjama_campbell_2020_ld_200052). No clinical outcomes reported. No health care workers infected. Patients were cared for in 3 Yale New Haven Health hospitals in southern Connecticut. Citation: Katherine H. Campbell, Jean M. Tornatore, Kirsten E. Lawrence, Jessica L. Illuzzi, L. Scott Sussman, Heather S. Lipkind, Christian M. Pettker. Prevalence of SARS-CoV-2 Among Patients Admitted for Childbirth in Southern Connecticut. JAMA. Published online May 26, 2020. doi:10.1001/jama.2020.8904

26 May update – studies 129 to 131 added.

Study 131 – Anti-SARS-Cov2 IgA antibodies in breast milk of recovering women.

The authors of this not yet peer-reviewed preprint report anti SARS-Cov2 IgA antibodies in breast milk samples from 15 women previously infected with SARS-Cov2 (click here or 2020.05.04.20089995v1.full). No clinical details. The authors, mainly from Icahn School of Medicine at Mount Sinai, New York, report that they have recruited over 350 lactating women who have recovered from COVID-19.  Citation: Alisa Fox, Jessica Marino, Fatima Amanat, Florian Krammer, Jennifer Hahn-Holbrook, Susan Zolla-Pazner, Rebecca L Powell.  Evidence of a significant secretory-IgA-dominant SARS-CoV-2 immune response in human milk following recovery from COVID-19 doi: https://doi.org/10.1101/2020.05.04.20089995

Study 130 – Case report from Amsterdam Medical Centre

A woman developed Covid-19 at 41 weeks gestation (Click here or ajh.25877). She also developed autoimmune throbocytopaenia. The baby was delivered by Caesarean. Citation: Man Wai Tang, Erfan Nur, Bart J. Biemond. Immune Thrombocytopenia during Pregnancy due to COVID-19. Am J Haematol. First published:23 May 2020 https://doi.org/10.1002/ajh.25877

Study 129 – 15 patients from Boston, Massachusetts

Of 213 admitted pregnant women screened by differential white blood count, 15 had Sars-Cov2 (click here or Duffy Green Lymphopenia_and_Severe_Acute_Respiratory_Syndrome.97345 (002)). Three required critical care for hypoxia. No other clinical details. From author affiliations patients were probably cared for in Beth Israel Deaconess Med Center, Harvard Med School, Boston, Mass. Citation: Duffy, Cassandra R. MD, MPH; Hart, Jessica M. MD; Modest, Anna M. PhD; Hacker, Michele R. ScD; Golen, Toni MD; Li, Yunping MD, MSc; Zera, Chloe MD, MPH; Shainker, Scott A. DO, MS; Mehrotra, Preeti MD, MPH; Zash, Rebecca MD; Wylie, Blair J. MD, MPH Lymphopenia and Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection Among Hospitalized Obstetric Patients, Obstetrics & Gynecology: May 19, 2020 – Volume Publish Ahead of Print – Issue – doi: 10.1097/AOG.0000000000003984

25 May update – studies 127-8 added.

Study 128 – 13 patients from North East Flanders

Of 470 pregnant women screened, 13 tested positive for SARS-Cov2, 8 were asymptomatic 4 had mild upper airway symptoms, and one respiratory symptoms. None developed severe disease (click here or Ceulemans Flanders uog.22099 (1)) The hospitals caring for the four patients are unnamed but shown on a map. Citation: Ceulemans, D., Thijs, I., Schreurs, A., Vercammen, J., Lannoo, L., Deprest, J., Richter, J., De Catte, L. and Devlieger, R. (2020), Screening for COVID ‐19 at childbirth: does it deliver?. Ultrasound Obstet Gynecol. Accepted Author Manuscript. doi:10.1002/uog.22099

Study 127 – SARS-CoV-2 in human breastmilk

Breast milk from two nursing mothers infected with SARS-CoV-2 was tested. Samples from one woman were positive (click here or PIIS0140673620311818). Where the patients were cared for, was not reported. The authors came from Ulm in Germany. Citation: Rüdiger Groß, Carina Conzelmann, Janis A Müller, Steffen Stenger, Karin Steinhart, Frank Kirchhoff, Jan Münch. Detection of SARS-CoV-2 in human breastmilk. Lancet. Published online May 21, 2020 https://doi.org/10.1016/S0140-6736(20)31181-8

24 May update

Study 126 – The ISARIC report in the BMJ

Among 20,133 patients admitted to hospital with covid-19 in the UK, 100/1033 (10%) women of childbearing age, were reported as being pregnant (click here or bmj.m1985.full). This is similar to the estimated proportion of pregnant women in the community. Pregnancy was not associated with mortality. This is an update of study 68. Citation: Docherty Annemarie B, Harrison Ewen M, Green Christopher A, Hardwick Hayley E, Pius Riinu, Norman Lisa et al. Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study. BMJ 2020; 369 :m1985

23 May update – studies 121-125 added

Study 125 – 60 cases from Madrid

Of 60 pregnant women with COVID-19 (click here or aogs.13921), 18 had pneumonia, 2 severely. One woman was admitted to ICU. No mothers died. Of 23 women delivered, 5 were by cesarean and 18 vaginally. Two delivered preterm. All 23 babies tested negative, and 21 were breast fed. Two babies were admitted to NICU for other reasons. No babies died. The patients were all were treated at Puerta de Hierro University Hospital Madrid, Spain from March 14th to April 14th, 2020. Citation: Pereira, A., Cruz‐Melguizo, S., Adrien, M., Fuentes, L., Marin, E. and Perez‐Medina, T. (2020), Clinical course of Coronavirus Disease‐2019 (COVID‐19) in pregnancy. Acta Obstet Gynecol Scand. Accepted Author Manuscript. doi:10.1111/aogs.13921

Study 124 – 16 cases from Chicago

Fourteen patients delivered at term, 1 at 34 weeks, & 1 at 16-weeks (click here or aqaa089). No mothers admitted to ITU. No mother or baby deaths. No baby infections. The cases were identified  via a search of placental pathology records. Where the women were cared for is not recorded, but from author affiliation and a footnote probably includes Prentice Women’s Hospital, Northwestern Memorial Hospital and Feinberg School of Medicine, Northwestern University, Chicago. Citation: Elisheva D Shanes, Leena B Mithal, Sebastian Otero, Hooman A Azad, Emily S Miller, Jeffery A Goldstein. Placental Pathology in COVID-19, Am J Clin Pathol. aqaa089, https://doi.org/10.1093/ajcp/aqaa089 Published: 22 May 2020

Study 123 – 16 cases from Michigan

Two patients received oxygen via nasal cannula, none were admitted to ITU. There were 8 vaginal births (one preterm) and 2 Caesareans. No babies were infected. Six women remain undelivered    (click here or Qadri Michigan Pregnancy affected by SARS CoV 2 infection a flash report…). Citation: Farnoosh Qadri & Federico Mariona (2020) Pregnancy affected by SARS-CoV-2 infection: a flash report from Michigan. J Mat-Fetal & Neonatal Med. DOI: 10.1080/14767058.2020.1765334

Study 122 – Response of Northwell Health to Covid-19 in pregnancy

A detailed description of how a large multi-hospital network in the centre of the New York pandemic organised itself to care for women with Covid-19 in pregnancy (click here or Rochelson [16193997 – Journal of Perinatal Medicine] New York). No patient numbers or details. Citation: Burton Rochelson, Michael Nimaroff, Adriann Combs, Benjamin Schwartz, Natalie Meirowitz, Nidhi Vohra, Victor R. Klein, Orlando Santandreu, Mitchell Kramer, Navid Mootabar, Eli Serur, Lisa Spiryda, Scott Berlin. Frank Chervenak. The Care of Pregnant Women During the COVID-19 Pandemic – Response of a Large Health System in Metropolitan New York. J Perinat Med. 2020 May 20;/j/jpme.ahead-of-print/jpm-2020-0175/jpm-2020-0175.xml. doi: 10.1515/jpm-2020-0175. Online ahead of print.

Study 121 – One week’s screening in Los Angeles.

The Cedars-Sinai Medical Center, Los Angeles, California screened 82 pregnant women over a one week period (click here or Severe_Acute_Respiratory_Syndrome_Coronavirus_2.97344). None of the 80 asymptomatic women tested positive but one of two symptomatic ones did. No further details reported. Citation: Mariam Naqvi, Richard M Burwick, John A Ozimek, Naomi H Greene, Sarah J Kilpatrick, Melissa S Wong. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Universal Testing Experience on a Los Angeles Labor and Delivery Unit, Obstetrics & Gynecology: May 19, 2020 – Volume Publish Ahead of Print – Issue – doi: 10.1097/AOG.0000000000003987

21 May update – studies 116-120 added.

Study 120 – 191 women from the Netherlands Covid-19 registry

This 14 May update of NethOSS (click here), accessed 21 May 2020, contains the following. 6/156 women with brief additional details were admitted to intensive care; one remains there. One mother had a molar pregnancy and one a miscarriage. 47 women have given birth, 16 by Caesarean. 109 pregnancies are ongoing. No mother or baby has died. No babies were infected. Citation: See Studies 42 and 46. Available here. Accessed 21 May. Note: we probably missed some intermediate updates from this registry.

Study 119 – 24 cases identified by screening in New York

24/155 asymptomatic women screened for SARS-COV-2 prior to a planned delivery, tested positive (click here or Bianco Green Testing_of_Patients_and_Support_Persons_for.97342). All their newborns were tested and none were positive. No maternal outcomes were reported. The patients were all cared for in the Mount Sinai Health system between April 4th and 15th. From author affiliations this was Icahn School of Medicine at Mount Sinai Hospital. These cases may therefore overlap with some in study 86. Citation: Bianco, Angela; Buckley, Ayisha B; Overbey, Jessica; Smilen, Scott; Wagner, Brian; Dinglas, Cheryl; Loudon, Holly; Garely, Alan; Brodman, Michael; Stone, Joanne. Testing of Patients and Support Persons for Coronavirus Disease 2019 (COVID-19) Infection Before Scheduled Deliveries, Obstetrics & Gynecology: May 19, 2020 – Volume Publish Ahead of Print – Issue – doi: 10.1097/AOG.0000000000003985

Study 118 – a maternal death from New York

A 36-year-old woman developed Covid-19 at 37 weeks gestation (click here or Vallejo Green A_Postpartum_Death_Due_to_Coronavirus_Disease_2019.97350). Within three hours of admission she required intubation and Caesarean, and she died within 36 hours. The baby tested negative and survived. The hospital is not named, and she was not transferred. From the author affiliations it was either Dept OBGYN, Urban Health Plan, Inc., Bronx, or Division of Maternal-Fetal Med, Dept OBGYN, Weill Cornell Medicine, New York. Citation: Victoria Vallejo, John G. Ilagan. A Postpartum Death Due to Coronavirus Disease 2019 (COVID-19) in the United States. Obstet Gynecol 2020;00:1–4 DOI: 10.1097/AOG.0000000000003950

Study 117 – 77 cases from 12 Italian hospitals

From Feb 23 to March 28th, 14/77 women with Covid-19 were severely affected, and one required ECMO (click here or Savasi Green Clinical_Findings_and_Disease_Severity_in.97347). 57 gave birth, 22 by Caesarean. Four newborns tested positive for SARS-COV-2, but none had symptoms. 20 pregnancies are ongoing. No mothers or babies died. The 12 hospitals L. Sacco (Milan), Mangiagalli (Milan), S. Gerardo MBBM Foundation (Monza), Papa Giovanni XXIII (Bergamo), and San Matteo (Pavia) and the hospitals of Padua, Florence, Lecco, Trento, Modena, Seriate and Piacenza. These are the same hospitals as studies 33 & 64. The patients probably overlap. Citation: Savasi, Valeria M. MD, PhD; Parisi, Francesca MD, PhD; Patanè, Luisa MD; Ferrazzi, Enrico MD; Frigerio, Luigi MD, PhD; Pellegrino, Antonio MD; Spinillo, Arsenio MD; Tateo, Saverio MD; Ottoboni, Mariacristina MD; Veronese, Paola MD, PhD; Petraglia, Felice MD; Vergani, Patrizia MD; Facchinetti, Fabio MD; Spazzini, Donata MD; Cetin, Irene MD, PhD Clinical Findings and Disease Severity in Hospitalized Pregnant Women With Coronavirus Disease 2019 (COVID-19), Obstetrics & Gynecology: May 19, 2020 – Volume Publish Ahead of Print – Issue – doi: 10.1097/AOG.0000000000003979

Study 116 – A “universal testing in pregnancy” series from Chicago

Northwestern Memorial Hospital, tested a consecutive series of 635 pregnant women admitted between April 8th & 28th, 2020. Of these 23 (3.6%) tested positive for SARS-CoV-2, of whom 10 (44%) were asymptomatic on presentation (click here or Miller NorthWestern Clinical_Implications_of_Universal_Severe_Acute.9734…). No maternal or baby outcomes were reported. Citation: Miller, Emily S. MD, MPH; Grobman, William A. MD, MBA; Sakowicz, Allie MS; Rosati, Jessica MSN, RN; Peaceman, Alan M. MD Clinical Implications of Universal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Testing in Pregnancy, Obstetrics & Gynecology: May 19, 2020 – Volume Publish Ahead of Print – Issue – doi: 10.1097/AOG.0000000000003983

20 May update Studies 113 (HT Fred Peret. We’d missed it!) to 115 added

Study 115 – Case report of Covid-19 & severe pre-eclampsia

A 26-year-old with Covid-19 at 37 weeks gestation also had severe pre-eclampsia (click here or AJOGMFM-20-1073 ). She was treated with magnesium sulphate and delivered vaginally. The baby tested negative. Both recovered. From author affiliations likely cared for at Stanford University Hospital. Citation: Joudi N, Henkel A, Lock WS, Lyell D, Preeclampsia Treatment in SARSCoV-2, American Journal of Obstetrics & Gynecology MFM (2020), doi: https://doi.org/10.1016/j.ajogmf.2020.100146.

Study 114 – 22 women from Bergamo, Italy

Of 22 women with Covid-19 in pregnancy two neonates tested positive, one born vaginally and one by caesarean. Both did well. Their placental histology is described (click here or AJOGMF-20-1112). No other mother or baby details are given. The women were cared for between March 5, & April 21, 2020 at Papa Giovanni XXIII Hospital, Bergamo, in the Lombardy region of Italy, so the women were probably also reported in study 32 & study 64. Citation: Patanè L, Morotti D, Giunta MR, Sigismondi C, Piccoli MG, Frigerio L, Mangili G, Arosio M, Cornolti G, Vertical transmission of COVID-19: SARS-CoV-2 RNA on the fetal side of the placenta in pregnancies with COVID-19 positive mothers and neonates at birth, American Journal of Obstetrics & Gynecology MFM (2020), doi: https://doi.org/10.1016/j.ajogmf.2020.100145.

Study 113 – 68 SARS-Cov-2 positive pregnant women  from New York

46 had Covid-19 and a further 22 asymptomatic women tested positive for SARS-Cov-2 (click here or s-0040-1712164). 12 women had severe disease, one requiring ventilation. There was one intrauterine death at 17 weeks but otherwise no mothers or babies died. All babies tested negative. 12 pregnancies are ongoing.  Women were cared for at a tertiary care hospital in Brooklyn, from March 15 to April 15, 2020. From author affiliations probably Maimonides Medical Center, Brooklyn, NY. If so, they have not been previously reported.  Citation: Viktoriya London, Rodney McLaren Jr., Fouad Atallah, Catherine Cepeda, Sandra McCalla, Nelli Fisher, Janet L. Stein, Shoshana Haberman, Howard Minkoff. The Relationship between Status at Presentation and Outcomes among Pregnant Women with COVID-19. Am J Perinatol. DOI https://doi.org/10.1055/s-0040-1712164. ISSN 0735-1631. Online April 27, 2020

19 May update – studies 108 to 112 added.

Study 112 – Case report from Nashville, Tennessee

A 35-year-old developed Covid-19 at 22 weeks gestation requiring intubation & ventilation (click here or  1-s2.0-S2214911220300515-main). She recovered and the pregnancy is ongoing. U Tennessee Health Science Center has not previously reported cases. Citation: J. Anderson, J. Schauer, S. Bryant, et al., The use of convalescent plasma therapy and remdesivir in the successful management of a critically ill obstetric patient with novel coronavirus 2019 infection: A case report. Case Rep Women’s Health (2020), https://doi.org/10.1016/j.crwh.2020.e00221

Study 111 – Case report from Livingstone, New Jersey

A 39-year-old woman, with IVF twins developed Covid-19 at 27 weeks of gestation (click here or 1-s2.0-S2214911220300503-main). She required ventilation and then an emergency classical Cesarean section a the bedside due to rapid deterioration.  She recovered. One twin was infected, but both survived. She was cared for in Saint Barnabas Medical Center, Livingston, New Jersey, which has not previously reported a case.  Citation:  H. Mehta, S. Ivanovic, A. Cronin, et al., Novel coronavirus related acute respiratory distress syndrome in a patient with twin pregnancy: A case report. Case Rep Women’s Health (2020), https://doi.org/10.1016/j.crwh.2020.e00220

Study 110 – Case report from Thailand

A 43-year-old with mild Covid-19 at 18 weeks gestation (click here or Panichaya Thailand PIIS0301211520303134). Amniocentesis done a week earlier showed trisomy 21, & the pregnancy was terminated. Placental & fetal swabs were negative. Citation: Panichaya P, Thaweerat W, Uthaisan J. Prolonged viral persistence in COVID-19 second trimester pregnant patient, Eur J Obstet & Gynecology & Reprod Biol (2020), doi: https://doi.org/10.1016/j.ejogrb.2020.05.030

Study 109 – 4 women from Parma, Italy

Four women with Covid-19 recovered and later delivered healthy term neonates (click here or Acta BioMed Parma 9743-Article Text-49126-2-10-20200514). They were cared for in Parma Hospital, in the Emilia-Romagna (not Lombardy) region of Italy. Citation: Serafina Perrone, Michela Deolmi, Maurizio Giordano, Tiziana D’Alvano, Lucia Gambini, Mara Corradi, Tiziana Frusca, Tullio Ghi, Susanna Esposito. Report of a series of healthy term newborns from convalescent mothers with COVID-19. Acta Biomed 2020; Vol. 91, N. 2: 251-255 DOI: 10.23750/abm.v91i2.9743

Study 108 – 27 cases from Central Hospital of Wuhan

These 27 women with Covid-19 in pregnancy included 4 early pregnancies. They delivered 24 babies (1 set of twins) (click here or Yang Wuhan arpa.2020-0232-sa). They were cared for at “Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology in Wuhan” between Jan 20 & Mar 19, 2020.  Assuming this is Central Hospital of Wuhan, grid.440160.7 these cases likely overlap with studies 39 and 73. They are probably also included in studies 55 & 57. Citation: Hui Yang, Bin Hu, Sudong Zhan, Li-ye Yang, Guoping Xiong. Effects of SARS-CoV-2 infection on pregnant women and their infants: A retrospective study in Wuhan, China. Arch Pathol Lab Med. In press. doi: 10.5858/arpa.2020-0232-SA

18 May update – studies 105 to 107 added

Study 107 – Maternal death in Birmingham, UK

A 29-year-old woman with severe Covid-19 was delivered by Caesarean section at Birmingham Heartlands Hospital at 31 weeks gestation (click here or Mat Death Bham BrJH bjh.16849). The baby tested negative and is doing well. The mother initially improved and was extubated on day 2 post natal. However on day 6 she developed basilar artery thrombosis, and she died on day 7. Case presumably included in study 92 UKOSS. Citation: Ahmed, I., Azhar, A., Eltaweel, N. and Tan, B.K. (2020), First Covid‐19 maternal mortality in the UK associated with thrombotic complications. Br J Haematol. Accepted Author Manuscript. doi:10.1111/bjh.16849

Study 106 – 2 cases from Reading, UK

Two women with severe Covid-19 were treated at the Royal Berkshire Hospital (click here or Cooke Reading PIIS0301211520302761 (002). Both were preterm (28+4, 28+6 days) and required Caesarean for deteriorating maternal condition. Both mothers recovered. One baby had a perforated bowel but both eventually recovered. Presumably both cases were included in study 92 UKOSS. Citation: Cooke WR, Billett A, Gleeson S, Jacques A, Place K, Siddall J, Walden A, Soulsby K. SARS-CoV-2 infection in very preterm pregnancy: experiences from two cases, Eur J Obstet Gynecol & Reprod Biol (2020), doi: https://doi.org/10.1016/j.ejogrb.2020.05.025

Study 105 – 12 cases from from Hospital Pedro Hispano, Portugal

All 123 pregnant women admitted to Hospital Pedro Hispano in Porto between March 25 & April 15 were tested for SARS-CoV-2. 12 were positive, of whom 11 were asymptomatic, 10 have delivered, 6 by
cesarean section and 4 vaginally. There was one set of twins. There were no maternal complications and all the newborns tested negative (click here or Doria N Portugal PIIS0301211520303122 (002) This series may include the cases in study 74 & study 94. Citation: D´oria M, Peixinho C, Laranjo M, Varejao AM, Silva PT. Covid-19 during pregnancy: a case series from an universally tested population from the north of Portugal. Eur J Obstet Gynecol & Reprod Biol (2020). doi: https://doi.org/10.1016/j.ejogrb.2020.05.029

16 May update – Study 104 added

Study 104 – ICNARC 15th May update

The 15th May ICNARC update (click here or ICNARC COVID-19 report 2020-05-15.pdf) contains 23 currently, and 32 recently, pregnant women critically ill with Covid-19. Of these 9 and 16 respectively had received advanced respiratory support.

Study 103 – Case report from Toronto, Ontario

A 40-year-old woman developed Covid-19 at 35 weeks gestation and was delivered by Caesarean (click here or cmaj.200821.full). The baby tested positive on the day of birth, breast fed and had some minor feeding difficulties, but eventually thrived. Citation: Maksim Kirtsman, Yenge Diambomba, Susan M. Poutanen, Ann K. Malinowski, Evangelia Vlachodimitropoulou, W. Tony Parks, Laura Erdman, Shaun K. Morris, Prakesh S. Shah. Probable congenital SARS-CoV-2 infection in a neonate born to a woman with active SARS-CoV-2 infection  CMAJ 2020. doi: 10.1503/cmaj.200821; early-released May 14, 2020 (HT Jon Dorling & Don Sharkey).

Study 102 – 46 patients from Washington State, USA

Of 46 pregnant women with SARS-CoV-2, 43 were symptomatic, 7 hospitalized, 6 categorised as severe, and 1 admitted to ICU (click here or Lokken-AJOG). Eight women delivered, 5 vaginal, 3 Caesarean. All mothers survived. There were 7 livebirths & one stillbirth at 38 weeks. That fetus tested negative.  One baby was preterm. No further baby details were given. 38 pregnancies are ongoing. The women were cared for in 16 hospitals: University of Washington Hospital system (Montlake, Northwest, & Harborview campuses), Swedish Medical Center (First Hill, Ballard, Issaquah and Edmonds campuses), University of Washington Valley Medical Center, MultiCare Health System (Auburn Medical Center, Covington Medical Center, Tacoma General Hospital, Good Samaritan Hospital, Valley Hospital and Deaconess Hospital), Evergreen Health Medical Center, and PeaceHealth-St. Joseph’s Medical Center. Citation: Erica M. LOKKEN et al. Clinical Characteristics of 46 Pregnant Women with a SARS-CoV-2 Infection in Washington State. Am J Obstet Gynecol. 2020 May 19 doi: 10.1016/j.ajog.2020.05.031 [Epub ahead of print] PMCID: PMC7234933 PMID: 32439389

Study 101 – Case report from Tabriz, Iran

A 33-year-old woman with severe Covid-19 at 34 weeks gestation was treated at Imam Reza hospital of Tabriz (click here or Taghizadieh Iran 1-s2.0-S2213007120302306-main). She required intubation, ventilation, renal dialysis & delivery by Caesarean. The baby tested negative & was in good health. The mother remains intubated but is recovering. The clinical details differ sufficiently from the two women who survived in study 67 to make it likely that this is a previously unreported case. Citation: Taghizadieh A, Mikaeili H, Ahmadi M, Valizadeh H, Acute kidney injury in pregnant women following SARS-CoV-2 infection: A case report from Iran, Respiratory Medicine Case Reports (2020), doi: https://doi.org/10.1016/j.rmcr.2020.101090.

Jim Thornton, Keelin O’Donoghue & Kate Walker

The risk of dying from Covid-19 in pregnancy

May 3, 2020

For the facts click here.  This is my interpretation.

It’s not zero, 13/73 (18%) of pregnant women with Covid-19, whose cases made it into the newspapers, died (click here). But this must be an overestimate. Covid may not have caused all the deaths, and there will be selective reporting.

In the scientific papers 16/367 (4%) of women died (click here). These data should be more reliable, in that we can can be confident, at least for the women reported in detail from Iran (S67 & S70), that Covid-19 caused the deaths. The other 7 cases from Brazil and Mexico (S66) include less detail, and some were identified only from newspaper reports, so the cause of death must be in some doubt. There is also a more serious problem. All the deaths were reported in studies of maternal death due to Covid-19. Mothers who survived in the relevant regions were not reported. This must also be an overestimate.

Restricting analysis to the the larger series probably gives a better estimate. In Wuhan 0/109, Netherlands 0/91, Lombardy 0/42, NY Presbyterian/Columbia 0/33 mothers died. In total that’s zero deaths out of 275 pregnant women with Covid-19.

But the death rate can’t be zero. Some women really did die, and many mothers in the larger series were seriously ill and nearly died. In the Whuhan series (S55 here) 9/109 pregnant women had severe disease (hypoxaemia) although only one required ventilation. In the Netherlands 5/91 (S41, here), Lombardy 7/42 (S32 here), & NY Presbyterian/Columbia 2/33 (S41 here), needed intensive care. That’s 14/166 (8%) in total. There have been other reports of pregnant women who were seriously ill (S69, S50, S28, S19, S3 here).

Mortality for non-pregnant people, age 16-49, with Covid-19, who needed intensive care is 24% (ICNARC).  If pregnant women on intensive care had the same mortality, this would correspond to a 2% overall mortality. Not zero. But significantly lower than the biased newspaper rate of 18% or the biased “all scientific reports” rate of 4%.

A two percent maternal mortality rate from Covid-19 is my best guess.

Let’s put this in context. 98% of women who develop Covid-19 in pregnancy will survive. But the background risk of mothers dying in pregnancy these days is only 0.01%. This means the risk of a mother dying, if she gets Covid-19, may be 200 times greater than the background risk in pregnancy.

Covid-19 is a serious disease. Don’t underestimate it.

Jim Thornton

Edited noon 3 May.

 

Covid-19 & pregnancy – navigation page

April 21, 2020

Ripe-tomato.org has been collecting the primary sources about Covid-19 in pregnancy for a month. All regularly updated. No opinion, no reviews, no guidelines. Just the primary data sources.

For the first 100 scientific reports (click here). Duplicates and overlaps noted. Curated by Jim Thornton, Keelin O’Donoghue & Kate Walker.

For the second 100 scientific reports(click here). Regularly updated.

For the first 100 news items describing cases of Covid-19 in pregnancy reported by traditional newspapers & broadcasters (click here).

For the second 100 news items (click here). Regularly updated.

Summary totals for non-overlapping cases here. Updated to 12 May, when UKOSS registry first reported. Corrections only after 12 May.

Help to disambiguate Chinese hospitals & universities here.

Covid-19 in pregnancy registries, & similar, here.

For my best estimate of the maternal mortality rate with Covid-19 (click here).

And finally, on a more cheerful note, some lockdown cocktails (click here).

Jim Thornton

Covid-19 & pregnancy – registries

April 19, 2020

Registries & regional data

A list of “Covid-19 & pregnancy” registries, as well as of some regional groups who have reported data.

Both are likely to be more representative than hospital-based series (click here), or news reports (click here), although they will overlap. Updated 24 June.

National Registries

1 UKOSS – The United Kingdom Obstetric Surveillance System (UKOSS) Pandemic COVID-19 in pregnancy registry (click here, & registered here) is collecting cases via each NHS Trust’s local UKOSS reporter. It includes early pregnancy, including miscarriage & ectopic pregnancy.

2. COVI-PREG – (click here) Based in Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne University Hospital, Switzerland.

3. PRIORITY – (click here), the Pregnancy Coronavirus Outcomes Registry (PRIORITY), coordinated through the University of California is collecting both confirmed and suspected cases. Doctors may refer patients. Patients may refer themselves. By 16 April, 300 participants had been enrolled.

4. ROI COVID-19 – The Republic of Ireland Covid-19 registry (click here).

5. NethOSS – the Netherlands Covid-19 registry (click here). To register cases email info@nethoss-perined.nl. By 12 April 2020, 107 reports had been received, 91 with brief, and 50 with extensive additional information.

6. CHOPAN – The Australian Registry. CHOPAN (Coronavirus Health Outcomes in Pregnancy & Newborns)  – click here, or here to register.

7. National Health Commission of China – Not strictly a registry, but on 17th April a group using this source reported all cases of Covid-19 in pregnancy seen in any hospital in Wuhan between December 8, 2019 & March 20, 2020 (click here). These data supersede all previous reports from Wuhan hospitals for women admitted before March 20.

8. ItOSS -The Italian registry – Click here.

9. PregCOVID, The National Registry of Pregnant Women with COVID-19 in India (click here). Contact: Dr Rahul Gajbhiye. Dept Clinical Research ICMR-National Institute for Research in Reproductive Health, J M Street, Parel, Mumbai email: gajbhiyer@nirrh.res.in

10. Obs Covid Spain – A Spanish Covid-19 in pregnancy registry based around the 77 hospitals in the previously exisiting “Emergency Obstetrics Spain Group”. (click here for the protocol).

Other registries

1. PANCOVID – Pregnancy And Neonatal outcomes for women with COVID-19 (click here). Run by Imperial College London and University of Wales.

2. US CDC – United States, Centres for Disease Control (CDC) includes pregnancy in its Covid-19 report forms. This report here, up to March 28, included 143 pregnant women.

3. ICNARC – The UK Intensive Care National Audit & Research Centre (ICNARC) includes some pregnant women. For their 4 April 2020 report, which included eight pregnant or recently pregnant women, click here.   Data updated 17 April.

4. ObsCovid – A UK registry, supported by RCOG, RCM, OAA & RCoA, for maternity healthcare workers to record and follow-up encounters with mothers with suspected or confirmed COVID-19 (click here).

5. Santé Publique France – Reports Covid-19 admissions to intensive care in France (click here, report in French). By 16 April, 13 pregnant women had been admitted to intensive care. None had died.

6. The Traditional, Complementary & Integrative Health & Medicine COVID-19 Support Registry (click here) includes a data field on pregnancy.

7. COVID-19 ICU registry – Click here. A Multicenter International Data Repository of patients admitted to ICU. Hosted by Massachussets General Hospital.  It will include pregnant women.

8. INTERCOVID – Click here. A prospective case control study using the centres who participated in the INTERGROWTH-21st Project.

9. IRCEP – International Registry of Coronavirus Exposure in Pregnancy (IRCEP) (click here). Not yet opened. Based in the TH Chan School of Public health, Harvard University.

10. COV-PREG-COAG – run by the International Society of Thombosis & Haemostasis. The International Registry on Pregnancy and COVID-19 Associated Coagulopathy and Thrombosis (COV-PREG-COAG) can be accessed here.

11. PeriCovid – Understanding COVID-19 infection in pregnant women and their babies. Run by St George’s, London. Protocol here.

12. COVID-19 New Mum Study – (click here).

13. Mother to Baby Covid-19 in pregnancy study.  (click here). Open to women in US or Canada. Also recruiting breastfeeding women with  COVID-19 .

14. COVID Mothers Study – (click here). Mothers who had Covid-19 in prengnancy or whose babies had it under the age of one year are eligible to participate in this anonymous registry.

Regional Reports

1. The COVID-19 Obstetrics Task Force, Lombardy, reported 42 cases in pregnancy from six regional hubs (including Milan, Brescia, Bergamo, Monza, & Pavia) up to March 20th (click here).

Jim Thornton

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