Maternal characteristics and pregnancy outcomes of hospitalized pregnant women with SARS-CoV-2 infection in South Africa: An International Network of Obstetric Survey Systems-based cohort study

Samantha Budhram*, Valerie Vannevel, Tanita Botha, Lawrence Chauke, Shastra Bhoora, Gaynor M. Balie, Natalie Odell, Hennie Lombaard, Amy Wise, Chrysanthi Georgiou, Nondumiso Ngxola, Emma Wynne, Unati Mbewu, Mfundo Mabenge, Sibusiso Phinzi, Nontsikelelo Gubu-Ntaba, Gareth Goldman, Kay Tunkyi, Sudhir Prithipal, Keshree NaidooSanthi Venkatachalam, Terence Moodley, Sean Mould, Mzuvele Hlabisa, Logie Govender, Charlene Maistry, John P. Habineza, Priya Israel, Serantha Foolchand, Nomandla V. Tsibiyane, Mala Panday, Priya Soma-Pillay, Sumaiya Adam, Felicia Molokoane, Matthew S. Mojela, Elizabeth J. van Rensburg, Tshililo Mashamba, Mushi Matjila, Sue Fawcus, Ayesha Osman, Mareli Venter, Gregory Petro, Ahminah Fakier, Eduard Langenegger, Catherine A. Cluver, Adrie Bekker, Liesl de Waard, Chantal Stewart, Nnabuike C. Ngene, Ongombe Lunda

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To describe risk factors and outcomes of pregnant women infected with SARS-CoV-2 admitted to South African healthcare facilities. Methods: A population-based cohort study was conducted utilizing an amended International Obstetric Surveillance System protocol. Data on pregnant women with SARS-CoV-2 infection, hospitalized between April 14, 2020, and November 24, 2020, were analyzed. Results: A total of 36 hospitals submitted data on 673 infected hospitalized pregnant women; 217 (32.2%) were admitted for COVID-19 illness and 456 for other indications. There were 39 deaths with a case fatality rate of 6.3%: 32 (14.7%) deaths occurred in women admitted for COVID-19 illness compared to 7 (1.8%) in women admitted for other indications. Of the women, 106 (15.9%) required critical care. Maternal tuberculosis, but not HIV co-infection or other co-morbidities, was associated with admission for COVID-19 illness. Rates of cesarean delivery did not differ significantly between women admitted for COVID-19 and those admitted for other indications. There were 179 (35.4%) preterm births, 25 (4.7%) stillbirths, 12 (2.3%) neonatal deaths, and 162 (30.8%) neonatal admissions. Neonatal outcomes did not differ significantly from those of infected women admitted for other indications. Conclusion: The maternal mortality rate was high among women admitted with SARS-CoV-2 infection and higher in women admitted primarily for COVID-19 illness with tuberculosis being the only co-morbidity associated with admission.

Original languageEnglish
JournalInternational Journal of Gynecology and Obstetrics
DOIs
Publication statusAccepted/In press - 2021

Keywords

  • COVID-19
  • low- and middle-income country
  • perinatal
  • pregnancy
  • SARS-CoV-2

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