P.19 Characteristics of SARS-CoV-2 positive obstetric patients within one UK health board

Abstract

Introduction: The obstetric impact of COVID-19 remains undetermined, with case series scarce and reported outcomes variable. The UK Obstetric Surveillance System (UKOSS) recently reported on a national cohort of pregnant women who required hospital admission due to COVID-19 between March and April 2020.1 We aimed to assess the demographics and outcomes for obstetric patients with COVID-19 infection within our Scottish, inner-city health board and compare this against that reported by UKOSS. Methods: Caldicott Guardian approval was obtained and the requirement for ethical approval waved by the local research ethics service. All female patients of child-bearing age (age 16–49) with a positive SARS-CoV-2 test between 16 March – 3 June 2020 were identified by the local Infection Prevention and Control team. These data were cross-referenced with local electronic notes systems to identify pregnant or recently pregnant women (within 6 weeks post-partum). Collected data were de-identified prior to analysis and analyses performed using R statistical software. Descriptive statistics are reported with results expressed as mean (SD), median [IQR], or n (%). Results: In total, 741 eligible women tested positive for SARS-CoV-2 within the study period. Twenty-three (3%) were pregnant or recently pregnant, with 14 of these women (60%) requiring hospital admission (representing 5.1 cases per 1000 maternities). All identified patients of Black or Asian ethnicity were admitted to hospital (5 in total), whilst only 47% of women of white ethnicity were admitted. The most common symptoms in admitted patients were cough (present in 64% of cases) and fever (present in 57% of cases). Amongst admitted patients, median age was 31.5 [29.3–34.0], median gestation at diagnosis 30.5 [24.3–37.5] weeks and 6 patients (43%) had a booking BMI [Formula presented]0 kg/m2. Three hospitalised patients (21.4%) required oxygen therapy and one required post-operative ICU monitoring. Two fetal losses occurred before 22 weeks gestation. No neonatal deaths occurred and no infants tested positive for SARS-CoV-2. Discussion: During this “first wave” of the pandemic, rates of COVID-19 were in keeping with those reported by UKOSS. This may reflect local adherence to shielding advice, or that testing was performed only on symptomatic patients. Also in keeping with results from UKOSS, patients from minority ethnic groups (and those with high BMIs) were over represented in hospital admission rates. All patients studied have subsequently been discharged home and mainly required level 1 care during admission. Numbers for neonatal outcomes are low and further conclusions cannot be made from these data.