Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome

Shell F Wong, Kam M Chow, Tse N Leung, Wai F Ng, Tak K Ng, Chi C Shek, Pak C Ng, Pansy W Y Lam, Lau C Ho, William W K To, Sik T Lai, Wing W Yan, Peggy Y H Tan, Shell F Wong, Kam M Chow, Tse N Leung, Wai F Ng, Tak K Ng, Chi C Shek, Pak C Ng, Pansy W Y Lam, Lau C Ho, William W K To, Sik T Lai, Wing W Yan, Peggy Y H Tan

Abstract

Objective: This study was undertaken to evaluate the pregnancy and perinatal outcomes of pregnant women with severe acute respiratory syndrome (SARS).

Study design: All pregnant women (12) who presented with SARS in Hong Kong between February 1 and July 31, 2003, were included. The pregnancy and perinatal outcomes were collected. Evidence of perinatal transmission of virus was assessed with the SARS-associated coronavirus reverse-transcriptase polymerase chain reaction on cord blood, placenta tissue, and subsequent follow-up of the neonate on serology.

Results: Three deaths occurred among the 12 patients, giving a case fatality rate of 25%. Four of the 7 patients (57%) who presented in the first trimester had spontaneous miscarriage. Four of the 5 patients who presented after 24 weeks were delivered preterm. Two mothers recovered without delivery, but their ongoing pregnancies were complicated by intrauterine growth restriction. No newborn infant had clinical SARS and all investigations were negative for SARS.

Conclusion: SARS during pregnancy is associated with high incidences of spontaneous miscarriage, preterm delivery, and intrauterine growth restriction. There is no evidence of perinatal SARS infection among infants born to these mothers.

References

    1. World Health Organization. Severe acute respiratory syndrome (SARS). Available at: . Accessed June 15, 2003.
    1. Ksiazek T.G., Erdman D., Goldsmith C.S., Zaki S.R., Peret T., Emery S. A novel coronavirus associated with severe acute respiratory syndrome. N Engl J Med. 2003;348:1953–1966.
    1. Peiris J.S.M., Lai S.T., Poon L.L.M., Guan Y., Yam L.Y.C., Lim W. Coronavirus as a possible cause of severe acute respiratory syndrome. Lancet. 2003;361:1319–1325.
    1. Tsang K.W., Ho P.L., Ooi G.C., Yee W.K., Wang T., Chan-Yeung M. A cluster of cases of severe acute respiratory syndrome in Hong Kong. N Engl J Med. 2003;348:1977–1985.
    1. World Health Organization. Case definitions for surveillance of severe acute respiratory syndrome (SARS). Available at: . Accessed June 15, 2003.
    1. Tsang O.T.-Y., Chau T.-N., Choi K.-W., Tso E.Y.-K., Lim W., Chiu M.-C. Coronavirus-positive nasopharyngeal aspirate as predictor for severe acute respiratory syndrome mortality. Emerg Infect Dis [serial online] 2003;19:1381–1387. Available at: Accessed November 15, 2003.
    1. World Health Organization. Severe acute respiratory syndrome (SARS): laboratory diagnostic tests. Available at: . Accessed October 15, 2003.
    1. Lee N., Hui D., Wu A., Chan P., Cameron P., Joynt G.M. A major outbreak of severe acute respiratory syndrome in Hong Kong. N Engl J Med. 2003;348:1986–1994.
    1. Ramsey P.S., Ramin K.D. Pneumonia in pregnancy. Obstet Gynecol Clin North Am. 2001;28:553–569.
    1. Harris J.W. Influenza occurring in pregnant women. JAMA. 1919;72:978–983.
    1. Greenberg M., Jacobziner H., Paketer J., Weisel B.A.G. Maternal mortality in the epidemic of Asian influenza New York City 1957. Am J Obstet Gynecol. 1958;76:897–902.
    1. Alaily A.B., Carrol K.B. Pulmonary ventilation in pregnancy. BJOG. 1978;85:518–524.
    1. Wilcox A.J., Weinberg C.R., O'Connor J.F., Baird D.D., Schlatterer J.P., Canfield R.E. Incidence of early loss of pregnancy. N Engl J Med. 1988;319:189–194.
    1. Kochhar D.M., Penner J.D., Knudsen T.B. Embryotoxic, teratogenic, and metabolic effects of ribavirin in mice. Toxicol Appl Pharmacol. 1980;52:99–112.
    1. Clark D.A., Banwatt D., Croy B.A. Murine trophoblast failure and spontaneous abortion. Am J Reprod Immunol. 1993;29:199–205.
    1. Ferm V.H., Willhite C., Kilham L. Teratogenic effects of ribavirin on hamster and rat embryos. Teratology. 1978;17:93–101.
    1. Madinger N.E., Greenspoon J.S., Ellrodt A.G. Pneumonia during pregnancy: has modern technology improved maternal and fetal outcome? Am J Obstet Gynecol. 1989;161:657–662.
    1. Benedetti T.J., Valle R., Ledger W.J. Antepartum pneumonia in pregnancy. Am J Obstet Gynecol. 1982;144:413–417.
    1. Unger C., Weiser J.K., McCullough R.E., Keefer S., Moore L.G. Altitude, low birth weight, and infant mortality in Colorado. JAMA. 1988;259:3427–3432.
    1. Moore L.G., Rounds S.S., Jahnigen D., Grover R.F., Reeves J.T. Infant birth weight is related to maternal arterial oxygenation at high altitude. J Appl Physiol. 1982;52:695–769.

Source: PubMed

3
Prenumerera