Follow-up study on the outcomes of recovered pregnant women who had
previous COVID-19 during the first and second trimester: a retrospective
cohort study
Abstract
Objective: The research aimed to study the pregnancy outcomes and
determine the safety of continued pregnancy until the third trimester
after being infected with SARS-CoV-2 during early pregnancy.
Design:Retrospective cohort study. Setting: Wuhan, Hubei,
China.Population:Pregnant women in recovery who had a history of
COVID-19 during early pregnancy at the Union Hospital from 15 Jan 2020
to 30 April 2020 were included. Methods:The clinical manifestation,
laboratory examinations, treatment, pregnancy outcomes, maternal
SARS-CoV-2 throat swab RT-PCR test results, and SARS-CoV-2 antibody
tests in neonates were detected. The placental pathology, ACE2
expression and SARS-CoV-2 presence was also studied. Main outcome
measures: Maternal and neonatal clinical and laboratory status. Results:
We included cases in our study. Three cases were diagnosed with COVID-19
during early pregnancy (Case A to C), and two cases were serum IgG
positive asymptomatic cases (Case D and E). Case A showed complete
recovery after severe COVID-19. Case C was infected at 6 weeks during
the first trimester and had induced medical abortion at 12 weeks. No
pneumonia was found in all neonates, the nucleic acid test and serum IgM
were negative, and IgG were positive. All placental samples were
negative for SARS-CoV-2 nucleic acid test. Infants followed-up at 1-3
months were healthy and asymptomatic. Placental pathology showed chronic
ischemia performance.Conclusions COVID-19 during pregnancy did not
significantly affect pregnancy outcomes. No adverse outcomes were
observed in all the neonates. The inflammatory state of COVID-19 may
cause placental injury. The placenta does not appear be a target organ
for SARS-CoV-2.