The current outbreak of atypical pneumonia in Wuhan, China caused by a novel Coronavirus is being monitored closely by the SOGC Infectious Disease Committee. Historically, pregnant women have been disproportionately affected by respiratory illnesses. As seen in the influenza epidemic in 1918, the Asian flu epidemic in 1957/58, H1N1 pandemic in 2009 and the Severe Acute Respiratory Syndrome (SARS) in 2003, respiratory infections in pregnant women have higher rates of mortality, ICU admission and other infectious morbidity compared to the non-pregnant population (1, 2, 3). The more recent SARS outbreak in 2003 (another coronavirus) provides limited data in pregnancy but outcomes again appeared to be worse for pregnant women with a 28% vs 10% mortality rate (pregnant vs non-pregnant) and 57% vs 20% (pregnant vs non-pregnant) mechanical ventilation rate (4). A single case was formally reported in Canada with no adverse outcomes (5). There were no cases of maternal to fetal transmission in the SARS outbreak.
At this point in time, there is limited data available on the novel Coronavirus from Wuhan in general and no pregnancy specific data. Any febrile respiratory illness in pregnancy should be taken seriously with appropriate diagnostics and therapies targeted at the most common causes of serious respiratory infection including bacterial and viral pneumonia, such as influenza. Women with a history of symptoms within 14 days of travel from the Wuhan region in China should have novel Coronavirus considered as a possible cause. Importantly this outbreak serves as a reminder to obstetric care providers of the need to practice good infection control practices including appropriate isolation and contact/droplet or airborne precautions as per local practices and guidelines.
The SOGC Infectious Disease committee will continue to follow the outbreak and provide its members and the obstetric community with updates as more information is gathered.
- McKinney P, Volkert P, Kaufman J. Fatal swine influenza pneumonia during late pregnancy. Arch Intern Med 1990;150:213e5.
- Larsen JW. Influenza and pregnancy. Clin Obstet Gynecol 1982;25:599e603.
- Eickhoff TC, Sherman IL, Serfling RE. Observations on excess mortality associated with epidemic influenza. JAMA 1961;176:776e82.
- Wong SF, Chow KM, de Swiet M. Severe acute respiratory syndrome and pregnancy. BJOG 2003;110:641e2.
- Yudin MH, Steele DM, Sgro MD, et al. Severe acute respiratory syndrome in pregnancy. Obstet Gynecol 2005;105:124e7.
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