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Association Between Mode of Delivery Among Pregnant Women With COVID-19 and Maternal and Neonatal Outcomes in Spain

Educational Objective
To understand how COVID-19 affects the mode of delivery for pregnant women
1 Credit CME

Data from China found severe complications in 8% of pregnant women with coronavirus disease 2019 (COVID-19).1 However, the high rate of cesarean deliveries (>90%) in Chinese reports is concerning,2 and whether mode of delivery is associated with maternal complications or neonatal transmission is unknown.3 We assessed births to women with COVID-19 by mode of delivery.

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Corresponding Author: David Baud, MD, PhD, Materno-Fetal and Obstetrics Research Unit, Department of Obstetrics and Gynecology, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland (david.baud@chuv.ch).

Accepted for Publication: May 26, 2020.

Published Online: June 8, 2020. doi:10.1001/jama.2020.10125

Correction: This article was corrected on July 21, 2020, for data and statistical significance changes.

Author Contributions: Drs Martínez-Perez and Vouga had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Drs Martínez-Perez and Vouga contributed equally.

Concept and design: Martínez-Perez, Vouga, Cruz Melguizo, Panchaud.

Acquisition, analysis, or interpretation of data: Martínez-Perez, Vouga, Forcen Acebal, Panchaud, Muñoz-Chápuli, Baud.

Drafting of the manuscript: Vouga, Cruz Melguizo, Forcen Acebal, Panchaud, Baud.

Critical revision of the manuscript for important intellectual content: Martínez-Perez, Vouga, Panchaud, Muñoz-Chápuli, Baud.

Statistical analysis: Martínez-Perez, Vouga, Panchaud, Muñoz-Chápuli, Baud.

Obtained funding: Martínez-Perez.

Administrative, technical, or material support: Martínez-Perez, Cruz Melguizo, Muñoz-Chápuli, Baud.

Supervision: Martínez-Perez, Cruz Melguizo, Panchaud, Muñoz-Chápuli, Baud.

Conflict of Interest Disclosures: None reported.

Additional Contributions: We thank the Emergencia Obstetrica España Group for participation in the study. We also thank Tirso Perez Medina, MD, PhD, Obstetrics and Gynaecology Department, Puerta de Hierro University Hospital, Autonoma University, Madrid, Spain, for his contribution to the design of the study and data collection. He received no compensation for his participation.

References
1.
Chen  L , Li  Q , Zheng  D ,  et al.  Clinical characteristics of pregnant women with Covid-19 in Wuhan, China.   N Engl J Med. Published online April 17, 2020. doi:10.1056/NEJMc2009226PubMedGoogle Scholar
2.
Della Gatta  AN , Rizzo  R , Pilu  G , Simonazzi  G .  Coronavirus disease 2019 during pregnancy: a systematic review of reported cases.   Am J Obstet Gynecol. Published online April 18, 2020. doi:10.1016/j.ajog.2020.04.013PubMedGoogle Scholar
3.
Kimberlin  DW , Stagno  S .  Can SARS-CoV-2 infection be acquired in utero? more definitive evidence is needed.   JAMA. Published online March 26, 2020. doi:10.1001/jama.2020.4868PubMedGoogle Scholar
4.
Middleton  PG , Gade  EJ , Aguilera  C ,  et al.  ERS/TSANZ Task Force statement on the management of reproduction and pregnancy in women with airways diseases.   Eur Respir J. 2020;55(2):1901208. doi:10.1183/13993003.01208-2019PubMedGoogle Scholar
5.
Sandall  J , Tribe  RM , Avery  L ,  et al.  Short-term and long-term effects of caesarean section on the health of women and children.   Lancet. 2018;392(10155):1349-1357. doi:10.1016/S0140-6736(18)31930-5PubMedGoogle ScholarCrossref
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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