• Valeria M Savasi, Francesca Parisi, Luisa Patanè, Enrico Ferrazzi, Luigi Frigerio, Antonio Pellegrino, Arsenio Spinillo, Saverio Tateo, Mariacristina Ottoboni, Paola Veronese, Felice Petraglia, Patrizia Vergani, Fabio Facchinetti, Donata Spazzini, and Irene Cetin.
• Department of Woman, Mother and Neonate, L. Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, the Department of Clinical and Biological Sciences, University of Milan, Milan, the Department of Obstetrics and Gynecology, Papa Giovanni XXIII Hospital, Bergamo, the Department of Obstetrics and Gynecology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, the Department of Clinical Sciences and Community Health, University of Milan, Milan, the Department of Obstetrics and Gynecology, A. Manzoni Hospital, ASST Lecco, Lecco, the Department of Obstetrics and Gynecology, University of Pavia, IRCCS Foundation Policlinico San Matteo, Pavia, the Department of Obstetrics and Gynecology, Santa Chiara Hospital, Trento, the Department of Obstetrics and Gynecology, AUSL Piacenza, Piacenza, the Obstetrics and Gynecology Unit, Department of Woman's and Child's Health, University Hospital of Padua, Padua, the Department of Experimental and Clinical Biomedical Sciences "Mario Serio," Obstetrics and Gynecology, University of Florence, Florence, the Department of Maternal Fetal Medicine, Fondazione MBBM, San Gerardo Hospital, University of Milano Bicocca, Monza, the Obstetrics Unit, Mother Infant Department, University Hospital Policlinico of Modena, Modena, and the Obstetrics and Gynecology Unit, Azienda Ospedaliera Bolognini, Seriate, Italy.
• Obstet Gynecol. 2020 Aug 1; 136 (2): 252-258.

ObjectiveTo investigate the clinical evolution of coronavirus disease 2019 (COVID-19) in hospitalized pregnant women and potential factors associated with severe maternal outcomes.MethodsWe designed a prospective multicenter cohort study of pregnant women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who were admitted to 12 Italian maternity hospitals between February 23 and March 28, 2020. Clinical records, laboratory and radiologic examinations, and pregnancy outcomes were collected. A subgroup of patients with severe disease was identified based on intensive care unit (ICU) admission, delivery for respiratory compromise, or both.ResultsSeventy-seven patients were included, 14 of whom had severe disease (18%). Two thirds of the patients in the cohort were admitted during the third trimester, and 84% were symptomatic on admission. Eleven patients underwent urgent delivery for respiratory compromise (16%), and six were admitted to the ICU (8%). One woman received extracorporeal membrane oxygenation; no deaths occurred. Preterm delivery occurred in 12% of patients, and nine newborns were admitted to the neonatal intensive care unit. Patients in the severe subgroup had significantly higher pregestational body mass indexes (BMIs) and heart and respiratory rates and a greater frequency of fever or dyspnea on admission compared with women with a nonsevere disease evolution.ConclusionIn our cohort, one in five women hospitalized with COVID-19 infection delivered urgently for respiratory compromise or were admitted to the ICU. None, however, died. Increased pregestational BMI and abnormal heart and respiratory rates on admission were associated with severe disease.

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