• Amihai Rottenstreich, Abraham Tsur, Nava Braverman, Doron Kabiri, Shay Porat, Shmuel Benenson, Yonatan Oster, Hadas Allouche Kam, Asnat Walfisch, Yossi Bart, Raanan Meyer, Shirlee Jaffe Lifshitz, Uri Amikam, Tal Biron-Shental, Gal Cohen, Yael Sciaky-Tamir, Inbar Ben Shachar, Yoav Yinon, and Benjamin Reubinoff.
• Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, POB 12000, 91120, Jerusalem, Israel.
• Arch. Gynecol. Obstet. 2021 Jun 1; 303 (6): 1401-1405.

Key MessageAmong SARS-CoV-2-infected mothers, vaginal delivery rates were high and associated with favorable outcomes with no cases of neonatal COVID-19.PurposeTo investigate the mode of delivery and its impact on immediate neonatal outcome in SARS-CoV-2-infected women.MethodsA prospective study following pregnant women diagnosed with COVID-19 who delivered between March 15th and July 4th in seven university affiliated hospitals in Israel.ResultsA total of 52 women with a confirmed diagnosis of COVID-19 delivered in the participating centers during the study period. The median gestational age at the time of delivery was 38 weeks, with 16 (30.8%) cases complicated by spontaneous preterm birth. Forty-three women (82.7%) underwent a trial of labor. The remaining 9 women underwent pre-labor cesarean delivery mostly due to obstetric indications, whereas one woman with a critical COVID-19 course underwent urgent cesarean delivery due to maternal deterioration. Among those who underwent a trial of labor (n = 43), 39 (90.7%) delivered vaginally, whereas 4 (9.3%) cases resulted in cesarean delivery. Neonatal RT-PCR nasopharyngeal swabs tested negative in all cases, and none of the infants developed pneumonia. No maternal and neonatal deaths were encountered.ConclusionsIn this prospective study among SARS-CoV-2-infected mothers, vaginal delivery rates were high and associated with favorable outcomes with no cases of neonatal COVID-19. Our findings underscore that delivery management among SARS-CoV-2-infected mothers should be based on obstetric indications and may potentially reduce the high rates of cesarean delivery previously reported in this setting.

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